Frankfurt Court Examines Failed Health Insurance Switches: €14,538 Loss and Coverage Gaps

The Frankfurt Regional Court has begun hearing a series of lawsuits concerning the pitfalls and financial losses associated with attempting to switch from private health insurance (PKV) back to statutory health insurance (GKV) in Germany. Multiple policyholders have filed independent actions against a company based in Eschborn, which had guaranteed to facilitate this complex transition for a service fee. This type of insurance change is heavily regulated by German law to prevent individuals from benefiting from lower private rates during their youth only to return to the GKV later in life when private premiums typically rise significantly. In one pivotal case, a 60-year-old man from Cologne, whose planned return to the GKV failed, is demanding the immediate refund of a prepayment amounting to €14,538 from the brokerage firm, informs by NT24.

A representative of the Eschborn-based company initiated contact with the plaintiff by telephone in late 2023, enticing him with the promise of saving thousands of euros on continually rising premiums by returning to the statutory health insurance system. Although the Cologne resident had already legally explored options, such as returning after at least one year of compulsory social insurance contributions abroad, the company presented an alternative proposal: he should switch to a European health insurance provider first, from which a subsequent return to a German GKV might be possible. This elaborate strategy ultimately failed. Due to Germany's mandatory health insurance requirement, both the departing and the receiving health insurance companies are obligated to thoroughly review the individual contractual situation before approving any switch. Following this crucial review, his existing private insurer refused to release him from his contract. The presiding judge of the 23rd Civil Chamber assured him that he was among the "lucky ones who are still health insured." The court is currently dealing with other, more serious cases where the private health insurance company did release the insured from their contract, but the subsequent re-entry into the GKV was unsuccessful. These individuals are now left without health insurance coverage and face the daunting prospect of having to secure a new private policy at prohibitively high tariffs at an advanced age.

For the Civil Chamber, the core issue in the Cologne man's case is clear. The service agreement signed with the 60-year-old in April 2024 explicitly guaranteed a successful return to the GKV, promising a full refund of the service fee if the attempt failed. The presiding judge concluded that this guarantee constitutes a violation of the Legal Services Act (Rechtsdienstleistungsgesetz), as it enters the domain of legal advice without the necessary authorization. The defending counsel for the brokerage firm, however, argues that no actual legal service was provided, and therefore no violation of the Act could have occurred.

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