Insurance cancelled due to broker error - now what?

13 posts in this topic

Evening everybody,

Hopefully somebody on here can help me as i've found myself a little stuck.

I live and work in germany and as such have the necessary (and unnecessary!) insurances that go along with it. Due to my lack of German language skills i went through a broken advised by some of my work colleagues. One of the insurances i took out was the top-up insurance for the krankenkasse - added on single/double room & the daily allowance (20€ per day). Luckily up until this point i have never needed my insurances. Over the last few weeks however this all changed. I won't bore anybody with the details but i have been on sick leave for 4 months now and diagnosed with a chronic illness. Hopefully it wont be too long until im back to work but until then im utilizing the insurance.

Part of this process i have sent the various sick notes, hospital letters etc to my insurance company. In these documents it mentions that i also have Asthma as a pre diagnosed condition. As a result of this they have written me a letter saying they are cancelling my policy as i didnt inform them about it. 

On the face of it i have no qualms with the insurance company. They found a legit way out of paying for someone who will undoubtedly cost them more than they will make. My issue is with the broker - I am 100% certain i told him about my Asthma. Specifically because i also tried to insure my partner but was unable to do so because of previous conditions.

What is my recourse now though? It is one thing that i wont get the insurance for this period of sickness but my main concern now is that i cannot get another policy as i have a second (far more serious) chronic illness. I do have legal insurance but wanted to check if i have any grounds for this - i would assume so but i never really know. The main issue is that all of my discussions with the broker were in person and done verbally so i have no written proof of any of this.

Thanks in advance for any help :)

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16 minutes ago, Krelborn said:

My issue is with the broker - I am 100% certain i told him about my Asthma.

Do you have written evidence of that? I.e. a copy of your application where it is written.

 

If yes, then you have a case. If not, it's „he said, she said“ = no case.

 

Also, I don't understand your last questions. Since you have

18 minutes ago, Krelborn said:

top-up insurance for the krankenkasse - added on single/double room & the daily allowance (20€ per day).

and this top-up insurance is cancelled, you still have the Krankenkasse. Which should at some point pay you some part of your salary, as far as I know. And you are insured.

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Thanks for your answer.

No - as I said everything was verbal. All forms etc were filled in by the broker.

Yes the standard state insurance pays a percentage of my salary. I then had a private policy which covered the difference. There are other things in the policy too though. These were just the examples as they are the ones currently pertinent to my question.

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1 hour ago, Krelborn said:

Evening everybody,

Hopefully somebody on here can help me as i've found myself a little stuck.

I live and work in germany and as such have the necessary (and unnecessary!) insurances that go along with it. Due to my lack of German language skills i went through a broken advised by some of my work colleagues. One of the insurances i took out was the top-up insurance for the krankenkasse - added on single/double room & the daily allowance (20€ per day). Luckily up until this point i have never needed my insurances. Over the last few weeks however this all changed. I won't bore anybody with the details but i have been on sick leave for 4 months now and diagnosed with a chronic illness. Hopefully it wont be too long until im back to work but until then im utilizing the insurance.

Part of this process i have sent the various sick notes, hospital letters etc to my insurance company. In these documents it mentions that i also have Asthma as a pre diagnosed condition. As a result of this they have written me a letter saying they are cancelling my policy as i didnt inform them about it. 

On the face of it i have no qualms with the insurance company. They found a legit way out of paying for someone who will undoubtedly cost them more than they will make. My issue is with the broker - I am 100% certain i told him about my Asthma. Specifically because i also tried to insure my partner but was unable to do so because of previous conditions.

What is my recourse now though? It is one thing that i wont get the insurance for this period of sickness but my main concern now is that i cannot get another policy as i have a second (far more serious) chronic illness. I do have legal insurance but wanted to check if i have any grounds for this - i would assume so but i never really know. The main issue is that all of my discussions with the broker were in person and done verbally so i have no written proof of any of this.

Thanks in advance for any help :)

You are 100 per cent you told the insurance person about your asthma, Krelborn. Do you have this in writing? An email , for example? Or is your real reason for writing  the second (far more serious ) chronic illness? 

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I'm 100% sure yes. I'm trying to find it in an email but I don't expect to find one as we did 99% of everything via him visiting my home.

The new diagnosis is the reason for me writing as that's the one which concerns me. The reason for cancelling the insurance was given as asthma though.

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Unfortunately oral contracts are only valid when both parties agree on what was said.

 

That's why I prefer online contracts. Personal communication = you will be betrayed.

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Look at your application for the insurance. I´m sure there will be a section in which you have to declare preexisting conditions and it will be pointed out that if you don´t want to declare them there (e. g. as you don´t want the broker to know about them) you have to do so in writing within probably 1 week. If there is no documentation proving that you declared your preexisting conditions you have no case against the insurance company. Whether you have a case against the broker (for damage compensation) depends on whether he admits that you told him about them or on that you can prove it (e. g. witnesses). If neither is the case even a lawyer won´t be able to help you.

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Unfortunately i don't have the initial application so i cannot check that.

My partner was present for all of the meetings though so having a witness is not a problem. I sent the broker an email 2 weeks ago but so far i have not received a reply. Judging from the feedback here i think its probably time to "lawyer up"

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On 19.5.2017, 19:50:31, Krelborn said:

Thanks for your answer.

No - as I said everything was verbal. All forms etc were filled in by the broker.

Yes the standard state insurance pays a percentage of my salary. I then had a private policy which covered the difference. There are other things in the policy too though. These were just the examples as they are the ones currently pertinent to my question.

Just to double check here... are you saying the insurance agent/broker/whatever he is...filled in the health questions for you????

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7 hours ago, Krelborn said:

Judging from the feedback here i think its probably time to "lawyer up"

Yep. A lawyer can try to claim damage anyway, and might succeed. Give it a try, at least first letter won't cost you much. Whether or not it makes sense to escalate it further to the court, is debatable.

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Lawyer up...

 

Get him/her to write to your insurance company and ask for a copy of the original application...

 

I beleive they are obliged to keep all new orders/policy requests for upto x years!

 

 

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