PKV cancelled - Nobody wants to insure me - what happens next

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Hi,

 

In a bit of a pickle. Last year I switched from GKV to PKV, filled out the ton of forms and assumed everything was ok. Went to claim for one of my visits and the insurer requested a full medical history from my doctors. I obliged and two weeks later my consultant received a letter stating my PKV was cancelled due to not declaring a chronic illness on the form. (Fine, I made a mistake  - didn't realise what I was treated for was considered chronic) 

 

So now, trying to get new insurance. No insurer will apparently take me until I get a letter from two doctors stating my illness is not chronic. I have tried to contact the doctors multiple times but still no letter. My consultant has warned me that if I do not get these by the end of the month then I will be charged a lot of money. 

 

Can anyone tell me what will be the outcome? I know I cannot get back onto GKV (Although that would be ideal)  If nobody will insure me, who is charging this money? Why am I not being offered the basis tariff? Am I being mislead by the consultant?

 

Thank you!! 

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39 minutes ago, BB1990 said:

I know I cannot get back onto GKV (Although that would be ideal)

 

Stop freelancing, get a job that pays at least 450.01€ a month gross but under the Versicherungspflichtgrenze of 5,062.50€ and you will automatically go back to public health insurance. 

Stay in that job for at least 1 month, you can then quit it and can remain in public health insurance even if you should start freelancing again.  

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I am not a freelancer. I am an employee earning over the amount to go back into GKV. (no plans to quit my job or reduce my salary ;) )

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Did the consultant know about your chronic complaint?

Did you as truthfully as possible answer the health questions?

A private health insurer has the right to cancel if your contract if you deliberately gave false health information. Fact.

You need , in your own interest , to go to two doctors- do it. No wishy washy „ I have tried to contact..“

DO IT.

No idea who your consultant is but he or she would have no interest in your contract being cancelled- he or she would have to pay back the commission and any false information he or she knowingly forwarded to the insurer could have serious consequences for him  or her as well.

 

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Not disputing the fact that the original insurance was cancelled through my own fault. I didn't fully understand the process. I didn't even know that something I had been to the doctor with in 2017 was considered an illness. I did declare some other medical stuff that I knew was chronic. 

 

Have also since changed consultants so no longer dealing with the same person that sold me the original (overpriced) contract. My new consultant has tried to get it reinstated but they are unwilling - fair enough.

 

I have to go to the two doctors that originally treated me. So far I have been in touch with one (I only found out I need a second one today) and was told I would receive something in the post but that was a week ago. Now I am concerned that the doctors are not going to provide this letter stating that it is not a chronic illness. Since reading up a bit about it, it sounds like it is. 

 

My question is - If I do not manage to get these letters (which it seems like I might not) and nobody is willing to insure me again - what happens. 

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Ah, so you changed consultants. What was the legal status of your first consultant and did he/ she know about your illness to the extent that he/she knew you might get into trouble later?

By the way, the second consultant cannot be blamed for not really wanting to follow up on this- the commission was earnt by the first consultant.

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No, the first one did not know of the first illness. I had been to the doctor for this once before my PKV consultation, got treated and thought no more of it so I didn't think of declaring it. I know this was a mistake and do not dispute this at all - no blame on the consultant.

 

The new consultant  would earn new commission by getting me on a new private insurance. If he cannot manage this and I get charged this high fee next month, who is charging me this? Does this mean I am actually insured by someone? Obviously I really want to get some form of insurance at this stage. I just want to be prepared for the outcome if I cannot get the letter from the doctors. I don't understand why I am not being offered the basis tariff but being told I have to pay this high fee if I do not get the letter. 

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Just wondering whether the cancellation of your public health insurance has actually become effective given that the private company rejected your application. Is the fee your consultant was talking about simply your contribution to public insurance (backcharged)?

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Again, Panda's advice (a very knowledgable person, btw) on reducing your salary under the Versicherungspflichtgrenze for a few months to get into public insurance is valid.

In the long run, with diseases that will constantly drive up your private health insurance premiums every year (the infamous Risikozuschläge - if you can get private insurance at all - ), IMHO biting a short term financial bullet is worth it.

 

 

(To any trolls that will turn up and shout about me not being a consultant and daring to voice an opinion - go away. I will report you.)

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17 hours ago, BB1990 said:

Have also since changed consultants so no longer dealing with the same person that sold me the original (overpriced) contract. My new consultant has tried to get it reinstated but they are unwilling - fair enough.

 

First of all, you need professional advice from a licensed independent insurance broker.

 

12 hours ago, BB1990 said:

The new consultant  would earn new commission by getting me on a new private insurance. If he cannot manage this and I get charged this high fee next month, who is charging me this?

 

This is a question that only your "consultant" can answer. It is possible that you are required to reimburse the insurance company or that you have to pay some sort of penalty for providing false information. 

 

12 hours ago, BB1990 said:

I don't understand why I am not being offered the basis tariff but being told I have to pay this high fee if I do not get the letter. 

 

The Basistarif is definitely a solution for the future, however, you first need to sort out the past. 

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I agree, and really recommend talking to John G. or Starshollow, both licensed INDEPENDENT insurance brokers with excellent reputations on Toytown.

Most so-called "consultants" merely are resellers of a specific insurance company, regardless of whether it was a wise choice for you or even legal.

Be careful. Germany is totally unregulated in this respect.

 

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9 hours ago, engelchen said:

 

 

First of all, you need professional advice from a licensed independent insurance broker.

 

 

This is a question that only your "consultant" can answer. It is possible that you are required to reimburse the insurance company or that you have to pay some sort of penalty for providing false information. 

 

 

The Basistarif is definitely a solution for the future, however, you first need to sort out the past. 

I am unhappy that I disagree with you, engelchen, re your last point.(Only your last point! ). Whatever happens: the Basistarif is terrible. About 800 euros a month and below public insurance level and many docs will not even accept the patient. This cannot be the solution for this young person.

There are too many pieces of the jigsaw still missing to make a judgement about what can happen now. She must be health insured but who was responsible for the current situation and what is now possible?

I am giving thoughts to the situation but I am not sure, either.

Yes, Paragraph this and that and another Paragraph but..in the real world? eg who knows whom?

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15 hours ago, john g. said:

I am unhappy that I disagree with you, engelchen, re your last point.(Only your last point! ). Whatever happens: the Basistarif is terrible. About 800 euros a month and below public insurance level and many docs will not even accept the patient.

 

I didn't say it was a good option, I just said that it is an option. 

 

15 hours ago, john g. said:

This cannot be the solution for this young person.

 

Why not? 

 

15 hours ago, john g. said:

There are too many pieces of the jigsaw still missing to make a judgement about what can happen now. She must be health insured but who was responsible for the current situation and what is now possible?

 

The OP really needs professional assistance to sort out the mess she made. Instead she has gone to another consultant who doesn't seem either willing or able to help her out of this mess. If the OP is not willing to consult a professional such as yourself or post the correspondence she has received (which I wouldn't recommend due to privacy issues), how is she supposed to find a solution? 

 

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On 24.5.2019, 17:21:52, BB1990 said:

I am not a freelancer. I am an employee earning over the amount to go back into GKV. (no plans to quit my job or reduce my salary ;) )

Do the math: Will your employer accept a temporary (e.g. 3 months) reduction of your work time, let's say going down to 30h/week? If that brings your earnings under the limit, you might be back in the game...

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Thanks everyone. I think I will have another conversation with the consultant tomorrow and ask these questions. I'm sure this has happened before and there must be a solution. Good to know about the basis tariff not being a great option, I am going to try and avoid this then (and go to the two doctors again personally to get the letters)

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On 24/05/2019, 18:14:32, PandaMunich said:

 

Stop freelancing, get a job that pays at least 450.01€ a month gross but under the Versicherungspflichtgrenze of 5,062.50€ and you will automatically go back to public health insurance. 

Stay in that job for at least 1 month, you can then quit it and can remain in public health insurance even if you should start freelancing again.  

 

What are some examples of jobs that always/usually pay over 450.01€ a month that are easy to obtain like this?

Does anyone have any examples?

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27 minutes ago, harveyl said:

What are some examples of jobs that always/usually pay over 450.01€ a month that are easy to obtain like this?

Does anyone have any examples?

 

Part-time jobs that are not minijobs.

 

Stocking shelves in supermarkets (one of the easiest jobs for foreingers) are usually only minijobs, whereas working in a coffee shop can either be a minijob (i.e. no health insurance) or part-time (with social security contributions).

 

The Starbucks at Kochstrasse (aka Check Point Charlie) seems to be having a staffing problem. You might want to try there. Or you could just walk around your Kiez and see if you see any help wanted ads.

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4 hours ago, harveyl said:

 

What are some examples of jobs that always/usually pay over 450.01€ a month that are easy to obtain like this?

Does anyone have any examples?

 

Some easy jobs to get like restaurant etc may be flexible. A lot probably prefer minijobbers but if you say you need a 451€ job, they might be ok with it. I believe it's actually cheaper for them.

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