Disputes with health insurance companies
Emergency room verdict sparks outrage
Sep 3, 2026 – 7:06 a.mReading time: 3 minutes
Several current rulings by the Federal Social Court (Az: B 1 KR 23/25 R; B 1 KR 21/26 R; B 1 KR 34/24 R) are currently causing outrage among doctors. Family doctor Laura Dalhaus, who is well-known on social media, described the judge’s rulings as “crazy” and raises the question of whether the patient’s health insurance company will be decisive in determining whether patients will be treated in hospital in emergencies in the future.
Many comments signal Dalhaus’s approval and anger at the health insurance companies. But what is behind this case?
Three health insurance companies are suing
The bone of contention are three rulings by the Federal Social Court. In each case, a health insurance company sued – Salus BKK, the technicians and AOK Hamburg/Rhineland. Each of the three cases involves an emergency that was treated by the respective hospitals.
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The dispute began when the treatment was finally billed to the health insurance companies. While the hospitals recorded the treatment as an inpatient admission, the health insurance company denied this and instead only wanted to pay a so-called emergency flat rate.
Big differences in compensation
Whether a patient is admitted to hospital is extremely important for hospitals. In these cases, you can bill patients using the so-called flat rate system. This allows health insurance companies to claim significantly higher costs. In the cases negotiated, the hospitals billed the health insurance companies for costs of almost 800 euros.
However, if a patient is not admitted as an inpatient but is only treated as an outpatient in the emergency room or intensive care unit, the hospital only receives an outpatient emergency flat rate. This depends, among other things, on the time and intensity of the treatment, but according to doctor Laura Dalhaus, in the present cases it is around 50 euros.
Since this in no way covers the enormous costs of personnel and equipment during resuscitation, hospitals vehemently oppose outpatient classification. They also argued that some of the insured people had been taken to the intensive care unit. The most intensive treatment imaginable in a hospital took place there.
