Verdict
This health insurance gift is prohibited
Updated August 19, 2026 – 3:27 p.mReading time: 1 min.
Competition between health insurance companies allows market participants to be creative. A court now prohibits generous promises by a fund.
In the fight for customers, some health insurance companies resort to unusual measures. But not every measure is legal, as the Bavarian State Social Court has determined (Az: L 5 KR 126/26 ER).
In this specific case, a health insurance company had paid an insured person a subsidy of 500 euros so that they could take back a previously given notice of termination. The subsidy was for a service that is not usually covered by health insurance.
The number of insured people is crucial
The number of insured people is very important for health insurance companies. It determines which payments the health insurance company is entitled to from the health fund. The cases negotiated involved families with large children.
The insured person later resubmitted his notice of termination. Once again, an employee of the health insurance company promised him a special service that was not covered by the health insurance company’s statutes. In this case, however, the health insurance employee was unsuccessful – the customer switched anyway.
- Millions of insured people affected: Large health insurance companies increase their additional contributions
- Additional contributions: Important cash register obligation “will be canceled”
The health insurance company promised another customer retroactive bonus advance payments and a premium payment to which the insured person would not have been entitled.
Another health insurance company recognized these actions as anti-competitive behavior and sued. Successfully. Health insurance companies do compete with each other. However, the promise of cash bonuses is an inadmissible measure and represents a violation of the Social Security Code. The court prohibited the health insurance company from persuading customers to stay with services not covered by the statute. Violations now result in a fine of 100,000 euros.
