If the insurance companies cannot prove that the time for the fact check was really necessary, the payment is considered delayed. Experts also speak of slow regulation. If this is the case, the insurers are obliged to pay the damages caused by the delay.
If you have hired a lawyer, the insurer may also have to cover his or her fees. However, you should not rely on this and only seek legal advice if you are fundamentally able to cover the legal fees yourself.
You do not have to tolerate your insurance company delaying the processing time, nor reducing or completely rejecting the benefit if the reasons for this are not understandable. Depending on which phase you want to intervene in, you start differently. Our guide will show you how.
Yes. Statutory health insurance is a special case because you have to receive benefits from it even if you are in arrears with your contributions. If the health insurance company does not respond to your application for benefits in writing within three weeks, it is considered approved.
If she refuses to provide a service, you should file an objection if the measure is medically necessary and economically justified. If this remains unsuccessful, you can still file a complaint with the social court. There are no costs for the insured person for the objection or lawsuit process itself. You only have to pay the lawyer’s fee yourself – unless you win, in which case the health insurance company will cover the fees.
