Decision: Health behavior-based insurance coverage requires full disclosure.
A disagreement involved the alleged telematics tariff for a disability insurance of Augsburg Generali's subsidiary, Dialog. The contract stipulated that the policyholders must use a smartphone app and join the "Vitality Program," earning points through movement, sport, or doctor's appointments. These points influenced their "Vitality Status," which in turn affected surplus participation and ultimately insurance premium heights.
However, the Hamburg consumer advocate group Bund der Versicherten took legal action. They won: The Federal Court of Justice deemed the contract clause too vague and therefore invalid. The court was unclear as to how the "modification of surplus participation" and the calculation of contributions would occur.
Moreover, the judges in Karlsruhe nullified a clause that assumed unhealthy behavior if the smartphone data from the "Vitality Program" was not transmitted. This was because it unjustifiably blamed the insured for technical or other issues beyond their control, according to the Federal Court of Justice.
