Wellness - Jogging enthusiasts may now enjoy decreased fees thanks to a ruling by the Federal Court of Justice (BGH), which has fortified the protections accorded to policyholders.
Consumer groups have long condemned a program by insurer Generali, which hands out vouchers and discounts to policyholders who practice health-conscious behaviors. The German Federal Court of Justice (BGH) has now weighed in on this issue by examining the 'Telematik' insurance tariff in a disability insurance policy. Below are the key details:
What are Telematik tariffs?
Telematik tariffs are insurance tariffs that monitor an insured person's behavior. Usually, this is done through an app, and the premium is calculated based on the data gathered. These programs are more common in car insurance, where driving habits are assessed. Insurers analyze the data and offer discounts to those who exhibit lower risks. However, the Generali subsidiary Dialog Life Insurance's tariff under scrutiny examines health and fitness data, making it a more personal matter. Stephen Rehmke, a spokesperson for the Federation of Insurers (BdV), says, "The behavior of insured persons is recorded, analyzed, and health-conscious behaviors are rewarded with discounts."
Which tariff was affected by the BGH?
In the specific case, the BdV took issue with a tariff from Dialog Life Insurance, a subsidiary of Generali. The policy requires members of the Generali health program, where insured individuals earn points by exercising or visiting the doctor. These points are recorded through an app, and in return for a healthy lifestyle, vouchers and discounts at partner businesses are given. The amount of the premium a person pays is influenced by the points they've earned, with those who reach Platinum or Gold status paying less than the previous year, as Generali informed dpa. Customers were notified about any changes in their contribution.
What is the BdV's criticism?
The BdV has raised objections to several aspects of the tariff, deeming it unclear. For instance, consumers were unable to know which specific behaviors led to what actual discounts. Rehmke stated, "Consumers weren't informed about how the discounts came about." Additionally, it was unclear that meeting the "surplus participation" of the insured wouldn't be possible, even with health-conscious behaviors, unless the insurer had high earnings. It was also seen as unfair that certain activities wouldn't be counted if the fitness data was submitted too late - whether caused by forgetfulness on the consumer's part or technical issues at the insurer.
What did the court rule?
The judges at the BGH concluded that the customer was not provided with the necessary information on how discounts were generated through "surplus participation". This clause was deemed unclear and thus invalid. Additionally, they agreed with the BdV that it was unfair for health-conscious actions not to be considered if fitness data was late - either due to customer forgetfulness or the insurer's technology malfunction. The insurer's customers would be unfairly disadvantaged by this clause, so it was declared ineffective.
How did Generali respond?
Generali stressed that its Vitality health program, not at the center of the dispute, was unaffected by the decision and was not openly questioned by the Federal Court of Justice. "The judgment confirms the principle of contractual freedom, allowing people to decide within legal boundaries how and with whom they insure themselves," said the company. The two clauses being debated will be adjusted, and the approximately 100 affected customers will be notified.
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Consumer advocates welcomed the Federal Court of Justice's (BGH) ruling, which deemed unclear and invalid the clauses in Dialog Life Insurance's 'Telematik' tariff that offered discounts to policyholders who demonstrated health-conscious behaviors, as the details of how discounts were calculated were not transparent. This decision could potentially impact other insurers offering similar programs in Germany, including Assicurazioni Generali.
The BGH ruling specifically addressed the "surplus participation" clause, which stated that health-conscious actions would not be considered if fitness data was late, whether due to consumer forgetfulness or insurer technical issues, resulting in unfair discrimination against customers. The court's decision suggested that insurers should provide more clarity in their policies regarding how discounts are calculated and applied.
Furthermore, the ruling could also have broader implications for preventive medical check-ups and occupational disability insurance, as consumers may now have stronger protections against discrimination based on health data. This development could encourage more companies to offer incentives for health-conscious behaviors, but with clearer provisions and fair treatment for all policyholders.
The German Consumer Protection Association (Verbraucherzentrale Bundesverband e.V.) applauded the decision, stating that it represented a significant step forward in upholding consumer rights and promoting transparency in insurance policies. The association also encouraged insurers to take note of the ruling and adjust their policies accordingly to ensure fair treatment for all customers.
Moreover, the Court's decision could have a ripple effect on the fitness industry as well. Consumers who are more conscious of their health and fitness may seek out affordable health and fitness programs or incentives from insurers, encouraging growth in the sector and promoting overall wellness.
As consumer advocates continue to monitor developments in the insurance industry, they will be closely following how insurers respond to the Federal Court of Justice's ruling and any potential amendments to their policies. This decision could serve as a landmark case in the protection of consumer rights in the digital age, while also pushing insurers to provide more transparent and fair options for policyholders.
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