The Duty Behind the Health Questions
When you apply for private cover you answer the insurer’s health questions, and the law imposes a vorvertragliche Anzeigepflicht — a pre-contract duty to disclose the circumstances asked about, truthfully and completely. A breach of that duty is an Anzeigepflichtverletzung, and it is the single biggest reason a claim years later can suddenly be contested. Understanding it is less about fear and more about answering the application properly in the first place.
You must answer what is asked: the duty attaches to the questions the insurer puts in writing. You are not required to volunteer everything imaginable, but you must answer the specific questions honestly and fully — including conditions you might consider minor.
What the Insurer Can Do — and When
The consequences scale with fault. Broadly, the insurer’s options range from adjusting the contract (adding a surcharge or exclusion retroactively) to terminating it, or in the most serious cases rescinding it (Rücktritt) or challenging it for deceit — which can unwind cover and leave claims unpaid. Which remedy applies depends on whether the non-disclosure was innocent, negligent, grossly negligent or deliberate. Crucially, if the undisclosed condition is unrelated to the claim and the insurer would still have insured you on some terms, the outcome is usually an adjustment, not a collapse of cover.
The Protections That Limit It
- Only asked questions count: the insurer generally cannot rely on something it never asked about
- Notice and reasons: the insurer must act within set periods after learning of a breach, and explain its rights
- Time limits: the law caps how far back the insurer can reach — after a number of years the right to rescind for non-deliberate breaches falls away, with a longer window only for deliberate deceit
- Proportionality for minor cases: an unrelated, innocent omission should not automatically destroy cover
How to Stay on the Right Side
The defence is entirely in your hands at application time: pull your medical records rather than answering from memory, disclose everything the questions ask about (a broker or the insurer can advise on borderline items), and keep a copy of exactly what you declared. If you realise afterwards that something was missed, tell the insurer proactively — correcting the record early is far better than having it surface during a claim.
The Bottom Line
An Anzeigepflichtverletzung is the risk that an inaccurate health answer comes back to bite you — but it is bounded by real protections: only asked questions count, consequences scale with fault, unrelated omissions usually mean adjustment rather than collapse, and time limits stop insurers reaching back indefinitely. Answer the questions fully and keep your copy, and the duty becomes a formality rather than a threat.
Frequently Asked Questions
Compare PKV Tariffs for Your Situation
Our independent advisors help expats and professionals find the right private health insurance — personalised to your age, health, and budget.
Get My Free Quote