The insurance contract is a mutual contract under the law of obligations. The policyholder pays the insurance premium to the insurance company. When an insured event occurs, the insurance company then fulfills its contractual obligations to the policyholder.
The above initial situation with the insurance contract is the theory. Unfortunately, the practice often looks different. Insurance companies often try to evade their obligations to perform. It already starts with the fact that insurance companies sometimes make the assertion of claims dependent on compliance with certain formal requirements (e.g. deadlines for notification of claims). If the policyholder does not comply with these formal requirements, the insurance company may refuse to pay out. Insurance companies often cite supposed exclusions of benefits in their policy terms and conditions. Insurance companies also frequently claim that the policyholder has not complied with his or her pre-contractual duty of disclosure pursuant to Section 19 of the German Insurance Contract Act (VVG). Another reason given by the insurance company for the rejection: the policyholder is said to have violated contractual obligations according to § 28 VVG. As a result, the insurance company cancels or challenges the insurance contract.
If you have any problems with your insurance company, we will be happy to help you. JK LEGAL is a Frankfurt-based law firm specializing in insurance law. We advise our clients nationwide on all matters of insurance law.
The founder of the firm, Dr. Josip Kuvač, has worked for several years as an attorney at renowned international and national law firms in Frankfurt a.M. and Los Angeles (California). In doing so, he has dealt with many different types of contracts. Dr. Kuvac is therefore very familiar with the particular pitfalls of contracts and can therefore help you with your insurance law questions.
Occupational disability insurance pays a monthly pension if you are no longer expected to be able to do your last job, as it was structured without health impairment, "in whole or in part" in the long term. When the criterion "partially" is fulfilled is regulated in the respective insurance conditions. As a rule, the insurance conditions provide for occupational disability if the insured person can no longer perform 50% of his or her job. However, it is precisely at this point that the most frequent disputes arise in practice. Unfortunately, it often happens that the insurance company doubts the degree of occupational disability and accordingly refuses to pay. Another reason for refusal can be, for example, that the insurance company claims that the insured person has not fulfilled pre-contractual duties of disclosure (e.g. previous illnesses) and the insurance company therefore contests the insurance contract or withdraws from the contract. All of these cases involve legal issues, some of which can be very complex. The insurance companies are "professionals" and their employees are precisely trained for such cases. Therefore, it is important that you have a partner at your side here who can support you so that "equality of arms" is established here. As a specialized law firm for insurance law in Frankfurt am Main, we are happy to help you and are there for you.
There is private and statutory accident insurance. Every employee is insured through the statutory accident insurance. Accidents that happen at work or on the way to work are covered by the statutory accident insurance. Accidents that happen at home or during leisure time can be covered by private accident insurance. A prerequisite for the insurance company's obligation to pay is that an "accident" has occurred. The term accident is legally defined in § 178 para. 2 p. 1 VVG. According to this, an accident occurs "if the insured person involuntarily suffers damage to his or her health as a result of an event suddenly acting on his or her body from the outside." Unfortunately, it also often happens with accident insurance that the insurance company tries to evade its obligations to pay benefits. It can happen, for example, that the insurance company invokes an exclusion of benefits in its insurance conditions because the insured person was under the influence of alcohol at the time of the accident, for example. However, one must pay close attention here. The fact that the insured person was under the influence of alcohol at the time of the accident does not necessarily lead to an exclusion of benefits per se. Among other things, causality (i.e., the question of whether the alcohol was actually the cause of the damaging event) will also be decisive here. This example case shows the complexity of the possible legal issues. Therefore, it is important that you have a partner at your side here who can support you in order to be able to negotiate with the insurance company on an "equal footing". As a law firm in Frankfurt am Main specializing in insurance law, we will be happy to help you and be there for you.
Private health insurance companies only grant insurance coverage if the medical treatment used by the insured person was "medically necessary". In practice, however, it is precisely this characteristic of "medical necessity" that frequently leads to disputes between the private insurance company and the insured person. Another reason for refusal may be, for example, that the insurance company claims that the insured person has not fulfilled pre-contractual disclosure obligations (e.g. pre-existing conditions) and the insurance company therefore contests the insurance contract or withdraws from the contract. All of these cases involve legal issues, some of which can be very complex. It is therefore important that you have a partner at your side to support you. As a law firm in Frankfurt am Main specializing in insurance law, we are happy to help you and are there for you.
Low returns, money worries or even the loss of a job can be reasons why insured persons consider "getting rid" of their life insurance. Therefore, it often happens that the insured simply terminate their life insurance. However, you should pay close attention here! By cancelling their life insurance policy, you can very often lose a lot of money. Therefore, insureds should refrain from rash actions and check whether there are alternatives to the cancellation here. One such alternative could be the reversal of the life insurance policy by means of an objection. Cancellation of a life insurance policy may result in cancellation fees, and under certain circumstances you may also lose your acquisition costs, or you may forego interest on savings by cancelling the policy (particularly important for policies from the 1990s) and thus lose a lot of money. If, on the other hand, you cancel the life insurance policy by means of an objection, you will receive back the premiums paid as well as the interest on the premiums paid and thus save a lot of money. It is not possible to give a general answer as to which procedure is most worthwhile. Rather, in each individual case it must be specifically examined which "exit scenario" makes the most economic sense. The fact that a life insurance policy can be rescinded even years later was decided by the Federal Court of Justice in a ruling dated May 7, 2014 (Ref.: IV ZR 76/11). You are welcome to send us your documents. In a free initial review, we will determine for you whether legal action can be promising for you.
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