Those who exercise regularly and go to the doctor should be rewarded with discounts and vouchers. This is what a Generali insurance tariff provides – which is now being examined by the highest civil court.
Vouchers for jogging, discounts for preventive medical examinations – for years, consumer advocates have been criticizing a program run by the insurer Generali that rewards policyholders for health-conscious behavior with vouchers and discounts. The Federal Court of Justice (BGH) in Karlsruhe is now dealing with the so-called telematics tariff in occupational disability insurance. The most important questions and answers at a glance:
What is a telematics tariff?
Telematics tariffs are tariffs in which the behavior of an insured person is tracked, for example via an app. The amount of the insurance premium is then determined on the basis of this data. “Such programs are known so far mainly in car insurance, which evaluate driving style,” says Stephen Rehmke, spokesman for the board of the Association of Insured Persons (BdV). “Insurers record the behavior of their customers, analyze the data and reward reduced risks with discounts on premiums.” The tariff in question, on the other hand, targets the health and fitness data of the insured person and thus a “very personal area of life,” says Rehmke.
What tariff is the BGH concerned with?
In this specific case, the BdV is suing against a tariff offered by the Generali subsidiary Dialog Lebensversicherungen, which requires membership in the Generali health program. Insured persons collect points when they do sports or go to the doctor, for example. The data is recorded via an app, and vouchers and discounts from partner companies are offered as a reward for a health-conscious life. Depending on the number of points, insured persons also receive the status “bronze”, “silver”, “gold” or “platinum” – which in turn affects the amount of the insurance premium to be paid. Those who achieve platinum or gold status pay less than last year, Generali told the dpa. Customers will be informed of any changes to the premium to be paid.
What do consumer advocates criticize?
The BdV considers several of the tariff’s provisions to be ineffective because they are not transparent and disproportionately disadvantage policyholders. For example, consumers “cannot find out exactly which specific behavior leads to which actual discounts,” says BdV board member Rehmke. It is also concealed that the so-called surplus participation of the insured may not be paid out despite health-conscious behavior if the insurer does not generate sufficient income. It is also unfair that corresponding activities are not taken into account if the fitness data is delivered too late – “regardless of whether the customer missed this or the insurer’s technology failed,” says Rehmke.
What is the purpose of the lawsuit?
With the lawsuit, the BdV also wants to raise awareness among consumers. “It is problematic to transmit the most personal data to insurers when you don’t even know exactly what will happen to the data and what you will actually get out of it,” warns Rehmke. In private health insurance, too, there are considerations about behavior-based tariffs. “If this were to happen, the fit and healthy would be rewarded, while the vulnerable and sick would be left behind. We consider this to be a fatal development for the idea of solidarity in insurance, which is based on the strong supporting the weak.” This is also why the BdV cast a skeptical view of Generali’s program. The lawsuit was successful in the lower courts at the Munich Regional Court and Higher Regional Court.
What does Generali say?
Generali Insurance points out that the appeal court did not express any concerns about the insurance product itself or the principle that health-conscious behavior is taken into account. “The court only considers two partial clauses within the surplus participation regulation to be ineffective.” The fact that these discounts cannot be guaranteed despite healthy behavior is “based on the nature of the surplus participation itself,” according to the company. After all, surpluses are precisely the profits that arise over and above the calculated guarantee. According to Generali, with the fitness tariff, these surpluses can benefit the insured who contributed significantly to their creation through health-conscious behavior.
Source: Stern
