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The contributions for daily sickness allowance insurance will increase. This is forecast by the rating agency Assekurata. The reason is the corona crisis. Intermediaries should weigh the evaluation of private health insurers even more heavily.
The more solid the health insurer in the calculation, the lower the premium increases for this company are likely to be. However, practitioners are already finding that the risk assessment for daily sickness allowance insurance is particularly strict.
Loss rates are increasing
According to Assekurata, most private insurers are currently making negative business with the insurance of daily sickness allowance (KTG). “In 2020, the claims ratio, i.e. the proportion of benefits paid to gross premiums, increased noticeably in the daily allowance insurance segment at almost all private health insurers and was in some cases over 100 percent in the middle of the year,” said Abdulkadir Cebi, Head of Analysis and Evaluation at Assekurata Assekuranz Rating agency firm. The cause is the corona crisis.
Since it not only leads to economic upheaval, but the pandemic also directly affects people’s health, the analyst expects significantly stronger effects than the subprime crisis. Even then, the loss rates would have risen sharply.
For many, necessary protection
Tightly calculated tariffs are likely to be particularly expensive. However, since intermediaries and customers cannot see which offers these are, only an overall view of the private health insurer should help. Assekurata emphasizes, however, that despite higher premiums, private KTG is necessary for many and essential for privately insured employees, self-employed and freelancers. Intermediaries should therefore make this group aware of the great importance of the KTG in advice. Privately insured employees no longer receive any money after six weeks of continued wage payments. Cebi: “For them, taking out daily sickness allowance insurance is practically a compulsory exercise after the six-week parental leave period.”
For self-employed and freelancers, the need usually occurs much earlier, in many cases immediately after the onset of the incapacity for work. In contrast, the situation for employees with statutory health insurance is better. In the beginning, the continued payment of wages from the employer takes effect, but this usually ends after six weeks. Only then must the gap left by the statutory health insurance – only 70 percent of gross income is paid – be closed by a KTG insurance. Assekurata also advises that certain core services are strictly observed (see below).
Tough risk assessment
However, the rating agency does not seem to be aware of or to know the current practice of risk assessment. The insurance broker Matthias Helberg claims that the risk assessment for KTG would be significantly stricter than when taking out disability insurance (BU). Even at the BU, there are exclusions, supplements or, in individual cases, even rejections in the case of minor pre-existing illnesses.
Helberg: “That is why many of our customers, whom we can insure with full insurance coverage in the BU, have no chance of daily sickness allowance insurance.” That is why it is especially important for this group to choose a BU policy with benefits even in the event of long incapacity for work (BU protection with AU module).
These core services According to Assekurata, the following must be observed when advising on KTG insurance:
- Transparent definition of the insured event
- Sufficient coverage
- Inclusion of pregnancy, termination of pregnancy, or miscarriage
- Notification of the inability to work for the waiting periods only after the waiting period has expired
- Duration up to the age of 67
- Automatic adjustment of the tariff if the legislature increases the maximum retirement age
- Continued benefits if the insured person draws a private pension before reaching the statutory retirement age
- Continued payment for the period of a retrospective disability insurance
Author (s): Uwe Schmidt-Kasparek
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