Insurance broker / Insurance questions / Occupational disability

What should I watch out for in the health questions?

In short

State what your doctors wrote down, not what you personally think mattered. German applications usually ask about five years of outpatient treatment and ten years of hospital stays, surgery and psychotherapy. If something is missing, the insurer may rescind, void, adjust the contract or refuse to pay. Get your health insurer's billing data and your patient file first, then ask anonymously.

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What should I watch out for in the health questions?

What it costs

What pre-existing conditions cost, and what it costs if the contract fails later. Guide figures for EUR 1,500 monthly benefit until age 67.

Example	Typical range
Standard terms, age 30, office job	around EUR 70 a month
Loading for a spinal condition	about 25 to 75 percent on the standard premium
Loading after a mild depression that has resolved	often 50 to 100 percent
Basic abilities cover as a fallback, EUR 1,000 benefit, trade job at age 26 to 28	around EUR 38 to 41 a month
Your own medical report if it comes to a dispute	four figures, close to EUR 4,000 in one decided case
Complaint to the insurance ombudsman	EUR 0, binding on the insurer up to a value of EUR 10,000

As of September 2026. Premiums and report costs come from publicly quoted examples. The loading ranges are guide values from quoting practice; no public survey of them exists. Your premium depends on age, job and findings; we obtain the exact quote for you.

Worked example

Physiotherapist, age 29, three back appointments in 2023

What her own records turned up, and what it came to in the end.

Her own memory	one visit to the doctor, nothing serious
Billing data from the health insurer	three appointments, diagnosis lumbar sciatica, no follow up
Anonymous pre-enquiry with four insurers	two acceptances at standard terms, one spine exclusion, one deferral
Contract taken, EUR 1,500 benefit to age 67	around EUR 75 a month, no loading and no exclusion

Three entries that would have been missing from the application, and would have put the contract at risk at claim time, surfaced beforehand. Six weeks of preparation produced two usable offers. Illustrative calculation.

What is asked and for which period

The health questions (Gesundheitsfragen) are where a German disability policy (Berufsunfähigkeitsversicherung, BU) breaks down at claim time. Applications ask about a fixed period: five years for outpatient visits is common, ten years for hospital stays, surgery and psychotherapy. Some forms use shorter or longer windows, so read the exact wording, including the number of years.

You must state what your doctors recorded, not what you now consider trivial. A back complaint you forgot sits in your health insurer's billing data as a diagnosis and resurfaces when you claim. The reverse also holds: what the insurer did not ask about, you do not have to volunteer. The insurer carries the risk of its own questionnaire (section 19 (1) VVG).

What wrong or missing answers cost

The consequences are graded by how serious the mistake was. Between an oversight and deliberate concealment lies the difference between an adjusted contract and no contract at all.

One practical point: before you answer, the insurer must warn you of these consequences in a separate written notice (section 19 (5) VVG). Without that notice it has none of the rights in the table. Keep the notice together with your application.

Severity	What the insurer may do	Effect on your benefit
No fault of yours	retroactive adjustment only	benefit stays, terms may change
Simple negligence	cancel for the future, or adjust	a claim already running is usually still covered
Gross negligence	rescind, otherwise adjust	benefit lost if the mistake was causal
Intent	rescind, ten year window instead of five	benefit lost
Fraud (Arglist)	void the contract (section 22 VVG)	contract treated as never concluded

The deadlines, and why ten years means less than people think

Five years after the contract starts, the insurer can no longer rely on a wrong answer; ten years if the breach was intentional or fraudulent (section 21 (3) VVG). Once it learns of the wrong answer it has one month to act (section 21 (1) VVG). A fraud challenge must be declared within one year of discovery.

The common misunderstanding: these deadlines only help if the claim arises after they expire. If you become disabled in year four and the insurer reviews the file in year seven, it can still use the old wrong answer against you. Waiting is not a strategy; preparing is.

Getting your own records first

Before you fill in anything, collect your own medical history. Your statutory health insurer must tell you which treatments were billed and which diagnoses were stored (section 305 SGB V). Ask in writing and name exactly the period the application covers. Private health insurers issue a comparable statement of benefits.

That list shows which doctors you saw. From each of them request a copy of the patient file (section 630g BGB); the first copy is free. Allow four to eight weeks in total. This is the best spent part of the effort, because afterwards you answer from paper rather than from memory.

Language and cross border points

Application forms, the notice under section 19 (5) VVG and the health questions are normally in German only, and the German wording is what counts legally. Have the questions translated properly rather than guessing, and keep both versions. A mistake caused by a rough translation is still your mistake.

Treatment abroad counts too. Doctors outside Germany are not in your German billing data, so list those visits yourself and obtain reports, with a translation where needed. If you later move abroad while receiving benefits, most contracts keep paying, but check the clause on residence before you move.

Ask anonymously through a broker

Do not apply blind. A rejection, a loading or a deferral is recorded in the insurance industry's information system (Hinweis- und Informationssystem, HIS), which other insurers can query. Such an entry narrows your options before you have properly started.

In an anonymous pre-enquiry (anonyme Risikovoranfrage) your findings go to several underwriters without your name. You collect verdicts without leaving traces and then apply where the verdict is best. Once a year you can ask the operator of the file, free of charge, what is stored about you.

Typical findings and the usual underwriting answer

No finding is automatically the end. What counts is how long ago it was, whether it is closed, and what the records say. A one off episode with a clear end is judged differently from ongoing treatment.

The table shows what is usual in day to day quoting. Every insurer decides for itself, and underwriters differ widely, which is exactly why several verdicts are worth collecting.

Finding	Usual reaction	What you can do
Back pain, few visits, no consequences	acceptance, sometimes a loading	attach a closing report confirming you are symptom free
Slipped disc with surgery	spine excluded, or a loading	compare verdicts, an exclusion beats no cover at all
One course of psychotherapy, completed	deferral, or acceptance after a waiting time	obtain a report with reason, course and end of treatment
Ongoing mental health treatment	usually rejection	look at basic abilities cover, ask again later
Hay fever, allergy	acceptance, often without loading	state medication, frequency and triggers precisely
Clearly overweight	premium loading	document your weight over twelve months

The five possible outcomes

Underwriting ends in one of five answers: acceptance at the standard premium, acceptance with single diagnoses excluded, acceptance with a premium loading, deferral for a set time, or rejection. Published application statistics put roughly 80 percent at standard terms, about 14 percent with a loading or exclusion and about 3 percent rejected.

An exclusion is annoying but rarely a reason to walk away: every other cause stays fully covered. And a 50 percent loading on EUR 70 is EUR 35 a month, less than many pay for a mobile contract. Do that sum before turning down a contract you will not be offered again on these terms in ten years.

Step by step

Ask your health insurer in writing for the treatments billed and diagnoses stored, for exactly the period the application covers.
Request a copy of the patient file from every doctor on that list; the first copy is free.
Add treatment abroad yourself and obtain reports, with a translation where needed.
Put it all in one list: date, doctor, diagnosis, treatment, outcome, situation today.
Have a broker run an anonymous pre-enquiry, then apply only where the verdict is best.

Checklist

Billing data for the period asked about is in hand
Patient file requested from every doctor on the list
Treatment outside Germany listed and documented
Every question read in the German wording, including the period
Notice under section 19 (5) VVG received and filed
Copy of the complete signed application kept

Common mistakes

Answering from memory instead of from records
Deciding yourself what is important enough to mention
Applying without a pre-enquiry and collecting a rejection in the industry file
Signing a German form you have not had translated properly
Counting on the ten year window, which does not help if the claim comes earlier

Questions and answers

Frequently asked

Do I have to declare a visit I cannot remember?

You must declare what you know. That is exactly why you should know: get your health insurer's billing data and answer from documents instead of guessing.

Do treatments I had in my home country count?

Yes, if the question covers them. They are not in German billing data, so list them yourself and obtain reports with a translation.

Can I answer in English?

The German wording is what binds you. Have the questions translated properly, answer in agreement with your broker, and keep both versions.

What does a deferral mean?

The insurer decides again later, usually after six months to two years without symptoms. Another insurer may be the better choice in the meantime.

Is an exclusion worse than a loading?

Not necessarily. A loading costs money permanently, an exclusion only if that one diagnosis is the cause. Which is better depends on how likely that cause is for you.

May the insurer contact my doctors?

Only with your consent. Limit it to the individual case instead of signing a broad release from medical confidentiality.

What if I spot a mistake after the policy has started?

Report it in writing without being asked. A correction you make yourself is treated far more leniently than a discovery at claim time.