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What happens if I forgot something in the health questions for German private health insurance?

In short

What happens if I forgot something in the health questions for German private health insurance? It depends on fault. After a simple slip the insurer can usually only adjust the contract, for example with a surcharge. With intent or gross negligence it may withdraw. Its rights expire after three years, or ten years with intent or fraud.

What happens if I forgot something in the health questions for German private health insurance?

What it costs

Worked figures for a contract adjustment.

ExampleTypical range
20 percent surcharge on EUR 550 monthly premiumabout EUR 110 more a month
Same surcharge backdated for 2 yearsabout EUR 2,640 back payment
Surcharge above 10 percentright to cancel within 1 month
Typical surcharges for single conditionsabout 10 to 50 percent

As of October 2026.

Time limits and cancellation right are in the VVG.

Premium and surcharge levels are guide values from our quoting practice;

each insurer assesses conditions itself.

Worked example

Forgotten physiotherapy, found after 18 months

A policyholder forgot to list back pain treatment by mistake. The insurer would have accepted her with a surcharge.

Faultsimple negligence
Withdrawal or cancellationnot possible
Assumed surcharge, 15 percent on EUR 500EUR 75 a month
Back payment for 18 monthsEUR 1,350

The policy continues with EUR 75 more per month plus up to EUR 1,350 back payment. After three years the insurer would have had no rights left.

What German law says about forgotten health questions

You must disclose everything you knew that the insurer asked about in text form (§ 19 (1) VVG, Insurance Contract Act). What happens after you forgot something in the health questions depends on how much fault is involved.

The insurer only has these rights if it warned you about the consequences in a separate notice in text form. If it already knew the fact, it has no rights.

FaultPossible result
no faultnothing
simple negligencecontract adjustment, backdated on request
gross negligencewithdrawal if it would never have insured you, otherwise adjustment
intentwithdrawal
fraudno benefit, 10 year limit

Adjustment instead of cancellation

German full private health insurance that meets your duty to be insured cannot be cancelled by the insurer. If it would have accepted you on other terms, the contract is adjusted, for example with a risk surcharge or an exclusion.

If the premium rises by more than 10 percent or the condition is excluded, you may cancel without notice within one month of being told (§ 19 (6) VVG).

Time limits

The insurer must act within one month of learning about the missing answer. In health insurance its rights end three years after the contract was concluded, not five as in other lines.

Claims that arose before the limit are not covered by it, and with intent or fraud the limit is ten years.

Reporting it yourself

If you notice you forgot something in the health questions, report it in writing with a medical report and a short explanation. The insurer then has one month to decide. A broker can help with the wording; the decision is the insurer's.

Step by step

  1. Find your application copy and reread the questions.
  2. Check whether the treatment falls in the period asked about.
  3. Get the medical report.
  4. Report it in writing with a short explanation.
  5. Check any surcharge or exclusion offered.

Checklist

  • Period asked about (often 3, 5 or 10 years)
  • Separate warning about consequences in your application
  • Date of conclusion more than three years ago?
  • Written report with evidence

Common mistakes

  • Staying silent and hoping it never comes up
  • Not checking the three year limit when a claim is refused
  • Answering more than was asked instead of answering precisely

Questions and answers

Frequently asked

When does the insurer check my answers?

Usually when you claim and bills point to older diagnoses.

That is why gaps often show up years later.

Can the insurer simply cancel my policy?

Not full cover that meets your duty to be insured.

It can withdraw with intent or gross negligence, or adjust the contract.

What does withdrawal mean for a claim?

The contract ends.

The insurer must still pay a claim the missing fact did not cause, except in cases of fraud.

Do I have to mention things I was not asked?

No.

The duty covers questions in text form, including follow up questions before acceptance.

Sources

NAMMERT insurance broker

Request a quote: Private health insurance

We compare insurers and come back to you, in English.

Free; the insurer pays our fee.

1Who is it for?
2Which insurance?

Choose as many as you like. For each one, the details an insurer needs for a quote appear below.

Personal

Business

3Details

Private health insurance in Germany (PKV)

For employees this decides whether private cover is possible

Keywords are enough, including treatment abroad.

We clarify this anonymously before any application.

4Your current policy
5How can we reach you?

Related questions

Your broker: Norman Nammert, trading as NAMMERT.

Insurance broker licensed under section 34d(1) of the German Trade Regulation Act.

Broker register no. D-C08Q-TOSD4-37.

NAMMERT Assekuradeur GmbH is a separate company.

It does not arrange your contract.

Statutory disclosure (German) · Updated

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