Rapid Approach of Brokerage Contract

Trainee Sues Insurance Broker for Negligence in Private Health Insurance Case

A trainee civil servant has successfully sued an insurance broker for negligence in a private health insurance case. The incident, which took place in Germany, has highlighted the significant responsibilities that insurance brokers hold under the Insurance Contract Act (VVG).

The trainee, who had a pre-existing condition called Wolff-Parkinson-White syndrome, contacted an insurance broker via the broker's website to inquire about private health insurance. The broker requested documents about the trainee's health status but later informed her that she could not take out private health insurance.

According to legal expert Kosch, the insurance broker's liability in such cases can be substantial, as they can be held responsible for both incorrect mediation and non-medication. In this instance, the broker did not inform the trainee about the possible "opening action" for private health insurance, a procedure that could have allowed her to take out insurance with a surcharge of up to 30% in the first six months, without any exclusions of benefits and without risk assessment.

The omission of this information was considered equivalent to a materially incorrect statement and advice. The Oberlandesgericht Dresden and the Leipzig Regional Court agreed that a legally binding consultation occurred between the trainee and the insurance broker, based on their telephone contact, request for data, and discussion of the trainee's personal situation and insurance need.

Despite the broker's argument that no brokerage agreement was concluded between them, the court ruled that there was an insurance brokerage agreement, making the broker liable in this case. The trainee accused the broker of not informing her about the more favorable option and sued for damages due to incorrect advice.

It is important to note that a brokerage agreement can be oral, not just in writing. An example of establishing an oral brokerage agreement is when a customer leaves their contact details on a broker's website and the broker calls them back for individual consultation.

This case serves as a reminder for all insurance intermediaries active in the private health insurance sector. A regulation regarding openings for civil servants should be basic knowledge for all such intermediaries, as failure to adhere to these regulations can lead to legal consequences.

In conclusion, this case underscores the importance of comprehensive advice and full disclosure by insurance brokers. Brokers must ensure they are well-informed about the various options available to their clients and communicate these effectively to avoid potential legal issues.