Health Insurance Information Duties Regulation - Kv-Infov

Original Language Title: Krankenversicherung Informationspflichtenverordnung – KV-InfoV

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374. Ordinance of the Financial Market Supervisory Authority (FMA) on the information requirements for health insurance in the form of life insurance (health insurance information flightsordinance-KV-InfoV)

Due to § 255 (4) of the Insurance Supervision Act 2016-VAG 2016, BGBl. I n ° 34/2015, as last amended by the Federal Act BGBl. I n ° 112/2015, is ordered with the approval of the Federal Minister of Finance:

Subject-matter

§ 1. This Regulation lays down selected minimum content of information to be sent to policyholders by insurance companies in accordance with Section 255 (1) and (2) of the VAG 2016.

Pre-contractual obligation to provide information on the performance of the insurance undertaking

§ 2. (1) The policyholder shall be informed in the context of the presentation of the benefits of the insurance undertaking in accordance with Section 255 (1) Z 1 VAG 2016 on the insured risks and any waiting times.

(2) In connection with the presentation of the services of the insurance company pursuant to § 255 (1) Z 1 VAG 2016, a concrete indication of

1.

the statutory and generally applicable contractual risk exclusions shall be made and should be noted if the information is not exhaustable;

2.

the individual risk exclusions and waiting times, which may be contained in the insurance certificate, on the basis of the individual risk situation of the insured person. The policyholder is clearly based on his right of objection in accordance with § 5 insurance contract law-VersVG, BGBl. No. 2/1959 in the version of the Federal Law BGBl. I No 34/2015, and the consequences resulting from this for the policyholder.

Pre-contractual obligation to provide information on the conditions and modalities of a premium adjustment

§ 3. (1) The policyholder shall be informed in the context of the presentation of the conditions and modalities of a premium adjustment pursuant to § 255 (1) Z 2 VAG 2016 if the premium according to § 178f VersVG unilaterally by the insurance company can be continuously adjusted. In this case, the policyholder should also be informed that the adjustment may lead to a significant increase in premiums during the contract period.

(2) The policyholder shall be informed in the context of the presentation of the conditions and modalities of a premium adjustment in accordance with § 255 (1) Z 2 VAG 2016 on the increase in the premium of the at least last five years of the specifically applied tariff. Where the tariff has been applied for less than five years, the presentation of the annual increase in the premium over the last five years has to be based on a comparable tariff of the insurance undertaking concerned. It should be noted that, in the past, premium increases do not allow any compelling conclusions to be drawn on those in the future.

Pre-contractual obligation to provide information on the legal and economic consequences of a termination of the contract

§ 4. In the context of the presentation of the legal and economic consequences of a termination of the contract pursuant to Section 255 (1) Z 5 VAG 2016, the policyholder must be informed that no repurchase value will be paid out in the event of termination of the contract and Therefore, there is also no claim to the proportional ageing reserve.

Current information on the extent and reasons for the adjustment of the premium

§ 5. In the context of the information on the extent and the reasons for a premium adjustment made pursuant to § 255 (2) Z 3 VAG 2016, the policyholder must be informed of this information,

the specific reasons for the premium adjustment carried out, and

that pursuant to Section 178f (3) of the VersVG, the continuation of the contract with a maximum of the same premium and appropriately amended benefits may be required.

entry into force

§ 6. (1) This Regulation shall enter into force 1. Jänner 2016 in force and applies to insurance contracts concluded after 30 June 2016.

(2) By way of derogation from paragraph 1, § 5 shall also apply to insurance contracts which are already before the 1. Jänner 2016 was completed.

Ettl Kumpfmüller