Federal Court

This was now unable to work and referred by his Daily allowance insurance (due to the tariff, it should be the DKV) a sickness benefit. Because the disease very long and stretches, action until a donor organ in sight, not even was it is quite substantial amounts. With more than 83,000 EUR sickness brings many insured quite on the brink of financial ruin, because balance from private resources is usually not possible. The private health insurers (DKV) thus announced the hospital per diem contract according to 14 of the conditions of sick allowance (MB CT). Much like in the present version of the (MB KT 2009, in the section 15 b) the termination for disability is regulated there. In principle, it is logical and easy to understand, because I can be at the same time not berufsunfahig and unable to work. In the corresponding paragraph a Beedigungsrecht is to the insurance company, if: the policyholder according to medical findings so far exercised professional not foreseeable more than 50% incapacity for work is.

The disability set goal, that of Policyholder not foreseeable will remain at least 50% incapacity for work. The District Court in its decision is based among other things on the current case law of the Supreme Court, the Federal Supreme Court and performs in his judgment, inter alia: to see, that after the recent case-law of the Bundesgerichtshof (BGH VersR 2010, 1171) the disability is a condition whose continued existence is predicted from well-informed point of view not foreseeable, which however typically also can be judged not as a definitive or immutable. It often can be a falling weight improvement at any later time, reliably predict nor ruled out. The required forecast can be used therefore, according to the Federal Court only on the particular case involved. The Court was thus the plaintiffs (and insured) law and ordered the German health insurance (DKV) to pay the contested 83.387,40 EUR.