Emergency tariff

(1) Non-payers within the meaning of section 193(7) of the Insurance Contract Act form a tariff within the meaning of section 155(3), first sentence. The emergency tariff provides exclusively for reimbursement of expenses for benefits necessary for the treatment of acute illnesses and pain conditions, and in the case of pregnancy and maternity. By way of derogation, for insured children and adolescents, expenses must also, in particular, be reimbursed for preventive check-ups for the early detection of disease under statutorily introduced programmes and for vaccinations recommended by the Standing Committee on Vaccination at the Robert Koch Institute under section 20(2) of the Infection Protection Act.
(2) A uniform premium must be calculated for all insured under the emergency tariff; section 146(1), points 1 and 2, otherwise applies. For insured persons whose contract provides only for reimbursement of a percentage of the expenses incurred, the emergency tariff grants benefits amounting to 20, 30, or 50 percent of the insured treatment costs. Section 152(3) applies correspondingly. The calculated premiums under the emergency tariff may not be higher than is necessary to cover the expenses for insured events under the tariff. Additional expenses arising to ensure the limits named in the third sentence are met must be distributed equally among all policyholders of the insurer holding insurance that satisfies an obligation under section 193(3), first sentence, of the Insurance Contract Act. The ageing provision must be credited against the premium payable under the emergency tariff in such a way that up to 25 percent of the monthly premium is paid by drawing on the ageing provision.