(1) In the case of an existing insurance agreement, the policyholder may demand that the insurer
1. accept applications to change to other tariffs with equivalent insurance cover, taking into account the rights acquired under the contract, and old-age reserves; insofar as the benefits payable according to the tariff to which the policyholder wishes to change are higher or more comprehensive than those in the previous tariff, the insurer may demand to be released from the obligation to effect payment for the additional benefit, or may demand an appropriate risk premium, and thus a qualifying period; the policyholder may avert the agreement of a risk premium and a qualifying period by agreeing release from the obligation to effect payment in respect of the additional benefits; in case of a change from the basic tariff into another tariff, the insurer may also demand the risk premium which was calculated on conclusion of contract; a change to the basic tariff of the insurer allowing for the rights acquired from the contract and of the old-age reserve is only possible if
a) the existing cost-of-illness insurance was concluded subsequent to 1 January 2009, or
b) the policyholder has reached the age of 55, or has not yet reached the age of 55, but meets the prerequisites for a claim to a pension from the statutory pensions insurance, and has applied for this pension, or draws a pension in accordance with civil service law or comparable regulations, or is in need of assistance in accordance with Book 2 or 12 of the Social Code, or
c) the existing cost-of-illness insurance was concluded subsequent to 1 January 2009, and the change into the basic tariff was applied for prior to 1 July 2009;
a change from a tariff in which the premiums are calculated on a unisex basis to a tariff in which this is not the case is ruled out;
2. in case of termination of the contract, and simultaneous conclusion of a new contract which can completely or partly replace the health insurance cover provided for in the statutory social insurance system, with another health insurer
a) assign the calculated old-age reserve of the part of the insurance the benefits of which correspond to the basic tariff to the new insurer insofar as the terminated cost-of-illness insurance was concluded subsequent to 1 January 2009;
b) in case of conclusion of a contract in the basic tariff assign, the old-age reserve calculated of the part of the insurance the benefits of which correspond to the basic tariff to the new insurer insofar as the terminated cost-of-illness insurance was concluded prior to 1 January 2009, and termination took place prior to 1 July 2009.
Insofar as the benefits according to the tariff from which the policyholder wishes to change are higher, or more comprehensive, than those in the basic tariff, the policyholder may require the previous insurer to agree an additional tariff in which the old-age reserve extending beyond the basic tariff is to be accounted for. It is not possible to waive the entitlements in accordance with sentences 1 and 2.
(2) If the policyholder has changed to the basic tariff in accordance with section 152 of the Insurance Supervision Act subsequent to 15 March 2020 owing to existing need of assistance within the meaning of Book 2 or 12 of the Social Code, and if the policyholder’s need of assistance comes to an end within two years of the change, he or she may demand in text form, within three months of the need of assistance coming to an end, that the insurer continue the contract from the first day of the month after next in the tariff in which the policyholder was insured prior to changing to the basic tariff. At the request of the insurer, the policyholder proves commencement and coming to an end of the need of assistance through suitable documents; the certification of the competent funding organisation in accordance with Book 2 or 12 of the Social Code is deemed to constitute proof. With regard to the change, the policyholder is placed as he or she was prior to being insured in the basic tariff; the rights and old-age reserves acquired in the basic tariff are taken into account. Premium adjustments and amendments to the general terms and conditions of insurance in the tariff in which the policyholder was insured prior to changing to the basic tariff apply from the day of continuation of the contract in this tariff onwards. The sentences 1 to 4 apply accordingly to policyholders with regard to whom need of assistance within the meaning of Book 2 or 12 of the Social Code would arise solely from payment of the contribution. Section (1) sentence 1 no. 1 last clause does not apply.
(3) In the case of termination of the contract on private compulsory long-term care insurance and simultaneous conclusion of a new contract with another insurer, the policyholder may require the previous insurer to transfer the old-age reserve as calculated for him or her to the new insurer. It is not possible to waive this entitlement.
(4) Subsection (1) does not apply to time-limited insurance agreements. If this is a time limit in accordance with section 196, the right to change tariffs in accordance with subsection (1) no. 1 applies.
(5) Insofar as the health insurance is calculated in the form of a life insurance policy, the policyholders and the insured person have the right to continue a terminated insurance contract in the form of a coverage-retention policy.