Austria’s insurance undertakings are generally fully observing their information obligations in relation to private health insurance correctly. This was the conclusion of a thematic review by the Austrian Financial Market Authority (FMA) in relation to compliance with the Information Requirements Regulation, which entered into force on 1 January 2016, conducted for eight providers, with their respective most widely sold products being analysed. In a few isolated cases there were however severe shortcomings in the presentation of the legal right of appeal and the subsequent resulting consequences as well as in the presentation of premium increases over the past five years. Based on the findings of this analysis the FMA has drawn up a Best Practices Guide, which is being made available to all insurance undertakings.
The information requirements issued by the FMA in relation to health insurance allow every consumer to select the health insurance product that best suits their needs and requirements. The customer must receive all information in a comprehensible, fair and non-confusing manner prior to the conclusion of the contract in order to be able to reach a well-grounded decision.
The consumer must in particular be informed about the following points prior to the conclusion of the contract:
- Individual exclusions from types of risk as well as waiting times are to be explained clearly.
- The insurance policyholder must receive a clear explanation about their right to appeal (Article 5 of the Insurance Policy Act (VersVG; Versicherungsvertragsgesetz) as well as the subsequently resulting consequences.
- The consumer must be informed that the premium (Article 178f VersVG) may be unilaterally adjusted by the insurance undertaking on a constant basis, as well as that the insurance undertaking may also increase the premiums considerably during the contractual period.
- The increase in premiums for at least the previous five years must be stated for the tariff that is specifically being used.
- It should also be highlighted that past premium increases do not provide any reliable indicator for future premium increases.
- Furthermore, consumers must also be informed that in the event of termination of the policy that there will not be a surrender value paid out, and therefore that no claim exists to a pro rata reserve for increasing age.
The aim of the exercise was to check and ensure full compliance with the pre-contractual information requirements. On the other hand, the exercise was also intended for collecting examples of best practices, to increase transparency as well as to improve the comparability of products offered by different providers.
Approximately 2.9 million Austrians, or around 35% of the total population, also have additional private health insurance. In 2016, 168,664 new health insurance contracts were concluded by the eight private health insurance providers in Austria. Insurance for the costs of out-patient treatment was the most significant product (around 53,000), following by insurance to cover the cost of hospital treatment (around 30,000). Considerably fewer policies were concluded for daily allowances for in-patient hospital treatment, sickness payments, as well as insurance for the costs of nursing care.
Journalists may address further enquiries to:
Klaus Grubelnik (FMA Media Spokesperson)
+43/(0)1/24959-6006
+43/(0)676/882 49 516