LSG Stuttgart confirmed unequal treatment for the severely disabled

Health insurance companies are allowed to severely disabled persons access to voluntary statutory health insurance that Exceed a specified age limit, refuse. The approved Statute of the Fund provides for an age limit of 45 years, this will not constitute unlawful discrimination on grounds of age or disability, decided by the social court (LSG) of Baden-Württemberg in Stuttgart on Saturday, 6. In April 2019, published a written judgment (Az.: L 4 KR 2182/18).

In the resolute dispute the self-employed and yet in private had assured the severely disabled plaintiff, 2017 in the case of a statutory health insurance Fund, the inclusion in the optional insurance requested. The at the time of Application 60-year-old man referred to the fact that his wife had for over 30 years, a member of the statutory health insurance.

But the Fund rejected the application and declared that the statutes of the health insurance Exceed the access to voluntary health insurance for the severely disabled from the age limit of 45 years excludes.

The plaintiff, held, the age limit for severe disability to be illegal. This was discriminating against him because of his age and his disability.

The LSG dismissed by judgment of 22. March 2019 the action. Severely disabled people could join in accordance with the applicable provisions of the statutory insurance although, in principle, if you were insured, a parent, your spouse or your life partner, in the last five years before the accession of at least three years. This benefit is likely to limit the health insurance companies and in their licensing statutes an age limit for the candidate.

Here, the insurer of this possibility have made use of and in its bylaws that Exceed the 45. Year of life severely disabled is no longer a new member.

While this constitutes a difference in treatment, this had to be objectively justified. The legislator wanted to prevent that data to insure first a convenient private, and then with a higher age and the associated higher health risks to the community of solidarity of the Insured.

The possibility of the introduction of an age limit in the articles of Association of a statutory health insurance Fund to fend off abuse and the statutory health insurance funds relieve. The setting of an arbitrary age limit in the articles of Association was not possible because these had to be approved. fle/mwo