Suche
Mein Konto
Revolution in occupational disability law: OLG Hamm strengthens consumer protection!
Hamm Higher Regional Court strengthens rights in occupational disability insurance: judgment clarifies withdrawal and challenge.
Revolution in occupational disability law: OLG Hamm strengthens consumer protection!
On April 4, 2025, the Hamm Higher Regional Court decided in a groundbreaking case on occupational disability insurance (case number 20 U 33/21), which has far-reaching consequences for policyholders. The focus of the proceedings was a self-employed snack bar operator who had stated that he had been unable to work since November 2013. The insurance company in question wanted to withdraw from the contract and argued that it had violated its pre-contractual disclosure obligations.
The regional court initially dismissed the lawsuit, but the higher regional court found that both the withdrawal and the challenge were ineffective. As a result, the plaintiff was recognized as unfit for work from November 2013, but the insurance company was able to refer him to a new job as an administrative economist, which led to the termination of his obligation to provide benefits at the end of December 2020.
Health issues and their importance
The insurance company accused the plaintiff of concealing previous health conditions and rejected previous applications. However, these claims were ultimately refuted by the court. The Hamm Higher Regional Court made it clear that the plaintiff had not provided any false information; the relevant medical information was correctly stated in the application. An important aspect of the ruling is the strict interpretation of the health questions in the application form.
The critical questions to which the plaintiff answered “no” included, among other things, information about illness-related treatments of the respiratory system and the spine. The court noted that a one-off acute bronchitis should not be specified because the question was aimed at “repeated or chronic” illnesses. A scoliosis mentioned in the X-ray findings from 2006 was also not a relevant event requiring information for the court, as no treatment or advice took place.
Legal consequences and information for policyholders
The Higher Regional Court also emphasized the need to specify grounds for challenge within the one-year challenge period, in accordance with Section 124 of the German Civil Code (BGB). Blanket references to previous medical reports are not sufficient; these must be mentioned immediately and in a timely manner in the process. The ruling serves as a signal to all policyholders that answering health questions correctly protects against subsequent interpretation by the insurer.
| aspect | Details |
|---|---|
| Plaintiff | Self-employed snack bar operator, unable to work since November 2013 |
| Insurance | Wanted to withdraw from the contract due to alleged breach of duty of disclosure |
| Verdict | Withdrawal and challenge were ineffective, plaintiff received over 60,000 euros |
| Important questions in the application | B4.2 and B4.9, concerning respiratory organs and spine |
| Deadlines and mandatory information | Reasons for challenge must be given within one year of the conclusion of the contract |
Finally, experts emphasize that it is crucial for policyholders to carefully examine declarations of cancellation and dispute and to comprehensively document health impairments. The ruling strengthens the rights of policyholders in disputes with insurance companies and should serve as guidance for similar cases.
Further information on this ruling can be found at anwalt.de as well as on pfefferminzia.de.