this post was submitted on 11 Aug 2025
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Political Memes

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Sadly true (piefed.cdn.blahaj.zone)
submitted 3 days ago by LadyButterfly@piefed.blahaj.zone to c/politicalmemes@lemmy.world
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[–] yetAnotherUser@discuss.tchncs.de 2 points 3 days ago* (last edited 3 days ago)

Wow, that sucks. Somewhat surprised you didn't have the finiancial penalties for providing too much already though, Germany had so since forever:

§ 12 SGB: Economic efficiency requirement

(1) The benefits must be sufficient, appropriate and economical; they must not exceed what is necessary. Insured persons may not claim benefits that are not necessary or uneconomical, the service providers may not provide them and the health insurance funds may not approve them.

(2) If a fixed amount has been set for a service, the health insurance company fulfills its obligation to pay benefits with the fixed amount.

(3) If the health insurance fund has provided benefits without a legal basis or contrary to applicable law and if a member of the Board of Management knew or should have known about this, the competent supervisory authority shall, after hearing the member of the Board of Management, cause the Board of Administration to claim compensation from the member of the Board of Management for the damage resulting from the breach of duty, if the Board of Administration has not already initiated recourse proceedings on its own initiative.

Of course the only recourse if they don't provide coverage is to first write a letter of complaint and if it's rejected to sue for coverage. If you have suffered quantifiable damage due to the lack of coverage you will have to launch a separate lawsuit to get compensation. Being in pain alone does not qualify.