The statutory health insurance company KKH-Allianz apparently urged the seriously ill on the phone to quit because they cause excessive health costs. The health insurance fund announced an internal review of the processes, but contradicted the systematic attempt to push out chronically ill patients.
Basically, statutory health insurance companies are obliged to accept every insured person, regardless of whether they are old or chronically ill. The ZDF magazine "Frontal 21" makes serious allegations against the KKH alliance. Insureds, because they are seriously ill and therefore expensive, have been forced to cancel on the phone. The magazine relies on existing internal telephone protocols for this assertion. In response to the allegation, the KKH Allianz now wants to have an internal audit undertaken.
"The customer is blind, a cash register change is shown as an option". This was, for example, a note in a KKH Allianz telephone protocol. In another case, the ZDF journalists describe how a seriously ill insured person suffering from diabetes was also persuaded to cancel on the phone. The cashier clerk asked her to cancel the health insurance. In a note, the employee then wrote in a rather cynical manner: "Cried on the phone; notice of termination has been given." In another case, a man infected with the HI virus was forced to switch, even after a long membership and repeated words. So it said in the telephone log: "He has always been at KKH and they also pay for his HIV therapy; after a long conversation, nevertheless convinced to think about changing the till; Termination is given. "
No isolated cases: Hundreds asked to give notice According to the ZDF editors, these should not be isolated cases. For example, "sick patients were contacted by phone for months". Hundreds are said to have been asked to change the register. The main focus of the telephone campaign was on the seriously ill, because they apparently cause high health costs. "This business practice of Allianz has been confirmed by both the insured and the employees of the health insurance company to the editors," reports Frontal 21. "It was explicitly the aim to force the insured people out of the health insurance company." Employees of the health insurance company have already confirmed this to the magazine.
The treasurer, Ingo Kailuweit, initially denied all allegations when asked. He "could not imagine" such an approach by his employees. The calls were about a regular dunning procedure. On Tuesday, the box office in Hanover announced that the board had initiated an internal review based on ZDF research. One "wanted to investigate the allegations", as it was said. However, the health insurance company disagreed with the allegation that they had explicitly contacted sick people. Rather, the health insurance fund wanted to demand additional contributions from offending health insurers. Therefore, the campaign was "without exception for all debtors and regardless of age, gender, medical history or other criteria," said a spokesman. Furthermore, it was also not the intention to ask the cash register members to leave the KKH alliance the law violated and health insurance companies would not be worse off financially thanks to the new provisions if many chronically ill people were insured in the fund, and the risk structure compensation prevented economic losses due to chronically ill patients.
Health economist speaks of a scandal In the KKH alliance, 1.8 million members are currently covered by statutory health insurance. Legislation obliges all health insurers to treat every member equally. Criteria such as age, gender, origin or health status are irrelevant. Therefore, the respected health economist and managing director of the Joint Welfare Association Professor Rolf Rosenbrock rated the operation of the KKH Allianz as "a scandal". "This is in no way the same as mandating a statutory health insurance company." The paragraph of the responsible social law clearly regulates it. Statutory health insurance is a community based on the principle: "The healthy support the sick, the young, the old."
Was data protection also violated?
Federal data protection officer Peter Schaar also criticized the actions of the fund. Competition must not lead to legal boundaries being exceeded ”. He also told the magazine that it could not be that "people would be forced out of the statutory health insurance because they might be too expensive." In addition, "health insurance companies may only process data that is expressly stipulated in the law". Performance data and health data must not be merged, says Schaar.
Against this background, the box office's current campaign against the practice fee is less credible. The KKH alliance only announced in October that it would reimburse the fees because the "practice fee unilaterally charged insured persons." That was not fair, CEO Ingo Kailuweit recently said in a press release. (sb)
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