News

New Ombudsman for Private Health Insurers

New Ombudsman for Private Health Insurers

Klaus Theo Schröder is the new Ombudsman for Private Health Insurers (PKV).

16.11.2010
The private health insurers (PKV) appointed a new ombudsman at the beginning of 2011. The former State Secretary of the Federal Ministry of Health Klaus Theo Schröder (SPD) will take over from Helmut Müller at the turn of the year.

The SPD politician and former State Secretary of the Ministry of Health, Dr. Klaus Theo Schröder, will take over the arbitration board for private health insurance (PKV) on January 1, 2011. Schröder is replacing the former head of insurance supervision, Helmut Müller. The new Ombudsman Schröder is considered to be an expert in the healthcare sector and should also have experience in conflict management. As a former secretary under ex-Minister of Health Ulla Schmidt (SPD), Schröder has among other things advanced the model of the electronic health card. Schröder also proved to be steadfast and ready to face the violent criticism from the federal medical profession.

The PKV federal association was very pleased with the new chairmanship. "Klaus Theo Schröder has a high level of expertise, knows the different corners of the healthcare system and is widely accepted," said the chairman of the PKV association Volker Leienbach. In December 1999 Schröder became State Secretary of the Berlin Senate Department for Labor, Social Affairs and Women. There, too, he was particularly responsible for health policy, the stabilization of Berlin's health insurance funds and the redesign of Berlin's urban hospitals.

What is a PKV ombudsman position? The task of an ombudsman is to settle disputes between private patients and private health insurance. The arbitrator can make a recommendation, but this does not have to be accepted by both sides. The arbitration attempt is free of charge for both the consumer and the insurer. The main task of a conciliator is to review decisions made by an insurance company and to act neutrally, quickly and unbureaucratically.

The Ombudsman is also responsible for bringing extra-judicial arbitration to disputes between insured parties and health insurance companies. as well as insurance intermediaries and insurance advisors. The ombudsman should mediate between the parties at every stage of the procedure and achieve reconciliation if possible. If there is no satisfactory agreement for both sides, a court must still be consulted.

Helmut Müller is leaving due to age reasons
Helmut Müller has worked as an ombudsman since 2007. For reasons of age, Müller no longer wants to extend his work. As the chairman of the PKV association Reinhold Schulte announced, Müller had made a significant contribution to the fact that the arbitration board as an institution had acquired a "high reputation and great trust among the insured". "They always took the interests of the insured and those of the insurers into account and brought both parties to a fair balance of interests," added Schulte. Last year, the PKV Ombudsman received a total of 5015 complaints, an increase of 14.6 Percent. (Sb)

Author and source information


Video: IRDA Integrated Grievance Management System IGMS (November 2020).