Court obliges insurance undertakings of private dental insurance obligation OLG Karlsruhe forcing the Swiss insurance company with German approval for the reimbursement of dental prostheses (OLG Karlsruhe, 27.06.2013, 12 U 127/12). The Versicehrungsunternehen of private dental insurance did not pay out its obligation due to the subordinate “pre-contractual duty of disclosure violation”. Each legally insured knows that a dentist is no longer paid special prevention. This provision is useful in the future to get as long as possible maintained his own teeth. Of course, you will be asked firmly in dentures to cashier. For this reason, many members of the statutory health insurance (GKV) complete a private dental insurance. These aims after the latency or the generally existing Dental Squadron, the secured services and costs in the future.
Facts dental insurance insurers denied its obligation: A member of the statutory health insurance August 2008 had let visited his dentist, make an X-ray and perform a PA treatment. Due to this treatment was a tooth replacement (15 17) has been established, which was not ideal bite State. However, the Fund member was asymptomatic. The dentist saw no current need for action here. The legally insured.
graduated from a private dental insurance in November 2008. 2010, the patient went to his dentist because of severe toothache in the above-mentioned posterior region (cyst). 2011, the Member received (15-17) implants, the statutory health insurance (GKV) at the listed teeth. His private tooth insurance should take over 80% (MB/KK => 5.534,67 incl. interest) the cost of the dental Bill.