27.09.2017

Rat vom Experten: Online versichern – ja, aaaaber! (Teil 2)

The first part of my article ended with the conclusion that online processes can save the customer a lot of time and provide a good overview with just a few clicks. As soon as it comes to living biometrics products, however, it remains essential to become a specialist. For example, the risk of being in the BU case without protection is too great. In this second part, I would like to underline my remarks with the example of occupational disability insurance.

Purely digitized graduation process?

Why this is – at least still – difficult to imagine, the following examples illustrate:

The customer wants to take out occupational disability insurance:

  • Insurer A refuses.
  • Insurer B would accept with a risk premium.
  • Only insurer F would accept on normal terms.

When practicing hobbies, the following consequence may also play a role:

  • Some insurers estimate for the hobby karate up to 150% risk premium.
  • Only the eg sixth request leads under certain circumstances to a normal acceptance.

Interests wherever you look

Unfortunately, there are also cases where doctors have provided a so-called phantom diagnosis in order to be able to bill at all or higher. Because one thing must be clear to us: the gods in white are ultimately only commercial enterprises with a profit-making intent. We had to experience such a case recently:

During the usual professional consultation process of a BU interested party in our house, it was noticeable during the examination of his treatment history that his doctor invoiced our client unknown diagnoses. And on days when our customer was not even in treatment. In addition, mental illnesses were also diagnosed. An almost sure knock-out criterion for the conclusion of occupational disability insurance.

The Kaufmännische Krankenkasse (KKH) claims damages of EUR 1.8 million for the past year. Caused by fake bills and other scams in her house.

Simple solution – great effect

The first step should therefore be the risk questionnaire already mentioned several times. The health history of the customer is meticulously processed and made available to insurers for pre-examination. Insurers then tell if and how they would insure the risk. Research is an integral part of our service and also provides the customer with transparency – coupled with know-how, advice and a sense of security.

It is nowadays no longer so easy to classify currently valid occupational titles clearly in a professional group. Too often, I experience that just the degree, such as Diplom-Betriebswirt is specified. This „occupation“ is classified by most insurers in the most favorable professional group. A rogue who thinks evil. However, this is not a job title, but an academic degree.

It is best to directly include a job description in the risk assessment in part one of the blog . The insurer then classifies you into a professional group and you are on the safe side.

This is a tip from your neutral insurance broker, a specialist. It is currently difficult to imagine that an automated comparison or online process will give you these tips and at the same time make suggestions in your favor, or take your needs into account. For this purpose, just that neutral, customer- and service-oriented attitude and professional ethics is necessary. Would you expect this ethics within an automated process without being able to look the business partner in the eye?

An online contract can not explain this to you

A risk inquiry has two decisive advantages:

  1. The fact that a REQUEST and no REQUEST is made does not correspond to the legal definition of a declaration of intention to initiate a legal transaction. So you are not yet a rights and obligations. Thus, no signatures are yet to be paid in order to file a privacy policy or release of confidentiality or similar. leave.
  2. The insurers may only use their data as part of the risk assessment and not forward them to third parties, such as the risk file (HIS), which is often discussed in this context.

Any form of use of personal data – from collecting, storing, modifying, querying, to transmitting or deleting – is considered an interference with the fundamental freedoms and the privacy of the person concerned and therefore requires legitimacy (legal regulation or consent). For details, § 4 BDSG.

Health data belong to the so-called special types of personal data – also called „sensitive“ personal data (§3 Abs. 9 BDSG). Such data is therefore subject to a particularly high level of data protection.

Digression: The information and information system of the insurance industry (HIS) is a common database of insurers. The primary goal is to more easily expose insurance fraud and abuse.

The entries are in seven categories:

  • liability
  • automotive
  • accident
  • Legal
  • property
  • transport
  • Life

Only entries in suspicious cases or preventive will be made and evaluated according to a points system. For example, if someone uses their personal liability insurance several times a year or witnesses a suspected fake traffic accident, points are distributed.

If the score exceeds the individual threshold for each insurance division, a coded entry is made. Thus, from the entry can not be deduced to a specific person. This includes the following facts:

  • Atypical loss frequencies
  • Special damage consequences
  • Aggravated risks
  • Discrepancies in the claim
  • Completed life and disability insurance

The storage period is 5 years, if no new entry has been made in the meantime. Every year, you can request a self-assessment from informa HIS GmbH. ( http://www.informa-his.de/selbstauskunft/selbstauskunft )

Back to the risk pre-inquiry and the next steps:

After your insurance has collected the results of insurers and processed, you can choose both together in peace, in which insurers it makes sense in the collective analysis Step 2 to get in.

After separating the wheat from the chaff, so to speak, the next step begins – the fine adjustment step 3 of the selected tariff. Only at the end, if it has been designed according to your specifications, you will receive a contract offer conforming to the Insurance Contract Act (VVG) Step 4 .

If you are satisfied with the offer, your insurance broker will provide you with the application form step5 . If you have not previously carried out the risk assessment request anonymously, you will generally receive your insurance policy very quickly, as the insurer no longer has to carry out the risk assessment completely.

Of course, the prerequisite for this is that your information in the application form does not differ from those in the risk assessment. That’s why you should not consider the vote of a risk pre-request as carved in stone. The insurers explicitly reserve the right to deviate from this and formulate this in writing.

All five steps in the summary:

Find a longtime experienced insurance broker who by the way is by definition a vicarious agent of the policyholder. Not an exclusive agent who has a small office in the village, let alone a multi-agent working for a three or four-letter financial officer on an independent basis.

  • Carry out risk evaluation and have it evaluated
  • Separating wheat from chaff. BU is not the same BU!
  • Adapt the tariff to your life situation and planning
  • Provide a complete offer (including insurance conditions, etc.) and allow time for review

My conclusion to pure online deals

Digitization is a great opportunity, also for the insurance industry. Hoesch & Partner is one of the pioneers of this development. In particular Carlos Reiss, founder and owner of this company and Michael Reeg (CEO) have been pursuing an organic strategy for years, in order to be able to use the possibilities of digitization for the benefit of the customer. In general, however, the searcher should of course take into account that technology is also designed by people with interests.

A neutral entity, which advises the customer technically correct and with regard to his needs is for the time being not to be replaced by algorithms.

Have I piqued your interest? How do you see the developments around digitization and FinTechs? Did you perhaps have your own experiences? Then talk to me. I am looking forward to read your comments!

And beyond that, the entire Hoesch & Partner is at your side with help and advice.

Yours, Alexander Kukovic

 

2 Gedanken zu „Rat vom Experten: Online versichern – ja, aaaaber! (Teil 2)“

  1. Frau Müller sagt:

    Leider kann ich diesen Teil Ihres Artikels leider nicht bestätigten:

    „Während des üblichen professionellen Beratungsprozesses eines BU-Interessenten in unserem Hause fiel bei der Sichtung seiner Behandlungshistorie auf, dass sein Arzt unserem Kunden unbekannte Diagnosen abgerechnet hat.“

    Ich habe über Hösch und Partner eine BU abgeschlossen mit dem Hinweis des Beraters die Krankheitsfrage nach bestem Wissen und Gewissen auszufüllen! Keinerlei Hinweise auf irgendeine Behandlungshistorie.
    Mittlerweile frage ich mich, ob es überhaupt sinnvoll ist die BU zu behalten wenn am Ende eh nicht gezahlt wird weil die Ärzte wer weiß was abgerechnet haben.

  2. Liebe Frau Müller,

    vielen Dank für Ihre Reaktion auf meinen Beitrag.

    Als unsere Kundin haben Sie einen Anspruch auf bestmögliche Beratung. Es ist jedoch – ohne persönliche Rücksprache – seriös nicht möglich Ihren Fall hinreichend nachzuvollziehen.

    Ich bitte Sie deshalb Ihren Consultant zu kontaktieren und Ihre Bedenken mit ihm auszutauschen.

    Sollte sich herausstellen, dass antragsrelevante Inhalte fehlen, liefern wir diese Ihrem Versicherer nach und stellen gegebenenfalls eine neue Risikovoranfrage für Sie.

    Gern können Sie mich auch direkt kontaktieren per Telefon unter 0211 / 42 47 40 – 25 oder E-Mail an alexander.kukovic@hoesch-partner.de.

    Wir werden alles in Ihrem Sinne in die Wege leiten und die für Sie beste Lösung finden, um Ihren Vertrag sozusagen „wasserdicht“ zu gestalten.

    Aktuell sehe ich aber keinen Grund zur Besorgnis: Der Gesetzgeber steht grundsätzlich auf der Seite der Versicherungsnehmerin – also auf Ihrer Seite.

    In diesem Sinne freuen wir uns auf Ihren Kontakt!

    Beste Grüße
    Alexander Kukovic

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