PKV Overall Rating: Transparency Crisis as 17 Insurers Score 'Needs Improvement'
Few industry topics were debated as aggressively before the German federal elections as the future of private health insurance (PKV). A political majority nearly voted to end the dual health system of PKV and statutory health insurance (GKV). Despite this existential threat, many providers seem to feel no urgency to improve transparency—a critical flaw exposed in the latest industry assessment.
Advertisement
The current MAP Report No. 921 highlights this alarming trend: seventeen out of thirty PKV providers refused to participate and did not supply requested data. From the experts' perspective, the most frequent reason was that companies were asked to provide information on the development of their in-force policy premiums (for the years 2000 to 2021).
The High Cost of Non-Transparency
For opponents of the current PKV system, this lack of transparency is a gift—and it breeds misunderstanding. "Opponents of PKV have argued for decades that when signing a private health insurance contract, customers run the risk of constant, excessive premium adjustments. If the premium development for existing PKV policies remains competitive with the GKV—which we consistently demonstrate—then the path we have taken cannot be so wrong," justifies MAP author Reinhard Klages regarding the investigation's focus on "premium development."
Criticism is also directed at sales and consumers. Transparency today apparently has "less impact on sales success than it did a few years ago." The report poses the question: "Have sales and consumers become less critical?"
No clear answer is given. More important to the rating experts is to "put a finger on the wound" and ultimately call for a higher degree of transparency in private health insurance.
Advertisement
The Non-Participants: A List of Insurers
The following providers refused to participate in the rating survey or did not respond: Arag, Axa, Bayerische Beamtenkrankenkasse (no response to the experts' inquiry), Continentale, DEVK (no response), DKV, Generali, Gothaer (no response), HUK-Coburg, Inter, LKH, Münchener Verein, Nürnberger (no response), UKV (no response), Universa (no response), VRK (no response). Key figures missing for these insurers were subsequently rated with zero points in the rating.
How the PKV Overall Rating Was Conducted
What was done in the current overall PKV rating? To evaluate the companies, a multitude of key figures were to be collected for three sub-areas:
- Financial Stability & Security: Assessing the insurer's long-term ability to meet its obligations.
- Premium Development & Price Stability: Analyzing historical premium increases for existing policyholders.
- Service Quality & Contract Conditions: Evaluating customer service, claims processing, and policy benefits.
Advertisement
If key figures met a specific condition in line with the rating's criteria, points were awarded. A maximum of 100 points could be acquired in total across the sub-areas. These points were then translated into a grade.
The Winners and the Grading Scale
Thirteen insurers provided all data. These were insurers with convincing key figures—eight of these insurers are test winners with the grade 'mmm' ('excellent'). The rating winner, as in previous ratings, is the market leader Debeka, followed by Signal Iduna and LVM.
In addition, four insurers received an 'mm' ('very good'). One insurer received an 'm' ('good'). However, seventeen insurers only scored an 'm - -' ('needs improvement')—a result for which a lack of transparency is also to blame for some providers.
For consumers, especially those comparing private health insurance plans, this rating underscores a critical point: an insurer's willingness to be transparent about its historical premium increases is a strong indicator of its customer-centric approach and long-term reliability. When choosing a plan, whether in Germany's PKV market or when selecting a US private medical insurance plan, always prioritize companies with a proven track record of transparency and stability.
The current MAP Report No. 921 can be ordered. This analysis serves as a crucial tool for making informed decisions in the complex health insurance market.
Insurers and brokers struggle in claims management with high backlogs, increasing claim frequencies, skilled labor shortages, and growing customer expectations. Manual processes are expensive and slow.