Health Insurance Should Pay For Hearing Aid Equipment

Hearing aid hörgerät

Most health insurance contracts have the obviously ambiguous statement, “Erstattungsfähig sind Kosten nur in angemessener Ausführung” (Costs are only refundable when “appropriate”). This statement has been the saving grace for most insurance companies who abscond paying for costs incurred by their clients.

A ruling from the local court in Munich (Az.: 159 C 26871/10), declared that the statement wasn’t reason enough for insurance companies to refuse to pay for hearing aid equipment. The court found that the statement was not clear nor understandable. The court pointed out that use of such statements penalised the clients because they lacked transparency and could be interpreted differently.

The ruling came in after a man had gotten himself an extra private health insurance. Considering the man had hearing problems, his doctor suggested he gets a hearing aid device. The man paid for the device which cost €4105 that he forwarded to the health insurance. The health insurance company only paid €2124, siting that they only paid for devices that covered the average requirements and not for personal preferences. The man took them to court.

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