Insurance relationship
In insurance , the insurance relationship is a legal term that describes the legal relationship and business relationship between two or more contracting parties with the aim of providing insurance protection .
General
The insurance relationship not only regulates the legal basis between insurance companies , policyholders and insured persons , but also includes the economic relationship between the contracting parties. Equating the insurance contract and the insurance relationship is not recommended, because there are insurance relationships that arise directly by virtue of the law ( compulsory insurance ; Section 113 (1) VVG ) and which are therefore not based on an insurance contract.
An insurance relationship can come about through a contract , law or, more rarely, through a court decision . A contract that establishes an insurance relationship is referred to as an insurance contract , even if it contains other provisions. An insurance contract can also establish several insurance relationships or, in rare cases, an insurance relationship can also be established by several contracts together. An insurance relationship can also be established directly by law, especially in social security , without an insurance contract being concluded between the parties. These insurance relationships are created by law under certain conditions, without either party having to take any initiative. This includes compulsory insurance such as motor vehicle liability insurance , which must be taken out by law (e.g. § 1 PflVG ) if certain requirements are met, whereby only the choice of the insurer is free. An insurance relationship also arises through a court decision, usually in cases of statutory liability , if the injured party or his insurer has to pay an annuity to the injured party .
Legal issues
The Insurance Tax Act (VersStG) clearly differentiates between insurance contracts and insurance relationships: “ Insurance tax is subject to the payment of the insurance fee based on an insurance relationship that has arisen through a contract or otherwise” ( § 1 VersStG). Accordingly, an insurance relationship arises either through an insurance contract or in some other way. The Federal Finance Court (BFH) restricts the insurance relationship to the legal relationship between the insurer and the policyholder.
If the policyholder fulfills his legal obligations and obligations , one speaks of a "healthy insurance relationship". On the other hand, there is a "sick insurance relationship" if the insurance company due to legal (e.g. default in payment according to § § 37 VVG, § 38 VVG) or contractual (e.g. breach of its obligations such as the notification of the increase in risk (§ § 23 para. 2 VVG, § 26 Paragraph 2 VVG, Section 57 Paragraph 2 VVG)) Fundamentals is completely or partially exempt from payment. If the insurer is wholly or partially exempt from the obligation to provide benefits to the policyholder, his obligation with regard to the third party in the compulsory insurance remains in accordance with Section 117 (1) VVG. Failure to meet a deadline - for example when paying the insurance premium - is also a “non-performing insurance relationship”.
If the insurance relationship is terminated before the end of the insurance period , the insurer is only entitled to that part of the insurance premium for this insurance period that corresponds to the period in which the insurance cover existed ( Section 39 (1) VVG). If insolvency proceedings are opened against the assets of the insurer, the insurance relationship ends one month after the opening in accordance with Section 16 (1) VVG; up to this point in time it remains effective against the bankruptcy estate.
Membership and insurance relationship
The membership in a mutual insurance company (mutual insurance companies) is necessarily linked to an insurance relationship, it usually ends with the end of the insurance contract ( § 176 VAG ). The insurance relationship is the most important part of membership in a VVaG and includes the rights and obligations arising from the insurance contract. A change in the articles of association or the general insurance conditions only affects an existing insurance relationship if the insured person expressly agrees to the change. This does not apply to those provisions for which the articles of association expressly provide that they can also be changed with effect for the existing insurance relationships ( Section 197 VAG). While membership in the VVaG is based on company law, the insurance relationship is subject to contract law .
In the social security law can - but need not - the members also maintain an insurance relationship, in addition can also insured persons who are not members, an insurance relation to social security received. An insurance relationship arises in social insurance by virtue of law ( Section 1, Paragraph 1, SGB I ).
- According to Section 5 (1) No. 1 SGB V, those subject to health insurance are members of the health insurance fund according to Section 186 (1) SGB V and have an insurance relationship with it. According to § 10 SGB V, a member of the salaried employee whose family members have an insurance relationship with health insurance is a member.
- In long-term care insurance , workers and salaried employees and, for their vocational training , employees who are paid for wages are in an insurance relationship in accordance with Section 20 (1) No. 1 SGB XI .
- In the statutory accident insurance , membership and insurance relationship always differ. The members are the entrepreneurs , but the employees are insured ( Section 2 Paragraph 1 No. 1 SGB VII ).
- According to Section 1 Clause 1 No. 1 SGB VI, members of the statutory pension insurance are employed in return for payment or in vocational training.
- In the unemployment insurance are compulsory to be insured against wages or in the vocational training ( § 25 Abs. 1 SGB III ).
In many cases, social security insures more people under an insurance relationship than it has members. Some members do not have an insurance relationship ( accident insurance ), some insured persons are not members ( health insurance ), but are subject to an insurance relationship.
economic aspects
The private insurance is based on the principle of contractual freedom that allows each policyholder to consider whether he is looking for insurance cover and if so, what insurers qualify for such treatment. Social insurance, on the other hand, is subject to mandatory contracting, at least on the part of the insurer, whereby the content of the insurance relationship can also be stipulated by law (see, for example, Section 32 (1) SGB I ). This difference is also reflected in the legal form . Private insurances are organized as a stock corporation (AG), European company (SE) or VVaG, social insurance carriers are always corporations under public law (KöR).
literature
- Literature on insurance relationships in the catalog of the German National Library
Individual evidence
- ↑ Ludwig Bendix, Terminology and Concept Formation in the Draft Law on Insurance Contracts , 1904, p. 21
- ↑ Ludwig Bendix, Terminology and Definition of Terms in the Draft Law on Insurance Contracts , 1904, p. 23
- ↑ Ludwig Bendix, Terminology and Concept Formation in the Draft Law on Insurance Contracts , 1904, p. 24
- ↑ BFHE 73, 628
- ↑ Alfred Müringer, comment for compulsory insurance in motor vehicle liability insurance , 1999, p 35
- ↑ BGHZ 79, 170
- ↑ Friedhelm Dresp (Ed.), Pension Funds: Basics and Practice , 2011, p. 83
- ↑ According to Section 8 (2) VAG, KöR and AöR are also permitted as private insurers
