Wegweiser Occupational disability · Pension & insurance Deutsch

🔁 Review, objection and lawsuit in private occupational disability insurance

Even after a rejection it is not automatically over: you can object to the insurer, turn to the Insurance Ombudsman free of charge or sue – and the insurer can also review ongoing BU pensions in a review procedure (Nachprüfungsverfahren).

Review procedure (Nachprüfungsverfahren) Insurance Ombudsman Limitation period § 195 BGB § 199 BGB Lawsuit

In brief

If a BU pension is already being paid, the insurer may, in the so-called review procedure (Nachprüfungsverfahren), check at regular intervals whether your state of health has improved. The procedure is governed by the policy terms and conditions and must be carried out formally, with reasons and a reasonable deadline – an informal stopping of payment is invalid.

In a dispute over rejection, referral to another occupation or review, several routes are open: a written objection to the insurer, a free complaint to the Insurance Ombudsman (Versicherungsombudsmann e.V.) or a lawsuit before the competent civil court. Claims under the insurance contract become time-barred after the regular limitation period of three years (§§ 195, 199 BGB).

Step by step

  1. Object in writing to the rejection or reduction letterWith reasons and – if available – medical documents.
  2. Consider a free complaint to the Versicherungsombudsmann e.V.No lawyer required, independent examination, decisions up to €10,000 in dispute are binding on the insurer.
  3. Keep the limitation period in mindAn ombudsman procedure suspends the limitation period, but does not replace your own monitoring of deadlines.
  4. File a lawsuit if necessaryBefore the competent civil court, if applicable with legal expenses insurance or legal aid (Prozesskostenhilfe).

Deadlines

3 years
Regular limitation period for claims under the BU contract, starting at the end of the year in which the claim arose and the person concerned became aware of it or should have become aware of it without gross negligence.§§ 195, 199 BGB
Watch out – common mistakes
  • An application to the Insurance Ombudsman suspends the limitation period (§ 204 Abs. 1 Nr. 4 BGB) – even so, you should not deliberately use up the deadline, as the exact calculation can be disputed in the individual case.
  • In a review procedure the insurer must notify a deterioration or improvement formally and with a reasonable deadline; an informal stopping of payment without a proper review notification is invalid.
In depth · legal basis, figures and practice – for advisers and professionals

Review procedure under the policy terms and conditions

The insurer's right of review does not arise directly from the VVG but from the respective policy terms and conditions; it must be exercised formally, with reasons and a reasonable deadline.

Versicherungsombudsmann e.V. (Insurance Ombudsman)

The ombudsman procedure is free of charge for policyholders. Under the Rules of Procedure of the Versicherungsombudsmann e.V., where the value of the complaint is up to €10,000 the ombudsman decides by a decision that is binding on the insurer; for higher values he issues a recommendation.

Limitation

§§ 195, 199 BGB govern the regular three-year limitation period; § 204 Abs. 1 Nr. 4 BGB provides that the initiation of an ombudsman procedure suspends the limitation period.

Who is responsible
  • Private insurer
  • Versicherungsombudsmann e.V.
  • Civil court (usually the regional court, Landgericht)
Further reading
Rejection and referral to another occupation in private occupational disability insurancePrivate occupational disability insurance: contract basicsAdvice and contact points for occupational disability

Quick questions

Worum geht es bei „Review, objection and lawsuit in private occupational disability insurance“?
Even after a rejection it is not automatically over: you can object to the insurer, turn to the Insurance Ombudsman free of charge or sue – and the insurer can also review ongoing BU pensions in a review procedure (Nachprüfungsverfahren).
Which deadlines and figures matter?
3 years: Regular limitation period for claims under the BU contract, starting at the end of the year in which the claim arose and the person concerned became aware of it or should have become aware of it without gross negligence.
What should I do first?
  • Object in writing to the rejection or reduction letter: With reasons and – if available – medical documents.
  • Consider a free complaint to the Versicherungsombudsmann e.V.: No lawyer required, independent examination, decisions up to €10,000 in dispute are binding on the insurer.
  • Keep the limitation period in mind: An ombudsman procedure suspends the limitation period, but does not replace your own monitoring of deadlines.
What do I need to watch out for?
  • An application to the Insurance Ombudsman suspends the limitation period (§ 204 Abs. 1 Nr. 4 BGB) – even so, you should not deliberately use up the deadline, as the exact calculation can be disputed in the individual case.
  • In a review procedure the insurer must notify a deterioration or improvement formally and with a reasonable deadline; an informal stopping of payment without a proper review notification is invalid.
Evidence
  • §§ 195, 199, 204 BGB (gesetze-im-internet.de)
  • Rules of Procedure of the Versicherungsombudsmann e.V. (§§ 12, 14 VomVO), versicherungsombudsmann.de
As of

September 2026 · Sources and method

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