Wegweiser Patients · Your rights in treatment and when things go wrong Deutsch

🏛️ Support from your health insurer (§ 66 SGB V)

Your health insurer should support you with damages claims after treatment errors, for example by reviewing the documents and obtaining an expert opinion.

health insurer 66 SGB V treatment error documents Medizinischer Dienst consent support

In brief

Your statutory health insurer should help you if you suspect a treatment error.

It can check documents for completeness. It can request further documents from doctors if you agree. It can ask the Medizinischer Dienst for an expert opinion.

Your data may be used for this only with your consent.

The help is support. It does not replace a lawyer.

Step by step

  1. Contact your insurerDescribe your suspicion to your health insurer.
  2. AgreeGive your consent so that documents can be requested.
  3. Ask for the resultHave the expert opinion explained to you.
  4. Next stepsDecide whether to choose arbitration or a lawsuit.

Deadlines

support
Health insurers should support insured persons with damages claims ("should" provision; no fixed deadline in the law)§ 66 SGB V
Watch out – common mistakes
  • The health insurer may have claims of its own; its interests need not match yours. Get independent advice.
  • The limitation period keeps running while the insurer reviews.
  • Privately insured: nothing was examined for private health insurance.
In depth · legal basis, figures and practice – for advisers and professionals

Content of the support

§ 66 SGB V provides that health insurers should support insured persons in pursuing damages claims that arose from treatment errors in the use of insurance benefits. The support can include checking documents for completeness and plausibility, requesting further documents from service providers (with the insured person's consent), the social-medical assessment by the Medizinischer Dienst and an overall evaluation.

Data protection

Data collected with the insured person's consent may be processed exclusively for the purpose of support in treatment errors.

In practice

According to its 2024 annual statistics, the Medizinischer Dienst produced 12,304 expert opinions on suspected treatment errors (search extract). Whether and to what extent individual insurers provide support was not examined.

Who is responsible
  • Your health insurer
  • Medizinischer Dienst
  • Stiftung Unabhängige Patientenberatung Deutschland (independent patient advice foundation)
Further reading
Expert opinions: Medizinischer Dienst and arbitration boardRecognising treatment errors and first steps

Quick questions

Worum geht es bei „Support from your health insurer (§ 66 SGB V)“?
Your health insurer should support you with damages claims after treatment errors, for example by reviewing the documents and obtaining an expert opinion.
Which deadlines and figures matter?
support: Health insurers should support insured persons with damages claims ("should" provision; no fixed deadline in the law) (§ 66 SGB V)
What should I do first?
  • Contact your insurer: Describe your suspicion to your health insurer.
  • Agree: Give your consent so that documents can be requested.
  • Ask for the result: Have the expert opinion explained to you.
What do I need to watch out for?
  • The health insurer may have claims of its own; its interests need not match yours. Get independent advice.
  • The limitation period keeps running while the insurer reviews.
  • Privately insured: nothing was examined for private health insurance.
Evidence
  • Gesetze im Internet, SGB V § 66, retrieved 20 September 2026
  • Medizinischer Dienst Bund, Jahresstatistik Behandlungsfehler 2024 (search extract), retrieved 20 September 2026
As of

September 2026 · Sources and method

A question about your situation that this page does not answer? Write to us or use the contact form – we will tell you which office is responsible and what to bring. Free of charge, without individual legal advice.