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Transparency in Insurance Contract Law pp 63–93Cite as

Transparency in the Insurance Contract Law of Germany

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Part of the book series: AIDA Europe Research Series on Insurance Law and Regulation ((ERSILR,volume 2))

Abstract

Transparency constitutes a well-recognised element in contract law. However, with regard to insurance contract law, transparency is even more important and may not be overestimated. This is due to the fact that insurance is a so-called legal product. The legal initial situation is, therefore, evidently different compared to contracts for the exchange of goods. Characterised by sold goods, the latter can usually be seen, touched, felt or perceived by other means. Insurance contracts, however, do not entail dealings with ‘visible’ goods. Solely after the occurrence of an insured event, the insured risk materialises and becomes ‘visible’. Hence, insurance contracts are not characterised by an exchange of physical goods for money but by the exchange of a promise of performance for financial compensation. In the absence of any physical manifestation of a mere promise, a visual inspection is not possible at all—but this fact is not rendering the insurance product non-transparent per se.

I would like to express my gratitude to research assistant Dr Kevin Bork for his valuable support. This analysis is based on Wandt (2012) and on Wandt (2017). In addition, I would like to thank Prof Dr Jens Gal for his consent to partly base this analysis on Wandt and Gal (2014).

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Notes

  1. 1.

    Cf. in detail particularly Dreher (1991).

  2. 2.

    Wandt (2012), p. 343.

  3. 3.

    With regard to the structural mix-up in Germany, see Sect. 3.

  4. 4.

    Motive zum VAG, reprint, Berlin 1963, p. 32.

  5. 5.

    Until that time, insurers were exempted from meeting the prerequisites for the inclusion of general terms and conditions set by sec. 2 Unfair Terms and Conditions Act old version, due to the fact that their GCI were the object of preapproval by the supervisory authority (cf. sec. 23 subsec. 3 Unfair Terms and Conditions Act old version).

  6. 6.

    Translation available at http://www.gesetze-im-internet.de/englisch_bgb/.

  7. 7.

    Translation available at http://www.gesetze-im-internet.de/englisch_vvg/index.html.

  8. 8.

    Cf., e.g., BGH, Entscheidungen in Zivilsachen (BGHZ) 104:92 with further references.

  9. 9.

    Directive 93/13/EEC of 5 April 1993 on Unfair Terms in Consumer Contracts.

  10. 10.

    Art. 181 sec. 1 Directive 2009/138/EEC of 25 November 2009 on the Commencement and Pursuit of Insurance and Reinsurance Business (Solvency II). However, Member States may impose a duty on the insurer to submit general policy conditions for health insurance and compulsory insurances to the supervisory authority before using them.

  11. 11.

    Also cf. Verordnung über Informationspflichten bei Versicherungsverträgen (VVG-InfoV) of 18 December 2007, BGBl. I 2007, p. 3004.

  12. 12.

    Gesetz zur Änderung der Vorschriften über Fernabsatzverträge bei Finanzdienstleistungen of 2 December 2004 (BGBl. I 2004, p. 3102; cf. thereto BT-Drucks. 15/2946); implementing Directive 2002/65/EC of 23 September 2002 with respect to the Distance Marketing of Consumer Financial Services.

  13. 13.

    Küster (2010), pp. 730 ff.

  14. 14.

    Bruns (2015), § 9 para. 40 considers the drafting of the provision on the right to revoke and its legal consequence to be inadequate.

  15. 15.

    The reform of pre-contractual disclosure of the policyholder is not comparable in its technical dexterity.

  16. 16.

    Cf. Weyers and Wandt (2003), para. 264.

  17. 17.

    RegE BT-Drucks. 16/3945, p. 67.

  18. 18.

    See at a glance Koch (2018, pp. 92 ff., 97 ff.) and Wandt (2017), pp. 419 ff.

  19. 19.

    Along with the harmonisation of insurance law by EU directives; since the early 1980s numerous national insurance contract acts of EU Member States have been reformed to strengthen consumer protection: Sweden and Spain (1980), Belgium (1992), Germany, Austria, Finland (1994), Luxembourg and Greece (1997), Denmark (2004), Bulgaria (2005), Sweden and the Netherlands (2006), Germany and Portugal (2008), Finland (2010), Great Britain (2012) and Hungary (2013).

  20. 20.

    See at a glance Wandt (2012), pp. 340–353.

  21. 21.

    Schmidt (2019), § 307 para. 43.

  22. 22.

    BGH, Neue Juristische Wochenschrift Rechtsprechungs-Report Zivilrecht (NJW-RR) 1995:749.

  23. 23.

    Brand (2011), p. 97.

  24. 24.

    BGH, Versicherungsrecht (VersR) 2003:236; BGH, Entscheidungen in Zivilsachen (BGHZ) 153:182.

  25. 25.

    BGH, Versicherungsrecht (VersR) 2005:639.

  26. 26.

    Rixecker (2019), § 1 para. 89; Höra (2017), § 1 para. 65.

  27. 27.

    Art. 3 sec. 1 Council Directive 93/13/EEC of 5 April 1993 on Unfair Terms in Consumer Contracts. Most legal systems consider unfair clauses as utterly ineffective. As a further consequence, the clause either ceases without replacement, or (must) be replaced by mandatory legislative provisions or supplementary interpretation will apply. Under the Directive, a national court is prohibited from reducing an unfair term to its legally permissible core (geltungserhaltende Reduktion); BGH, Neue Juristische Wochenschrift (NJW) 2013:991 (p. 993, paras. 33 f.).

  28. 28.

    According to Pilz (2010a), p. 164, this development was initiated by German jurisprudence.

  29. 29.

    Council Directive 93/13/EEC of 5 April 1993 on Unfair Terms in Consumer Contracts.

  30. 30.

    https://www.uibk.ac.at/zivilrecht/forschung/evip/restatement/final_report.pdf.

  31. 31.

    This may also be the approach of Turkish law, Art. 6 Regulation on Unfair Terms in Consumer Contracts.

  32. 32.

    BGH, Versicherungsrecht (VersR) 1994:1049.

  33. 33.

    BGH, Versicherungsrecht (VersR) 2014:625. However, the argument that there is no legal provision, which could substitute the term, appears doubtful because a supplementary contract interpretation is possible and also be based on legal provisions. Koch (2014), p. 1281 ff.

  34. 34.

    Sec. 307 BGB; cf. Langheid (2015), pp. 1071 ff.

  35. 35.

    Insofar, the national concept and understanding of the term ‘average policyholder’ may differ from the legal fiction under EU law. See for the CJEU’s concept of average consumer ECJ 6 July 1995, Case C-470/93, Neue Juristische Wochenschrift (NJW) 1995:3243 (p. 3244); ECJ 16.7.1998, Case C 210/96, Neue Juristische Wochenschrift (NJW) 1998:3183 (p. 3184). Cf. also Clarke (2005), p. 145.

  36. 36.

    Präve (2000), p. 140.

  37. 37.

    BGH, Versicherungsrecht (VersR) 2008:337, para. 11; BGH, Neue Juristische Wochenschrift (NJW) 2014:924 (securities business); Rixecker (2019), § 1, para. 92.

  38. 38.

    Stadler (2018), § 307 para. 8.

  39. 39.

    Wolf and Ungeheuer (1995), p. 180.

  40. 40.

    Reiff (2018), § 40 para. 38 f.

  41. 41.

    Armbrüster (2012b), para. 1016.

  42. 42.

    BGH, Versicherungsrecht (VersR) 1995:77 (p. 79).

  43. 43.

    Wandt (2016), para. 201.

  44. 44.

    BGH, Versicherungsrecht (VersR) 2013:1397; BGH, Entscheidungen in Zivilsachen (BGHZ) 194:208 (para. 45).

  45. 45.

    Unlike an enforceable duty (echte Rechtspflicht) an Obliegenheit does not confer an enforceable claim for neither performance nor damages. Instead a breach of an Obliegenheit leads to other specific legal consequences determined by law.

  46. 46.

    BGH, Neue Juristische Wochenschrift (NJW) 2014: 449.

  47. 47.

    Differentiated Wandt (2015, pp. 265 ff.); cf. OLG Naumburg, Versicherungsrecht (VersR) 2015:102.

  48. 48.

    See above Sect. 4.

  49. 49.

    See for the fundamental structure of private consumer protection laws in the light of distance selling contracts Bülow and Arzt (2000), pp. 2049 ff.; with reference to the application of the Consumer Directive as the onset for interpreting sec. 312 subsec. 1 BGB see von Loewenich (2016, pp. 2011 ff.).

  50. 50.

    See above Sect. 2.

  51. 51.

    Wandt (2012), p. 343.

  52. 52.

    In further addition to the forgoing remarks on the perspective of the average policyholder, see Pilz (2010b), pp. 1289 ff., in due consideration of the average policyholder’s situation when dealing with non-accessible material for the interpretation of GCI.

  53. 53.

    However, building on previous jurisprudence about the insurer’s duty to inform, statutory requirements must be seen in the light of all individual circumstances, see Rudy (2018), § 6 para. 3; Reiff (2016), § 68 para. 8 ff.

  54. 54.

    Cf. further Armbrüster (2016), Vorbemerkung zu §§ 6, 7 VVG; Koch (2018), pp. 130 ff.; Schwintowski (2015), § 18; Rixecker (2015), § 18a; RegE BT-Drucks. 16/3945, pp. 59 ff.; Cf. also Reformkommission, Abschlussbericht, pp. 10 ff. and pp. 294 ff. On the insurer’s and insurance intermediary’s (i.e. insurance agent’s) duty to inform under the VVG old version see Römer (1998), pp. 1313 ff.

  55. 55.

    Wandt (2016), para. 299.

  56. 56.

    Cf. for a more detailed perspective of the legislators rationale for the individual data-oriented duty to advice RegE BT-Drucks. 16/1935, p. 24.

  57. 57.

    BGH, Entscheidungen in Zivilsachen (BGHZ) 194:39; differing Römer (2016, § 7 para. 18); also see BGH, Entscheidungen in Zivilsachen (BGHZ) 203:174.

  58. 58.

    Cf. for an exemplary presentation of jurisdiction strictly requiring and interpreting a mere objective cause, BGH, Versicherungsrecht (VersR) 2014:861 and OLG Karlsruhe, Versicherungsrecht (VersR) 2013:885 (p. 886); furthermore, OLG Saarbrücken, Versicherungsrecht (VersR) 2011:1556 (under the old VVG).

  59. 59.

    Cf. on the exceptions to the requirement of the written form, concisely Wandt (2016), para. 302.

  60. 60.

    Regarding other branch-specific standardised information duties according to the VVG in general, cf. Loacker (2015), p. 200.

  61. 61.

    On the temporal sequence of documentation, see Wandt (2016), paras. 303 f.

  62. 62.

    By the same token Armbrüster (2016), § 6 para. 136 f.; insurers will regularly compile documentation during the customer call, cf. RegE BT-Drucks. 16/1935, p. 25; the insurer’s documentation serves, inter alia, the policyholder’s visualisation and, therefore, the comprehension of the insurance product, see BGH, Entscheidungen in Zivilsachen (BGHZ) 203:174 and Reiff (2006), p. 1709.

  63. 63.

    Critically on the policyholder’s option to waive his right to advice and documentation, Niederleithinger (2010), pp. 437 ff.; see also Römer (2007a), pp. 94 ff. discussing a possible threat to consumer protection.

  64. 64.

    Also, the German Federal Constitutional Court (Bundesverfassungsgericht—BVerfG) raised doubts with respect to transparency in general in this regard, in Versicherungsrecht (VersR) 2005:1109; also Römer (2007a), pp. 94 ff.

  65. 65.

    Wandt (2016), para. 310.

  66. 66.

    Niederleithinger (2010), pp. 437 ff.

  67. 67.

    BGH, Versicherungsrecht (VersR) 2015:107.

  68. 68.

    BGH, Versicherungsrecht (VersR) 2013:628; Reiff (2016, § 63 para. 51).

  69. 69.

    In addition, see on the integration into civil law Präve (2008), pp. 151 ff.

  70. 70.

    Cf. in relation to sec. 7 subsec. 2 VVG on duties to inform, formerly stipulated by insurance supervisory law, RegE BT-Drucks. 16/3945, p. 121.

  71. 71.

    See in further detail Wandt and Bork (2018), pp. 261–292; See also Koch (2018), pp. 133 ff.

  72. 72.

    The same applies to an occupational disability insurance or an accident insurance with premium redemption (sec. 2 subsecc. 4 f. VVG-InfoV).

  73. 73.

    The provision solely applies to consumers. In principal, the VVG 2008 treats every policyholder equally—except for contracts covering large risks. The VVG, thereby, refrains from providing exclusive rules on insurance contracts for consumers.

  74. 74.

    Wandt (2016), para. 317.

  75. 75.

    A particular problem which comes up in connection with the general possibility to claim damages consists in the question if premiums that have been paid—for insurance cover that has been provided—may also be claimed (at least in part) as damages. Insofar there are strong arguments that sec. 9 VVG precludes claims for damages on paid premiums in those cases in which it applies (i.e. where the cover was incepted with the policyholder’s accordance before the expiration of the limitation period for revocation; the policyholder was instructed about the power of revocation, the legal effects of a revocation and the payable amount of money by way of an instruction notice).

  76. 76.

    Cf. also Brand (2012), p. 81, who argues, with regard to issues outside the scope of directives, in favour of a de lege ferenda removal of a mandatory right to revoke.

  77. 77.

    BVerfG, Recht und Schaden (r+s) 2014:6; cf. Armbrüster (2012a, pp. 517 ff.) on the insured’s disloyal behaviour hindering the eternal right to revoke, which must be construed restrictively under the aspect of an abuse of law.

  78. 78.

    In the sense of not conferring an enforceable claim for neither performance nor damages, see above Sect. 4. V. 4.

  79. 79.

    Cf. with regard to the uniformity of the formal requirements in both provisions, Tschersich (2012, pp. 56, 60).

  80. 80.

    OLG Hamm, Versicherungsrecht (VersR) 2016:103.

  81. 81.

    OLG Karlsruhe, Versicherungsrecht (VersR) 2016:105; OLG Karlsruhe, Versicherungsrecht (VersR) 2016:445; concerning the exceptional case of a doubled instruction OLG München, Recht und Schaden (r+s) 2016:68.

  82. 82.

    OLG Saarbrücken, Versicherungsrecht (VersR) 2015:91.

  83. 83.

    Cf. Dreher (1991), pp. 145 ff.

  84. 84.

    See also Schneider (2015), pp. 477 ff. on the stress ratio between the insured’s (informational) self-determination and the insurer’s imperative to guide and care.

  85. 85.

    Loacker (2015, pp. 275 f.).

  86. 86.

    See with regard to GCI, Rixecker (2019, § 1 para. 82).

  87. 87.

    Römer (2007b, pp. 619 ff.).

  88. 88.

    Directive 2002/65/EC of the European Parliament and of the Council of 23 September 2002.

  89. 89.

    E.g. Franck (2014, p. 18).

  90. 90.

    Act implementing Directive (EU) 2016/97 of the European Parliament and of the Council of 20 January 2016 on Insurance Distribution and amending other Acts of 20 July 2017, (BGBl. I 2017, pp. 2789 ff.).

  91. 91.

    Directive (EU) 2016/97 of the European Parliament and of the Council of 20 January 2016 on Insurance Distribution, OJ L26/19.

  92. 92.

    However, authors argue that the legislator partly fell short with respect to the implementation of the IDD in the Insurance Contract Act (Versicherungsvertragsgesetz—VVG), see Beenken (2017, pp. 617 ff.).

  93. 93.

    Artt. 17 ff. IDD.

  94. 94.

    Definition provided by Art. 2 sec. 1 subsec. 8 IDD.

  95. 95.

    See in further detail Wandt and Bork (2018).

  96. 96.

    Bork and Wandt (2019; in print).

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    Manfred Wandt

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    Pierpaolo Marano

  2. School of Law, University of Exeter, Exeter, UK

    Kyriaki Noussia

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Wandt, M. (2019). Transparency in the Insurance Contract Law of Germany. In: Marano, P., Noussia, K. (eds) Transparency in Insurance Contract Law. AIDA Europe Research Series on Insurance Law and Regulation, vol 2. Springer, Cham. https://doi.org/10.1007/978-3-030-31198-8_3

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