Cancellation after a claim

What is cancellation after a claim?

Cancellation after a claim (Kündigung im Schadenfall) is a special right to cancel under the Insurance Contract Act (ICA). It allows you to end an insurance contract after a claim without waiting for the ordinary notice period and the ordinary date. The law speaks of “partial loss”: a loss has occurred, the insurer pays for it, and the contract would otherwise continue.

In health insurance, this only concerns supplementary insurance, for example supplementary hospital insurance, supplementary outpatient insurance or dental insurance. Every invoice that the supplementary insurance covers is a claim in this sense.

What matters is who holds the right. In general insurance law, both sides may cancel after a claim. For supplementary insurance to social health insurance, the ICA has made an exception since 01.01.2022: only the policyholder, in other words the person who took out the policy, has the right to cancel after a claim; for a child, that is the parents. So an insurer may not cancel your policy because you claim benefits. Only in collective daily allowance insurance, for example through your employer, do both parties still hold these rights.

Basic health insurance has no cancellation after a claim. There, you can only switch insurer on the dates set by the Federal Health Insurance Act (KVG), regardless of how many benefits you have claimed.

How it works

Cancellation after a claim follows a few clear rules:

1. There is a claim. You have submitted an invoice, and the supplementary insurance pays for it.
2. Cancel before the payout. You must cancel at the latest when the compensation is paid out. If the benefit has already been transferred, the right has been used up for that claim.
3. Form. As with any cancellation of supplementary insurance, you write to the insurer in writing or in a form that allows proof by text. State the claim and the product you are cancelling.
4. End of cover. The insurance ends 14 days after the insurer has received your notice of cancellation. Invoices for treatment up to that day are still covered.
5. Premium. If the contract ends early, you in principle only owe the premium up to the end of the contract; you get back any amount you have overpaid. Exception: if you cancel in the year after taking out the contract, the insurer may keep the premium for the whole current insurance period.

You can also cancel only individual supplementary insurance products and keep others. Whether a product can be cancelled individually is set out in the policy and in the general terms and conditions of insurance.

Legal basis

The rules are set out in the ICA, which applies to all supplementary insurance:

• Art. 42 para. 1 ICA: if a partial loss has occurred and compensation is claimed for it, the insurer and the policyholder may withdraw from the contract at the latest when the compensation is paid out.
• Art. 42 para. 2 ICA: the insurer’s liability ends 14 days after the notice of cancellation has been communicated to the other party.
• Art. 42 para. 3 ICA: if the policyholder cancels during the year following the conclusion of the contract, the insurer keeps the premium for the current insurance period.
• Art. 35a para. 4 ICA: in supplementary insurance to social health insurance, the ordinary right to cancel and the right to cancel after a claim belong only to the policyholder. In collective daily allowance insurance, both parties have these rights.
• Art. 24 para. 1 ICA: if the contract ends early, the premium is only owed until the contract ends, subject to Art. 42 para. 3 ICA.
• Art. 35c ICA: contract clauses allowing the insurer to unilaterally reduce or cancel periodic benefits for illness or accident that are still running when the contract ends are void.
• Art. 98 ICA: Art. 42 paras. 1 to 3 ICA may not be changed in the contract to your disadvantage.

Art. 7 KVG applies to basic health insurance. Under Art. 7 para. 8 KVG, the insurer may also not cancel your supplementary insurance solely because you switch basic health insurer.

Example: cancelling before the payout

Marco is 41 and has had supplementary outpatient insurance since 2019. On 02.03.2026, he submits an invoice that the supplementary insurance covers. Because he wants to switch to a different product and the new contract has already been accepted, he cancels by registered mail. The insurer receives the notice of cancellation on 05.03.2026; the payout follows on 10.03.2026.

What this means for you

Cancellation after a claim is a way out if you are dissatisfied with a supplementary insurance policy and do not want to wait for the ordinary date. Under Art. 35a para. 1 ICA, a contract can only be cancelled ordinarily with effect from the end of the third or any subsequent year, with three months’ notice. With a multi-year contract, a claim may be the only way to get out earlier.

Before you cancel, clarify three points:

1. Do you have new cover? A new supplementary insurer asks health questions. If you are currently claiming benefits, you are more likely to get a reservation. Only cancel once the new insurer has accepted you.
2. Has the benefit already been paid out? Then it is too late for that claim. Check in your account or in the statement of benefits when the insurer pays.
3. Are you cancelling the right product? In your letter, name exactly the supplementary insurance that is to end. Basic health insurance continues regardless.

You can create the letter with the cancellation letter generator. You can find other insurers’ products and benefits in the supplementary insurance comparison and in the profiles of the health insurers. If you also want to switch basic health insurer, the dates are listed under deadlines. Other ways of ending a contract early are explained on the page on extraordinary cancellation.

Common mistakes

• Cancelling after the payout. The right only exists until the compensation is paid out. After that, only the ordinary dates or good cause remain.
• Cancelling without new cover. After a claim, a new policy is often only possible with a reservation. The notice of cancellation cannot be withdrawn.
• Forgetting the 14 days. Cover does not end immediately. Treatment up to the end of the 14 days is still insured; submit those invoices.
• Fearing that the insurer will cancel. In supplementary health insurance, the insurer may not cancel because of a claim. If you nevertheless receive such a cancellation, contact the insurer and the Office of the health insurance ombudsperson.
• Including basic health insurance. Cancellation after a claim does not apply to basic health insurance; only the deadlines under Art. 7 KVG count there.

How we build deadlines and examples is explained under how we calculate.