Insurance application

What is an insurance application?

An insurance application is the form you use to tell a health insurer that you want to enter into a contract. In health insurance, this concerns supplementary insurance, for example supplementary hospital insurance for the semi-private ward, supplementary outpatient insurance or dental insurance. These contracts are governed by the Insurance Contract Act (ICA, VVG in German), not by the Federal Health Insurance Act (KVG).

Legally, the application is an offer from you to the insurer. The contract is only concluded when the insurer accepts the application, usually by sending you the policy. Until then, it checks your information and decides whether to insure you on the terms quoted, with a reservation, with a premium surcharge or not at all. An application is usually preceded by a quote: it shows the product, the benefits and the premium, but does not commit you to anything.

At the heart of every application for supplementary health insurance is the health questionnaire. The insurer wants to know which illnesses, accidents, treatments and medicines you have had in recent years. It uses your answers to assess the risk.

In basic health insurance, there is no application in this sense. You do register with an enrolment form, but the insurer must accept every person required to take out insurance within its area of operation, without a health check. That is why you can choose any insurer for basic health insurance; the premium calculator shows the premiums of all insurers.

How it works

The path from application to contract follows fixed deadlines:

1. Information before the application. The insurer must first inform you in text form about the insured risks, the scope of cover, the premium, the term, termination, data processing and your right of withdrawal. You must already have the General Insurance Conditions (GIC, AVB in German) in hand when you apply.
2. Filling in the application. You answer the health questionnaire, give your personal details, the product you want and the start date of cover, and sign the application or confirm it electronically.
3. Period during which you are bound. From the moment you hand it over or send it, you are bound by the application for 14 days. If the insurer requires a medical examination, it is four weeks. You can also set the insurer a shorter deadline for acceptance.
4. The insurer’s decision. If the insurer accepts, you receive the policy. If the acceptance does not reach you within the deadline, you are free and can take out insurance elsewhere.
5. Right of withdrawal. For 14 days from the application or the acceptance, you can withdraw without giving reasons. It is enough to notify the insurer of the withdrawal, or hand it in at the post office, on the last day.

If you withdraw, the application is void from the outset. You get back any premiums you have already paid. If the insurer carried out special investigations in good faith, such as a medical examination, it can ask you to pay all or part of these costs if that is fair.

A special case is an application to amend or extend an existing contract. If the insurer does not reject it within 14 days of receipt, it is deemed accepted; if the GIC require a medical examination, the deadline is four weeks. This does not apply to an application to increase the sum insured.

Legal basis

The rules on the application are set out in the ICA. Insurers may not change some of them to your disadvantage (Art. 98 ICA lists, among others, Art. 1 to 3a and Art. 6).

• Art. 1 ICA: you are bound by the application for 14 days, or four weeks if a medical examination is required (paras. 1 and 2). The period starts when you hand over or send the application (para. 3). If the acceptance does not arrive in time, you are released (para. 4).
• Art. 2 ICA: an application to amend or extend an existing contract is deemed accepted if the insurer does not reject it within 14 days (four weeks if a medical examination is required).
• Art. 2a and 2b ICA: right of withdrawal of 14 days from the application or the acceptance, in writing or in text form. The withdrawal makes the application void from the outset; any benefits received must be refunded.
• Art. 3 and 3a ICA: the insurer’s duty to provide information before the contract is concluded. If it breaches this duty, you can terminate the contract within four weeks of finding out, and at the latest two years after the breach.
• Art. 4 ICA: duty of disclosure. You must disclose all material risk factors that the insurer asks about in writing and that you know or should know. Anything asked in a specific and unambiguous way is deemed material.
• Art. 6 ICA: consequences of a breach of the duty of disclosure. The insurer can terminate the contract within four weeks of finding out and no longer has to pay for claims connected with the concealed fact.

For basic health insurance, by contrast, Art. 5 let. i of the Health Insurance Supervision Act (KVAG) applies: the insurer must accept every person required to take out insurance within its local area of operation.

Example: deadlines for an application in October

Lea is 29 and wants supplementary hospital insurance for the semi-private ward from 01.01.2027. She sends the application with the completed health questionnaire by post on 02.10.2026. The insurer does not require a medical examination.

What this means for you

Plan an application for supplementary insurance early enough. The insurer checks your health questionnaire, and if a medical examination is needed this takes up to four weeks. If you want to replace existing supplementary insurance, only cancel the old one once the new insurer has accepted your application. Otherwise, in the worst case, you are left without cover because the new insurer refuses or adds a reservation.

These questions help you fill in the form:

1. What exactly is being asked? Answer each question for the period stated. Use your insurer’s statements of benefits; they list doctor’s appointments, therapies and medicines.
2. Are you unsure? It is better to state the treatment and describe it briefly. Leaving it out can later lead to termination.
3. Do you have a copy? Keep the completed application, ideally as a PDF in your account. In a dispute, what counts is what you actually answered.
4. Is the product right for you? Compare benefits and premiums before you sign, in the comparison of supplementary insurance and in the health insurer profiles.

You switch basic health insurance independently of this. For that, you do not need an application with a health questionnaire, only a notice of cancellation sent on time; the dates are listed under deadlines. If you would like help filling in the form, you can request advice.

Common mistakes

• Cancelling the old supplementary insurance too early. Until the new insurer has accepted, you have no commitment. A notice of cancellation, on the other hand, cannot be undone.
• Answering the health questionnaire from memory. Many people forget short therapies or one-off examinations. The statements of benefits show what was billed.
• Confusing the application with the quote. The quote does not commit you to anything; the application binds you for 14 days or four weeks.
• Calculating the withdrawal period incorrectly. If you submit the application, the period starts with the application, not only with the policy. Only if the insurer offers you the contract and you accept does it start with your acceptance.
• Believing that basic health insurance checks your health. In basic health insurance, there is no health check and no reservation.

We explain how we present insurers and products under How we calculate.