Kindernachversicherung

What is the Kindernachversicherung?

The Kindernachversicherung is a statutory guarantee in § 198 VVG and the standard insurance terms § 2 Abs. 2 MB/KK: a newborn can be added to a parent's PKV contract without a health assessment, without risk surcharges, and without waiting periods. The cover begins on the day of birth and is retroactive if the application arrives within two months.

For parents in the PKV it is one of the most important features of the system. Without it, a newborn with a congenital condition could face rejection or heavy surcharges on their first policy. With it, the child enters the PKV on the same terms as a completely healthy baby.

The three conditions

All three must be met:

• One parent has been insured with the same insurer for at least 3 months on the day of birth. The three months are measured backwards from the birth date, not from the application date.

• The child is registered within 2 months of birth. The application must reach the insurer within that window. Cover is applied retroactively from the birth date.

• The child's coverage is not higher than the insured parent's. You cannot use the Kindernachversicherung to sign a child into a premium tariff if the parent holds a basic one. The child's tariff must be at or below the parent's level.

What is covered

A child insured through the Kindernachversicherung receives full PKV cover as defined by the chosen tariff, outpatient, hospital, dental, medication. The tariff's waiting periods (typically 3 months general, 8 months for dental and maternity) do not apply to Kindernachversicherung cases.

Most tariffs also include congenital conditions (angeborene Geburtsschäden) in scope. The AVB (Allgemeine Versicherungsbedingungen, the general policy terms) clauses vary: some tariffs have an explicit clause confirming it, others argue that "insurance begins at birth and the insured event arises after birth, so no pre-existing condition applies". A small number of tariffs have been observed in the past to omit the explicit clause, worth checking before the birth, not after.

The 2-month deadline

Missing the window has serious consequences. The child is not automatically covered as of a later application; instead, the parents must file a regular PKV application for the child, which means:

• Full Gesundheitsprüfung at the child's current health state

• Possible risk surcharges or rejections for any diagnosed condition

• Waiting periods apply

• In the worst case (e.g. a congenital condition identified at birth), the child may not be insurable at all in normal tariffs, only the Basistarif may remain open

For a healthy baby the difference is cosmetic. For a baby with a serious condition the difference can be life-shaping.

Practical tips

• Ask the insurer early. Many insurers accept a pre-notification (Schwangerschaftsmeldung) during pregnancy that flags the pending Kindernachversicherung. That speeds up the paperwork after birth.

• Include a copy of the Geburtsurkunde or Geburtsanzeige. The insurer needs proof of date of birth.

• Decide on the child's tariff before birth. The child can be placed in any of the parent's tariff tiers up to the parent's level. Think through what scope you want before the clock starts.

• Check the AVB for the congenital-condition clause. If you are still choosing a tariff, this is a meaningful differentiator.