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Less objections and legal complaints in the basic health insurance

• Number of contradictions and lawsuits dropped in 2018
• The number of objections in joint facilities has declined by 2.5 percent
 
10 Jan 2019 | Press Release No. 3

In 2018, 600,000 objections and 105,100 complaints were filed in the legal area of SGB II. That was 39,000 contradictions or 6,400 fewer lawsuits than in 2017. During the same period, the number of persons entitled to benefits also fell by 262,000 to 5.8 million.

Objections and legal complaint numbers are low

The rate for oppositions and complaints can only be determined for the 302 joint institutions - i.e. job centers, which are jointly managed by the BA and the municipality. In 2018, these have sent 20.3 million service notifications. On the other hand, 498,000 contradictions and 84,600 complaints were filed. Calculations show therefore that an objection was put in against a maximum of 2.5 percent of the decisions. This is related to the fact that several objections against a decision can be filed. The quota is therefore oversubscribed. About 0.4 percent of the decisions were filed.

Reasons for contradictions and complaints

Data for contradictory reasons are available for all Job Centers - i.e. both for the joint institutions with BA participation and for the municipal job centers. About one fifth of the objections are directed against cancellation and reimbursement notices. These notifications are sent out if, for example, incomes incur in varying amounts and the entitlement to benefits has to be recalculated. Most objections are filed against these decisions.

In places two and three, there are notices of crediting income and property as well as approved accommodation costs. The reasons for these are, above all, the extremely complex legal situation and the sometimes different case law across the federal states, which leads to legal uncertainty. The objections against sanctions are relatively small with a share of seven percent.

Complaints are also most frequently filed against cancellation and reimbursement claims. This is followed by lawsuits against the approved costs of accommodation and the crediting of income as well. Lawsuits against sanctions are rare with a share of four percent.

Completed objections and complaints

The job centers decided on about 611,800 contradictions last year. Almost two thirds of all contradictions were rejected by the job centers last year or withdrawn by customers. Around 214,000 contradictions were granted in whole or in part. Of these, nearly 40 percent of the documents subsequently submitted, which had not previously been submitted to the job center, led to a new decision. With one third of the awards - but not one third of the contradictions - the decision was changed because the law was misapplied.

Last year, around 110,300 cases were finalised. About 60 percent were rejected or withdrawn by the plaintiff, 40 percent of the lawsuits led to a new decision. Most are handled without judgment - often because so far missing documents were filed during the lawsuit. Of the 110,300 completed lawsuits, only 8.5 percent were granted by ruling or resolution.