Insurance claims: BaFin generally expects processing to be completed within one month

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In recent months,
BaFin has received a large number of complaints from consumers about very long processing times for claims. Under the requirements of civil law laid down in section 14 (1) of the Insurance Contract Act ( Versicherungsvertragsgesetz – VVG ), insurers are liable to pay cash benefits when they have concluded the enquiries necessary to ascertain whether an insured event has occurred and the extent of the benefit. “Enquiries necessary” refers to all measures that an insurance undertaking of average diligence must undertake to conclusively determine whether it is liable and to what extent. Such reviews also include a certain period of consideration for the insurer.

02.09.2025

Therefore, if the insurer has obtained all the information requested from the policyholder and no other objective reasons for refusing to pay benefits are apparent, the payment must be made without undue delay.

In accordance with section 294 (2) of the German Insurance Supervision Act ( Versicherungsaufsichtsgesetz – VAG ), BaFin monitors compliance with the laws applicable to the pursuit of insurance business and also ensures that the interests of the insured are sufficiently safeguarded. Under section 294 (3) of the VAG , the objective of legal supervision is, in particular, the proper operation of insurance business, including compliance with supervisory provisions, regulations governing insurance contracts and any other provisions concerning the insured. Within this framework, the following applies:

Insurance undertakings must organise their business operations in such a way that they comply with legal requirements (effective and proper business organisation). Proper business organisation within the meaning of section 23 (1) sentence 1 of the VAG also includes, in particular, ensuring that the claims to which the policyholders and beneficiaries are entitled can be met in good time, i.e. without undue delay after conclusion of the necessary enquiries. Therefore, a lack of personnel resources or an increase in the volume of claims cannot constitute grounds for any persistent delays in the processing of claims.

With the relevant case law taken into consideration, BaFin assumes that the necessary enquiries for an insured event of an average nature are completed within one month of the event being reported, provided that the policyholder fully complies with their obligations to cooperate. BaFin therefore expects that insurers will generally complete the processing of claims that consumers submit to them within one month at the latest.

When reviewing whether the conditions for the payment of benefits have been met in more complex cases, such as those involving personal injury, insurance undertakings may, for example, have to obtain and review information from experts’ reports, medical examinations, site inspections or official investigations or await the outcome of criminal proceedings.

In such cases, processing times for claims in excess of one month may also be appropriate.

If irregularities arise due to delays in the payment of benefits, BaFin may, on the basis of section 298 (1) of the VAG and exercising due discretion, take any action that is appropriate and necessary to prevent or remedy irregularities. An irregularity is any conduct that conflicts with the supervisory objectives under section 294 (2) of the VAG .

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