What happens if you are not insured? Avoid risks and cost traps
20 Apr 2025
8
Minutes
Katrin Straub
CEO at nextsure
Lack of insurance coverage can quickly become a financial nightmare. Many underestimate the serious consequences that range from high back payments to personal liability. Find out what happens when you are uninsured and how you can avert existential threats.
The topic in brief and concise terms
Missing health insurance leads to high back payments and limited medical care; emergency treatments often have to be paid out of pocket.
Driving without motor vehicle liability insurance is a criminal offense that carries substantial fines or prison sentences and personal liability in case of accidents.
Although usually not legally required, personal liability insurance protects against potentially devastating compensation claims at a low annual cost.
Legal Essentials: Which Insurance is a Must?
In Germany, the legislator mandates certain insurances to protect citizens from existential risks. The obligation to have health insurance has been anchored in the Insurance Contract Act (§ 193 para. 3 VVG) since 1 January 2009. Everyone residing here must have health insurance. Lack of coverage is not a criminal offence, but it does lead to back payments. For vehicle owners, motor vehicle liability insurance is essential according to § 1 of the Compulsory Insurance Act (PflVG). Driving without it constitutes a criminal offence. These obligations highlight that the state demands basic protection. The next section demonstrates the specific consequences of gaps in health insurance coverage.
Health Insurance Gap: An Expensive Health Risk
Those who are not insured risk significant financial burdens. The average medical costs per person were already around five thousand one hundred and ninety euros in 2020. Without insurance cover, these costs must often be borne personally. Although emergency treatment is guaranteed, the bill follows. Particularly severe are the back payments for the time without insurance. These can quickly add up to several thousand euros, as contributions are due for each month of non-insurance, starting from 1 April 2007 for statutory health insurance. For example, those who were uninsured for two years must expect significant demands. The mandatory health insurance in Germany is therefore an important protective mechanism. In cases of payment difficulties despite existing insurance, the range of services is often reduced to emergencies, for those privately insured, a switch to the emergency tariff occurs, which costs about one hundred euros per month. The consequences of surgery costs without insurance can be life-threatening. Next, we will look at the risks in road traffic.
On the Road Without Protection: Severe Penalties in Traffic
Driving without valid motor vehicle liability insurance is not a minor offence, but a criminal act according to § 6 PflVG. The penalties are severe: fines of up to one hundred and eighty daily rates or imprisonment for up to one year. A daily rate typically corresponds to one thirtieth of the net income; for three thousand euros net, this would be one hundred euros per daily rate. Additionally, up to six points in Flensburg, a driving ban, or the withdrawal of the driving licence may follow. If an uninsured driver causes an accident, both the driver and the owner are liable for all resulting personal, property, and financial damages. In the case of severe personal injuries, this can quickly amount to costs in the millions. The question "Car not insured by me, accident – what now?" then becomes particularly tricky. Riding an uninsured motorcycle or scooter incurs the same penalties. Even if you unknowingly drive without insurance cover, for example, due to a coverage gap after cancellation, it is punishable. Every vehicle owner should be aware of which compulsory insurances exist. However, financial risks lurk not only in traffic, as the next section on liability shows.
Everyday Liability Trap: When Personal Liability Insurance Is Missing
A private liability insurance is in Germany, unlike health or car insurance, usually not a legal requirement. Nevertheless, it is one of the most important protections available. According to § 823 of the German Civil Code (BGB), everyone is liable for any damage they cause to others – and with their entire assets, without limit. A brief moment of carelessness can lead to claims worth millions, for example, if someone becomes permanently disabled due to your fault. The cost of liability insurance is comparatively low, often under one hundred euros annually for the whole family. Without this protection, causing damage can mean financial ruin. Think of the wine stain on a friend's expensive sofa – a minor damage. But what if you, as a cyclist, cause a serious accident with personal injury? The necessity of liability insurance is evident. There are also specific regulations for pet owners, as the question "Must a dog be insured?" shows. To minimise such risks, we provide expert tips below.
Expert advice: Proactively close insurance gaps
Proactive measures are crucial to protect oneself from the serious consequences of lacking insurance. Regularly reviewing your insurance coverage is the first step. Our expert tip: Create a list of your existing policies and compare them with legal requirements and your individual risks. If you have uncertainties regarding the obligation to have health insurance, you should promptly contact your last health insurance provider or a clearing office. For private health insurance, the rule is: If you have once been privately insured, you must usually remain privately insured. In times of financial difficulty, reach out to your insurer; often, installment payments or temporary adjustments to contributions can be arranged to maintain coverage. For car insurance, it is important to ensure insurance coverage before purchasing or using a vehicle. The eVB number is proof for this. Also, consider accident insurance, which is usually not mandatory but often advisable. Comprehensive advice can help identify and close coverage gaps. Nextsure offers an individual risk analysis for this purpose. This helps you avoid unpleasant surprises, such as those that may occur with occupational disability without insurance.
Here are some specific recommendations for action:
Assess your insurance needs annually, especially during life changes like relocation, marriage, or job change.
Keep your contact details up to date with insurers to receive important notifications, e.g., about changes to contributions or impending loss of insurance coverage, in a timely manner.
Use comparison portals and advisory services to find the most suitable and cost-effective protection for you.
Document all insurance contracts and store them securely, ideally digitally as well.
Inform yourself about deadlines for back payments; for statutory health insurance, contribution debts become statute barred after four years.
The final step is often the most important: making contact for a professional assessment of your situation.
The Path Back to Protection: Recommended Actions
If you find that you are not or not adequately insured, quick action is required. For health insurance, the rule is: Anyone who was last insured under statutory insurance should contact their old insurer; they must take you back. For those previously privately insured, returning to private health insurance (PKV), often initially in the basic tariff, is necessary. Our expert tip: Don't hesitate to discuss contribution debts with your health insurance provider. Arrangements for installment payments or deferrals are often possible. For car insurance, taking out coverage before your first drive is essential. Without an eVB number, there is no registration. A claim report with car insurance is straightforward when coverage exists. For all other areas, particularly important personal liability insurance, the rule is: Better to act today than tomorrow. The costs are low compared to potential damage. Consulting helps find the right tariffs and avoid pitfalls, such as the question "When doesn't comprehensive insurance pay?"
The following steps will help you concretely:
Determine your insurance status: Which policies do you have, and which are missing?
If you don’t have health insurance, contact your last insurer or a counseling center.
Take out car liability insurance immediately if you wish to use a vehicle.
Consider taking out personal liability insurance – it costs little and protects against significant risks.
Consult experts like nextsure to receive tailored coverage.
Comprehensive coverage provides you with security and protects against unforeseen financial consequences.
More useful links
The Federal Ministry of Health provides comprehensive information about statutory health insurance (GKV).
The Deutsche Ärzteblatt highlights in an article the often overlooked issue of people without health insurance in Germany.
The Consumer Advice Centre offers important advice on the significance of private liability insurance as an essential protection.
The Consumer Advice Centre Lower Saxony emphasizes the necessity of private liability insurance.
The Federal Statistical Office (Destatis) provides a press release with relevant statistical data.
The German Pension Insurance provides detailed information about the disability pension and its requirements.
Laws in the Internet offers the official legal text on the Motor Vehicle Insurance Act (PflVG).
The GKV Central Association provides comprehensive information about long-term care insurance.
FAQ
What are the worst consequences of not being insured?
The most severe consequences are high debts due to back payments (health insurance), coverage of treatment costs, legal proceedings, and heavy fines or imprisonment (car insurance), as well as unlimited personal liability for damages (lack of personal liability insurance), which can lead to financial ruin.
How quickly do I need to arrange health insurance?
As quickly as possible. Every day without insurance can increase the repayments and poses a risk of high treatment costs. Contact your previous insurance company or a counseling service.
Can I receive anonymous medical treatment if I am not insured?
In some cities, there are centres that offer anonymous and free basic emergency care, often operated by charitable organisations. However, these are mostly limited to initial examinations and acute emergencies.
What happens if I can't pay my insurance premiums?
In the statutory health insurance, entitlement to benefits is suspended except in emergencies, and penalty charges apply. In the private health insurance, you will be reclassified to an emergency tariff. Always seek to discuss with the insurer about payment arrangements.
Does the state cover the costs if I don't have health insurance?
No, fundamentally you must bear the costs yourself. Only in absolute emergencies is the treatment guaranteed, but the costs can be claimed. If you receive citizens' allowance or unemployment benefit I, contributions to statutory health insurance are covered or private health insurance is subsidised.
Which insurance is the most important one I should have?
In addition to the mandatory health insurance and, if applicable, motor vehicle liability insurance, private liability insurance is essential to protect yourself against high compensation claims.
