Austrian OGH Ruling: Health Insurer May Convert Children’s Premiums to Adult Premiums

Oct 29, 2026 Benn-Ibler Rechtsanwälte

In a judgment dated 17 September 2026, the Austrian Supreme Court (Oberster Gerichtshof, hereinafter OGH) held that, in certain circumstances, private health insurers may convert children’s premiums to adult premiums. According to the OGH, a corresponding term in the insurance contract is valid.

Dispute concerning conversion of insurance

The proceedings arose from a private health insurance policy taken out by a mother for herself and her three daughters. The policy included both upgrade hospital coverage and supplementary dental insurance. The insurance terms provided that insured children would, as a rule, become liable for adult premiums upon attaining the age of 18. Under the upgraded hospital tariff, the children’s premium could, subject to certain conditions, be extended until the age of 25. No such extension was available under the supplementary dental coverage.

The mother objected to this arrangement and brought proceedings against the insurer. She contended that the contractual term lacked sufficient transparency and that the insurer was therefore not entitled to convert her daughters’ premiums to adult premiums. The insurer, by contrast, maintained that the term was unambiguous and that the adult premium was determined by reference to the tariff agreed in each case.

OGH confirms validity of the contractual terms

The lower courts dismissed the claim, and OGH upheld their decisions. In the Court’s view, the term was sufficiently intelligible to a reasonably well-informed policyholder. The conversion was triggered by the age of the insured children and was determined by reference to the agreed tariffs or comparable successor tariffs. The Supreme Court also held that the term did not contravene section 178f of the Austrian Insurance Contracts Act (Versicherungsvertragsgesetz).

Austrian Supreme Court (OGH) Ob 94/26p (17 September 2026)