Appeal against the decision on the degree of care

The PDF document is always created in German, regardless of the selected page language, as this is sent to German health insurance companies.

Please use only Latin alphabet characters (A–Z, a–z, 0-9) for inputs.

Sender

Surname, first name

Street, house number

ZIP CODE

Location

Receiver

e.g. AOK Bayern - Die Gesundheitskasse

Recipient Street, house number

ZIP CODE

Recipient location

Please take this information from the letter of refusal from the long-term care insurance fund.

File number

e.g. 45.123456.002025XY

Insured person number

e.g. A123456789

Decision from

Appeal against the decision on the degree of care

Ladies and Gentlemen,

We would like to inform you that we have lodged an objection against your above-mentioned decision within the deadline.

We are of the opinion that the decision is not correct.

We request that you review the decision and send us the expert opinion on the basis of which the decision was made.

I will submit the reasons for my objection later.

Please confirm receipt of this letter.

Thank you in advance for your support.

Yours sincerely

Date

X Please sign here

Signature of applicant or authorized representative

E-Mail:

Phone

Menu

Sender

Receiver

Appeal against the decision on the degree of care

Any questions?
We are here for you!

First of all, use our information area with valuable tips and further information on topics such as care level, quality of care aids, changing the order and much more.

Of course you can also send us an e-mail with your request.
We will get back to you as soon as possible.

200+

450+

1000+

1000+

E-Mail:

Phone

Menu

Sender

Receiver

Appeal against the decision on the degree of care

Any questions? We are here for you!

First of all, use our information area with valuable tips and further information on topics such as care level, quality of care aids, changing the order and much more.

Of course you can also send us an e-mail with your request.We will get back to you as soon as possible.

200+

450+

1000+

1000+

Any questions?
We are here for you!

Of course you can also send us an e-mail with your request.
We will get back to you as soon as possible.