As soon as we receive your objection, the administration will first review your request on behalf of the Executive Board. This is to clear up any obvious misunderstandings, for example. Your objections or new documents will be reviewed again and, if necessary, an expert will be consulted.

If the administration is able to remedy your objection, you will receive a positive decision (approval).

If the requirements are still not met, the case will be processed and forwarded to the office of the Appeals Committee. This office will review the case again and then submit it to the Appeals Committee for a decision at the next meeting. You will then receive an appealable notice of appeal.

To cut a long story short... nothing! The appeal procedure is free of charge for you. However, if you seek external help, the reasonable costs will only be reimbursed if you are successful in your appeal.

Of course, we are not in a position to judge this. Even if we can understand your concerns in principle, we are bound by legal requirements and must also reject applications if these are not met. However, we recommend that you read your decision carefully and contact us if necessary. Perhaps we have not received the necessary evidence or we can offer alternatives. In any case, you will receive an explanation of our decision and the background to it.

It may also be worth having the decision checked by a third party (lawyer, pension consultant, social association, trade union, etc.) beforehand. Please note, however, that this may involve costs for you.

We would like to point out that the Medical Service is an independent body under public law and that we have no influence on the content of its assessments. In such cases, we refer you to the ombudsman www.plv-ombudsmann.de at the Medical Service and ask you to contact them. We do not employ medical experts and cannot prepare or conclusively evaluate medical reports.

You have 1 month after notification to lodge an objection. We strongly recommend that you comply with this deadline in order to avoid any legal disadvantages.

We have two employer representatives and two employee representatives on the Appeals Committee. They are subject to strict data protection and perform their duties on a voluntary basis. They are not employed by ZF BKK / Pflegekasse der ZF BKK, but come from the administrative board (self-administration) of your BKK.

We have formed 4 appeal committees at ZF BKK / Pflegekasse der ZF BKK. The background to this is that, in your interest, no appointment (for whatever reason) should be canceled.

Every first Thursday of the month (if this falls on a public holiday or is canceled; the replacement date is exactly one week later) 2 committees always meet.

Each committee receives cases from the ZF BKK (health insurance fund) and from the ZF BKK long-term care fund for a decision.

The meetings are held in camera.

We are required to decide on your objection within 3 months and will do our utmost to meet this deadline. Please remember, however, that we can only review your case once you have submitted all documents / objections. Should it take longer, please contact us and ask about the status of your objection.

Filing an objection is very simple, but there are still a few rules to follow. We will show you the options.

• As a rule, you submit the objection in writing and sign it (please do this yourself).
• You can also submit the objection in writing. This means that you visit us or one of our offices and inform one of our employees of your objection. They will write down the objection for you and ask you to sign it.
• You can submitan objection via our ZF BKK ServiceApp. No signature is required here as you are already registered.
• You have the option of using the electronic mailbox for citizens and organizations (eBO). You can find information on eBO here.
• You can have the objection lodged by any body that is authorized to provide legal advice (lawyers, social associations, trade unions, pension consultants, etc.)

However, please ensure that you adhere to the deadlines and observe the above-mentioned formal requirements. Ultimately, this is a preliminary judicial procedure.

However, it is quite possible to file an objection on the merits first and then submit the grounds later. This allows you to check your documents and obtain advice without time pressure.

You cannot no object by telephone or e-mail. Nor can any third party lodge an objection on your behalf without appropriate authorization from you.

Documents, certificates, hospital records, powers of attorney, etc. are often missing, as is your personal description of the circumstances. We therefore strongly recommend that you obtain an overview in advance and discuss the matter with your doctor, medical practitioner, tax consultant, etc. and submit everything that could help your case. Please bear in mind that we use the Medical Service as our medical expert and that they must obtain a comprehensive overview in order to be able to make a proper assessment of your case.

Our appeals procedure is designed in such a way that you can take action yourself. You are welcome to ask your relatives or trusted persons to help you. However, please remember that a written objection must be signed by you and that the above-mentioned deadlines apply.

Even if the objection is directed against us, we will be happy to help you with the formalities and explain all the steps of the procedure to you.

If you have granted a corresponding power of attorney or a legal guardian has been appointed for you, these persons can of course act directly on your behalf. However, they must prove their legitimacy (documents).

Of course, you can also have a licensed legal advisor (lawyer, pension consultant) or social associations/trade unions etc. act on your behalf. However, in your own interest, please clarify the question of costs in advance.

Please remember that minors are represented by their parents or a guardian. As a rule, all legal guardians must sign an objection. However, applications for social benefits can also be pursued by persons who have reached the age of 15.

Do you need help and are unable to follow the procedure yourself? Please contact us, we will help you and advise you on the options available.

Your case will be discussed at the appeal meeting and a new decision will be made (see above).

• The Appeals Committee can remedy your appeal, i.e. you will receive a positive decision and the administration will implement it promptly.
• The Appeals Committee can partially resolve your appeal. In this case, you will also receive a decision and the administration will promptly implement the positive part.
• It is possible that the Appeals Committee will have further questions and will ask the administration to clarify them. This is regularly done in your interest and we ask for your patience.
• The Appeals Committee cannot remedy your appeal. In this case, you will receive a negative decision that is subject to appeal.

In any case, you will be informed of your further rights and we also consider an action before the social court to be a legitimate means of obtaining your rights. We would also like to point out that appeals to the social court are generally free of charge for you. The applicable deadlines and the competent social court will be indicated with each notice of objection.

As already mentioned, none of us will ask you to withdraw your objection. However, should you come to the conclusion that the rejection was justified (e.g. due to a new medical report etc.) or that the matter has been settled in some other way, you can inform us of this briefly in writing. This will save us some work.

Please remember your data protection.

We comply with data protection regulations at all stages of processing and are subject to supervision by the Federal Commissioner for Data Protection and Freedom of Information and the Federal Social Security Office. Our in-house data protection officer ensures that your data is protected. However, this is of no use if we receive personal data (certificates, medical reports, expert opinions, etc.) by e-mail, for example. Please use the regular postal service or hand in the documents to us. You are also welcome to use our ZF BKK Service App.