In the past, some insurance companies have refused to reimburse Invisalign treatment, either because it was not medically necessary or because there was no individual indication. Sometimes these insurance companies produced medical opinions from so-called consultant dentists to support the refusal of the insurance companies.
In the meantime, the first court proceedings and expert assessments have been completed, which ultimately recognize the Invisalign procedure as conventional medicine in the interests of patients, with the corresponding obligation for the insurance company to bear the costs. In extension of the DGKFO's catalog of indications from January 2004, the treatment of children is now also recognized if a certified orthodontist approves this. Corresponding court opinions have also clarified that treatment may be indicated not only for cosmetic reasons, but also for medical reasons, even in the case of minor misaligned teeth. Finally, it should be emphasized that when assessing whether you are entitled to reimbursement of costs for Invisalign treatment, you can claim that only a certified specialist orthodontist will make the relevant findings.
From all of this, it is clear that the rejection practice of the insurance companies mentioned was at least highly questionable in the past and would no longer be the case today. In fact, Invisalign treatment is now regularly recognized and regulated in accordance with the tariff provisions.
This communication is being made on behalf of an interest group consisting of patients, users and other supporters of the procedure. It is necessary because it can now be proven that the blanket rejection of your orthodontist's treatment efforts as allegedly "medically unnecessary" was itself not medically justifiable.
File number: 14 S 388/03 + 2 C 652/03
