Das Verfahren vor dem Sozialversicherungsträger

In health insurance matters, the procedure always starts with a request for a benefit or service (for example, a request for reimbursement of costs, section 361(1) ASVG.
The requests can be submitted to any social security provider thanks to the so-called cross-divisional service. As a rule the factual and local competent social security provider shall conduct the procedure in accordance with the General Administrative Procedures Act (AVG).

At the conclusion of the procedure, the social security provider must render a decision on the request: the requested benefit will either be granted or the rendering of the service will be denied. The procedure before the social security provider must be concluded with an administrative settlement before the decision of the social security provider may be appealed.

If a health insurance benefit or service is requested, the social security provider is only obligated to issue a ruling if it denies the requested benefit either wholly or in part and if the claimant expressly demands a ruling (section 367 (1) line 2 ASVG; section 70 ASGG (Labor and Social Court Act))!

The procedure before the social security provider in benefits issues is concluded when the ruling takes legal effect. If you are not satisfied with the outcome of the ruling, you may contest it before the courts.