German law allows health insurers to charge customers extra fees when they can’t make do with the money doled out for each customer by the government’s central statutory health care fund. In early 2010, more than a dozen health insurers began charging their members such fees, which top out at €37.50 per month.

In March, hundreds of thousands of Germans reportedly began switching health insurers to avoid such fees, but some have apparently opted to simply not pay, according to a poll by daily Bild.

Depending on the health insurer, up to 30 percent of customers have not paid their share of the recent increases, the paper said.

Some 10 percent of the 4.6 million people covered by popular insurer DAK have yet to make the payment. And insurer KKH-Allianz still has outstanding payments from just over 10 percent of its insured.

The highest rate of failed payments belongs to BKK, where some 30 percent of customers have ignored the extra fees. Currently BKK is encouraging payment via letter and telephone, the company told Bild.

Germany’s public health care system instituted a new universal premium in January 2009. Set at 15.5 percent of an individual’s gross pay, it has turned out to be insufficient to cover the budgets of many of the country’s statutory insurers, thus the extra fees.

Switching insurers may not help customers avoid extra fees for long, though.

In March Health Minister Philipp Rösler said he plans to tack a monthly per capita premium of €29 on health insurance beginning in 2011 to make up for chronic deficits. The fee would be paid by every person who is publicly insured, meanwhile employers and employees would continue to pay equal parts of insurance fees.

According to Health Ministry estimations, public insurers face a deficit of around €11 billion for 2011 due to the flagging economy.