EPISODE · Feb 3, 2022 · 50 MIN
Roman Rittweger: Insights on building a winning HealthTech startup in Germany
from Scouting for Growth · host Sabine VdL
On this episode, Sabine VdL interviews Roman Rittweger, founder and CEO of Ottonova – a digital health insurance provider for individual patients and self-employed people. Today, seven+ years after it was started, Ottonova has over 100 employees and has deployed a marketplace (or an end-to-end platform) that helps users register for and access health insurance coverage for medical services. By 2022, the team had raised over $145 million in Series E. Some of its investors include great names such as Early Bird Venture Capital and Seven Ventures. KEY TAKEAWAYS Health insurance is one of the most complicated types of insurance to build. People asked me why I wanted to do this, build a HealthTech InsurTech, and why I wouldn’t just want to be a service provider for a health insurance company. My answer is that I had already been a service provider, and I didn’t enjoy it much because you can’t steer the business your way. I wanted to be able to design the tariff, be the customer’s partner, make the sale at the very beginning of the engagement, manage the customer, make them really happy, and save costs at the end for all the parties involved. To do this, you need to have the whole package. We work in two ecosystems: the insurance ecosystem, where we are the most modern player in Germany, and the financial services ecosystem, where we have the highest net promoter score (67, where the number two has 34). At the same time, we sell our software in Germany and get into other areas and other ecosystems, like life insurance, where we’re starting to sell products and software to other health insurance providers. I definitely see that the lines between health and wellness are blurring. We have created a HealthX Club where, in exchange for participating in our market research, we give our users bonus points to spend on their Apple Watch, fitness club, meditation app, etc. The German customers are insured with us, and we want them to stay healthy. Also, we’re starting to work with partners in the fitness field, and even in cosmetics and dental as we figure out if we can add an insurance part to their product. As we’re digital and relatively agile, it’s very easy for us to build that for them. Our VCs were very shocked by the amount of regulation and the number of people we had to bring on board to become compliant and obtain our insurance licence. They were also shocked by the amount of money we had to invest. After a while, we began looking for other ways to bring financing into the company. We had to go via new routes, including refinancing. Note that German investment leaders are not tech-savvy, so they invested with us to learn from us. We know that corporate venturing (or the stage where corporates want to partner and invest) will always be there for companies like ours because it is part of the stages of any industry-led startup growth process. BEST MOMENTS ‘I had to wait for the right time and have a little bit of luck as well to start Ottonova. This took me 10 years.’ ‘Finding the right customer was the only easy part!’ ‘We ask our customers what they want because what you think they might want isn’t what’s important for them. Here is an example: rather than getting medicine delivered by drone before they need it, they’d prefer bills to be paid within 24 hours rather than 48 hours. Understanding such nuances is truly understanding your customers' needs.’ ‘In our case, our direct chat and the service we provide day-to-day is actually much more important for our customers than the ‘sexy’ telemedicine engagement platform we created – we haven’t seen a big uptake in that for instance yet.’ ABOUT THE GUEST Roman Rittweger is a doctor by training, though he didn’t practice medicine for long. He worked as a consultant at the macro level of healthcare and insurance, focusing on the customer and how to provide a better experience for them, and on making it more affordable by steering customers towards the right kind of medical care. His first startup was a medical provider for health insurance, helping the insured population find the right physician or manage their chronic diseases. He sold this company to Germany’s largest private health insurer at the time and became a consultant again. He learned about marketing and sales because he’d realised through his experience that this is the most important thing. He eventually began looking for the next big area where he could start more startups, and six years ago, he sold his consultancy and jumped into the world of digital health insurance, founding Ottonova. ABOUT THE HOST Sabine VanderLinden is a corporate strategist turned entrepreneur and the CEO of Alchemy Crew Ventures. She leads venture-client labs that help Fortune 500 companies adopt and scale cutting-edge technologies from global tech ventures. A builder of accelerators, investor, and co-editor of the bestseller The INSURTECH Book, Sabine is known for asking the uncomfortable questions—about AI governance, risk, and trust. On Scouting for Growth, she decodes how real growth happens—where capital, collaboration, and courage meet. If this episode sparked your thinking, follow Sabine VanderLinden on LinkedIn, Twitter, and Instagram for more insights. And if you’re interested in sponsoring the podcast, reach out to the team at [email protected]
What this episode covers
If you want to redesign health insurance, you can’t sit on the sidelines. You have to own the whole system. In this episode of Scouting for Growth, Sabine VanderLinden speaks with Roman Rittweger, Founder and CEO of Ottonova, one of Europe’s most ambitious digital health insurers—and a masterclass in what it really takes to build end-to-end innovation in a heavily regulated industry. Roman is unequivocal: health insurance is one of the most complex products you can build. That complexity is precisely why he chose not to remain a service provider to insurers—but to become the insurer himself. Control matters. To truly improve customer outcomes, you must be able to design the tariff, own the relationship from day one, manage the experience end-to-end, and optimise costs for all parties involved. That decision came after 10 years of preparation. Seven years into the journey, Ottonova has grown to 100+ employees, raised over $145M by Series E, and built a fully digital marketplace that allows individuals and self-employed customers to register, manage, and access health insurance seamlessly. In Germany’s traditionally conservative insurance market, that alone is a statement. But Roman goes further. Ottonova now operates across two ecosystems: As the most modern player in German health insurance As a software and platform provider within broader financial services and adjacent insurance verticals With a Net Promoter Score of 67—double that of the nearest competitor—Ottonova demonstrates what happens when customer needs, not technology hype, drive product decisions. One of the most revealing parts of the conversation? Roman’s insistence on listening before building. Customers didn’t want drones delivering medicine faster. They wanted bills paid within 24 hours. They valued reliable chat-based service more than flashy telemedicine tools. These nuances, Roman explains, are where real differentiation is created. The episode also offers a rare, honest look at funding realities in regulated markets. Roman shares how investors initially underestimated the cost, compliance burden, and operational weight of becoming a licensed health insurer. That reality forced Ottonova to explore alternative financing routes, including refinancing—and highlighted why corporate venturing and partnerships become inevitable growth stages for industry-led startups. Looking ahead, Roman sees health, wellness, and insurance converging fast. From fitness and wearables to cosmetics and dental partnerships, Ottonova is experimenting with embedded insurance models that reward healthy behaviour—enabled by digital agility incumbents simply can’t match. You’ll learn: Why full-stack ownership matters in complex industries How customer insight beats “sexy” tech every time What investors often underestimate about regulated innovation Why corporate partnerships are not optional—but structural This episode is essential listening for anyone building in health, insurance, or regulated ecosystems. 🎧 Tune in—and ask yourself: are you optimising part of the system… or designing the whole experience around the customer?
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Roman Rittweger: Insights on building a winning HealthTech startup in Germany
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