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Stand:updated on 26.07.2022 | Topic Consumer protection Private accident insurance

Accidents can happen in the blink of an eye, and you may be left with more than just an unpleasant memory. Statutory accident insurance only provides coverage for accidents that happen at school, at your place of work or vocational training, or on the way to these places. It does not provide coverage for accidents that happen in your free time, for example when you are walking your dog or cleaning your windows at home. This is where private accident insurance (private Unfallversicherung) comes in.

What is the purpose of private accident insurance?

Victims of accidents often have to bear considerable short-term or long-term financial burdens, for example as a result of long-term physical or mental impairment, or due to rescue operations. Private accident insurance provides protection for such financial losses by paying the agreed benefits in the event of an accident. The precise scope of benefits is defined in the general insurance conditions.

Your health insurance covers the cost of medical treatment, even in the event of an accident. But while health insurance covers the costs of treating acute injuries, private accident insurance provides cover for any resulting long-term physical or mental impairments.

What benefits does private accident insurance provide?

As the policyholder, you can agree with your insurer what benefits are to be covered and how high the sum insured should be. The most important benefit types that can be included in an insurance contract are set out below:

  • Invalidity benefit: invalidity describes the state in which a person’s physical or mental capacity is permanently impaired. In their terms and conditions, insurers normally understand permanent impairment to mean that the impairment is anticipated to last for at least three years and that no change to the insured’s condition is expected. The insurance benefit is based on the degree of invalidity or permanent impairment, which is assessed by a doctor and calculated as a percentage, and on the agreed sum insured.
  • Benefit in the event of death
  • Accident pension (Unfallrente)
  • Daily allowance, daily hospital allowance, convalescence allowance
  • Transitional allowance: before the accident insurer pays any benefits, the degree of invalidity must be determined, which can take some time. A transitional allowance can be agreed so that the insured does not encounter any financial difficulties during this time. In the event of an accident, this is paid immediately, before the degree of invalidity is determined.
  • Costs of search, rescue or recovery operations
  • Plastic surgery

Who needs private accident insurance?

Private accident insurance is voluntary. The policyholder is normally free to negotiate the contents and scope of their insurance policy.

Accident insurance can be taken out by anyone who wants to protect themselves financially against the risk of an accident and the associated burdens. Before taking out an accident insurance policy, consider, for example, the coverage already provided by other insurance policies, or the insured sum you would like to receive in the event of lasting damage to your health. Consider carefully what protection is offered by the various insurance companies and in what circumstances benefits are excluded.

Income protection insurance can provide further protection in the event of invalidity not only following an accident, but also as a result of illness. In the overwhelming majority of cases, invalidity is caused by illness.

What problems might arise?

  • Pre-contractual disclosure obligations: if you wish to take out accident insurance, you are obliged to provide your insurer with complete and correct information regarding circumstances that may be relevant to your risk, such as your health or specific accident risks, for example in connection with extreme sports. On this basis, the insurer decides what your risks are and whether they wish to offer you insurance or not. If there are any changes to these risk-related circumstances, you must inform your insurer of this without delay. Keep in mind that if the insurer is not correctly and completely informed about any pre-existing health conditions or other risks, they can change the policy retroactively, withdraw from the policy, or terminate or contest the contract.
  • Deadlines: you must claim benefits for an accident within the time limit set out in the insurance terms and conditions. Otherwise, you may lose your entitlement to benefits.
  • Exclusions: the insurance terms and conditions can exclude insurance protection from the outset in certain cases. For example, no insurance protection is provided for accidents caused by mental disorders or impaired consciousness. Accidents caused by a criminal offence or acts of warfare are likewise not insured. Detailed information can be found in the insurance terms and conditions.
  • Accident insurers only pay benefits for the consequences of an accident, i.e. if the accident itself results in damage to the insured’s health. If the consequences of an accident coincide with illness or infirmity, the accident insurer may, under certain circumstances, reduce the benefits paid.

What do I need to bear in mind after an accident?

  • After an accident that is likely to result in a claim, you must contact a doctor immediately and inform your insurer about the accident.
  • You are obliged to fill in the accident report truthfully and send it to your insurer without delay.
  • You must consent to examination by a doctor appointed by your insurer.
  • In the event of a fatal accident, the policyholder’s heirs or those entitled to the insurance benefits must inform the insurer within 48 hours.
  • The accident insurance policy stipulates various time limits you must observe. In particular, this relates to the occurrence and medical attestation of invalidity, and the corresponding insurance claim. The insurance terms and conditions normally stipulate that invalidity must occur within 12 to 15 months following the accident and that it must be confirmed by a written medical attestation and claimed by the policyholder within 15 months.

Where can I take out private accident insurance?

You can take out private accident insurance with an insurance company directly (for example in a branch or online). Alternatively, you can take out a policy via an insurance broker or insurance agent.

How much does private accident insurance cost?

The premiums for private accident insurance depend on the benefits chosen, which can vary greatly according to the policy and the insurer. It can help to compare prices, but you should always consider the insurance coverage offered!

The costs of premiums for accident insurance may also be tax-deductible.

What information is the insurer required to provide?

The insurer must provide the following information:

  • Insurance product information document: this contains the most important information about your policy in a compact format and includes, for example, details of your insurance protection, contributions and termination periods.
  • Customer information: you must receive information about the insurer, the services provided, the contract and available legal protections.
  • General conditions for accident insurance (Allgemeine Versicherungsbedingungen für die Unfallversicherung – AUB).

What do I need to bear in mind when terminating a private accident insurance policy?

If you want to terminate your accident insurance, you normally have to observe a notice period of three months up to the agreed expiry date or, if the contract has been extended, to the end of the policy year. The insurer can also cancel the policy under the same conditions.

The policyholder or insurer can also terminate the accident insurance if the insurer has provided benefits or if the policyholder has taken legal action against the insurer with regard to a claim for benefits. The notice of termination must normally be received within one month following the payment of benefits or conclusion of the legal dispute.

How are accident insurers supervised?

BaFin supervises German insurance companies and monitors all of their business operations. BaFin’s responsibilities include ensuring that the legal and financial interests of all insured persons are adequately protected. In order to protect the interests of all insured persons, BaFin processes complaints about insurance undertakings. However, BaFin cannot enforce your rights as an individual. That is the responsibility of the courts.

The quality and contents of insurance policies are not subject to review by BaFin, and BaFin also does not approve insurance terms and conditions. Insurers are generally free to decide on the scope of insurance protection they offer and on the conditions under which they accept applications for insurance.

If BaFin determines that insurance terms and conditions are in breach of the law (in particular consumer protection law) or (high) court decisions, it can take measures to remedy or prevent such shortcomings.
Statutory accident insurance is not supervised by BaFin.

Where can I find more detailed information?

You can get further information:

  • from insurance companies, who can provide information about the specific contractual terms and the scope of insurance cover they offer;
  • from local consumer advice centres and other consumer protection organisations – contact details can be found on the website of the consumer advice centre (Verbraucherzentrale);
  • on the website of the German Insurance Association (Gesamtverband der Deutschen Versicherungswirtschaft e. V.);
  • and in specialist media.

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