- On 15.10.2021
Many myths surround the accident insurance. Does it make sense or not? When does it apply and when doesn’t it? What does it cover? What exactly is the difference between a legal and a private accident insurance? And do I even need a private one? The legal insurance already regulates everything, doesn´t it? Today we will get to the bottom of these questions and bring light into the darkness!
The benefits of legal accident insurance
How many accidents do you estimate happen in Germany in a year? And how many per day? In Germany alone, an accident happens every 4 seconds! In a year, that’s just under 9 million!
Both minor and major accidents with little to considerable damage to health are included. Most people immediately think of a traffic accident when they think of an accident. But that is only one area – and a very small one at that – where accidents happen. Before we look at the statistics of where the most common accident happens, let’s take a quick look at the actual definition of an accident. According to this definition, an accident occurs when the insured person involuntarily suffers damage to his or her health as a result of a sudden external event (§ 178 II p.1 VVG). If this is the case, the legal accident insurance applies. However, there are some restrictions. The legal accident insurance covers occupational accidents, commuting accidents, occupational diseases (e.g. bakers’ allergy to flour dust – „Popular diseases“ such as musculoskeletal disorders or cardiovascular diseases are not usually included) and school accidents (for schoolchildren).
This means: you are ONLY covered at work and on the way there! But even here restrictions apply. For one thing, insurance coverage is excluded in break rooms and on the toilet. And secondly, the insurance coverage only applies on the DIRECT way to work. If you make a little detour and go shopping on the way, there is no insurance coverage anymore! Pretty tricky, isn’t it? Furthermore, certain circumstances are excluded, such as: Intentionally caused damage, accidents due to drunkenness and accidents based on private activities. So you don’t just have to be at work, you have to be doing your job.
This seems fair enough since it’s the employer alone who pays the contributions to the legal accident insurance. Therefore, the main task of the GUV (legal accident insurance) is to restore professional performance “by all appropriate means”. In other words, it is about getting you fit again so that you can go back to work. In addition, the payment of transitional allowances and pensions (depending on the individual case) falls within the scope of the legal accident insurance. However, it should be noted that an accident pension, for example, is only paid if you have a 20% reduction in gainful employment.
Where do most accidents happen?
But now back to the graph we promised earlier. It shows where the most frequent accidents occur:
Of all accidents that happen in Germany (every 4 seconds!), over 70% occur in the private sphere and NOT at work. Most of them happen at home and during leisure time.
Fortunately, many accidents are without permanent damage. However, people are often injured so severely that they can no longer pursue their leisure activities or their profession in the long term. And in the vast majority of cases, unfortunately, the legal accident insurance does not apply at all.
The additional private accident insurance
That’s why there is private accident insurance. It gives you full protection 24/7 and around the world. Whether you’re at work or in your free time, on vacation or at home, the private accident insurance covers you always and everywhere. Its scope of benefits* covers a. o.:
- Disability benefit
- Accident pension
- Death benefit
- Hospital daily allowance
- Cosmetic surgery
- Rescue costs
- Injury benefit
The most important components are the disability benefit and the accident pension. In contrast to the legal accident insurance, the benefits are not measured by the degree of reduction in earning capacity, but by the so-called limb tax. According to this, percentages are assigned to various body parts, sensory organs and, in some cases, internal organs for their loss or permanent disability.
The following graph shows the limb tax as sample conditions** for accident insurances:
The amount of the benefit is ultimately determined by the degree of disability times the insurance sum. In other words, the higher the degree of disability, the higher the disability sum benefit. This is a one-time benefit. The accident pension is a permanent, monthly payment that can be included. Last but not least a word about the injury benefit, which can be included as well. It is especially useful if you are active in sports or susceptible to injuries such as a fracture or torn ligaments. Because you get an immediate benefit if the module is integrated.
Of course, there is much more to say about the individual components of the private accident insurance, but this is too many details for now.
Be safe out there
In summary, legal accident insurance leaves many gaps that only private accident insurance can cover. For freelancers or any self- or unemployed person a private accident insurance is even more important, because these groups aren’t covered by the legal accident insurance at all. This leads to the fact that out of those roughly 9 million people having an accident in Germany per year, roughly 6 million don’t get anything at all from the legal accident insurance. So without the additional support of private accident insurance, they’re left alone in their misery. That’s every 13th person. Every year.
Let’s not be among them.
* There are differences depending on the company. Both in the amount of coverage and in the integrated modules. However, only a general overview should be given here.
** The limb tax can vary from insurer to insurer. The one shown here shows the sample conditions of the German Insurance Association. In addition, a progression is usually added to the insurance sum (this also varies from insurer to insurer or can be selected differently), which further increases the insured person’s benefit for any degree of invalidity.