Accident insurance: tariffs insurance obligation damage cases overinsurance

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An accident insurance will cover you if you are physically or mentally impaired as a result of an accident. In specialist jargon such an impairment is called disability.

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Simone Janson Simone JansonSimone Janson is publisherConsultant and head of the Institute's job pictures Yourweb.


Duty or frustration?

The biggest problem with choosing the right accident insurance is the complexity of the offer: On the one hand, insurers are not exactly open-minded when it comes to presenting their customers with a clear offer.

But at the beginning there is the question: Is accident insurance compulsory or rather freewheeling? Entrepreneurs who employ even workers, the statutory accident insurance is well known: Because the need to secure their employees, even their interns, in a so-called professional association.

Statutory accident insurance essentially applies to employees. The entrepreneurs themselves, on the other hand, are only compulsorily insured in some branches, in other branches the self-employed are free to protect themselves against accidents either legally or privately.

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You should be aware of that

When choosing insurance, you should consider the following points:

  • When is a private accident insurance useful?
  • What do you have to look out for?
  • How high are the costs?
  • What are the best policies?

Different tariff variants!

Some insurers have even more than a hundred different tariff variants - all with different conditions, insurance sums and progressions, which can be combined as desired.

In addition, many insurances advertise unnecessary extras such as hospital fuel money (more on this later), which are rather uninteresting for customers, rather than the important core services and prices. This confusion can make the selection of the right insurance enormously more difficult.

What protection do you still need?

On the other hand, many insured persons also do not know which insurance cover they already have - and which you still need: Even if you have never directly signed a contract for accident insurance, you can still be insured - somehow at least.

Check it out: Perhaps you already have an insurance with an association, a travel insurance or a credit and customer card - because accident insurance is often part of such a package or can be bought here as cheap extras. Only in this way is it possible to explain that there are already 30 million contracts for accident insurance in Germany.

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Differentiation from other insurance companies

In order to avoid differentiation from other insurances, you should check any overlaps with other insurances. A legal protection insurance can also be responsible for accidents. Because the question of guilt cannot always be clearly clarified. Or the incident is presented differently by the other party involved in the accident. If you then want to enforce your claim for damages in court, you may be better off with a traffic legal protection insurance, as the costs can quickly skyrocket in legal disputes.

It is then advantageous if the legal protection policy assumes this financial risk. The insurance pays the legal and court costs even in the event of a lost lawsuit. The dispute can arise at many levels outside of the transport sector. It is not uncommon for property boundaries to be involved, and even a tree canopy can lead to the process. In work life, there are often disputes between workers and employers regarding layoffs or severance payments.

Which policy for which claim?

No wonder that insurance companies offer different individual policies and packages. Private legal protection is the most common variant and, depending on personal needs, can be supplemented by, for example, professional, traffic, housing and property legal protection.

However, legal expenses insurance does not cover the costs of all disputes. Defense against claims for damages is just as insured as active prosecution. Disputes with your own legal expenses insurer are also excluded, as are lawsuits before the constitutional court or international courts. And very often the construction risk exclusion comes into play. Legal expenses insurance can make sense, but since it is also expensive, it must be checked whether it really covers the specific risks.

Who is insured?

But even the number of insured persons themselves can vary depending on the tariff: you can take out personal accident insurance for individuals, but just when you have children is a policy for the whole family, which includes your attachment, often more favorable. If you do not want to insure yourself, you can also secure a private children's accident insurance.

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Attention! Detach yourself from redundant insurance Many completed accident insurance schemes are simply not profitable for the insured:

Why many insurance companies are superfluous

  • Either you only apply to specific areas of life (only in the country, only during leisure time, only during sports),
  • only for certain persons (eg children are not included),
  • the conditions are not customer friendly
  • or the benefits in case of damage are simply too low.

Check existing policies

Ultimately, there is only one thing: check thoroughly existing policies. The following parts of our series show you what you need to look out for.

Announce all insurance contracts that do not meet your needs and look for an insurance that fully covers your accident risks.

What exactly is insured?

An accident presupposes that the insured person involuntarily suffers damage to health as a result of an event that suddenly affects the body from outside (accident event). However, if an illness or an existing ailment has caused the accident, this will be taken into account in the insurance payment by a corresponding deduction.

Accidents which are caused by special dangers in professional or private life, eg due to extreme sports, are excluded from insurance coverage, but can be additionally insured with an extra charge.

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Extended insurance

Some insurances also offer extended insurance coverage, eg injuries to limbs or spine (dislocations or tears of muscles, tendons, capsules or ligaments), even if the damage occurs only through excessive force exertion without external impact (for example, if you are a heavy piece of furniture to lift).

Also tick bites and even some woman-typical cancer diseases are treated by some insurance as an accident. Ask for specific conditions.

What is excluded?

In general, however, are excluded accidents that occur in the execution or attempted crime, as well as accidents caused by war or civil war, civil unrest or nuclear energy.

Also not paid is accidents caused by drunkenness, mental and mental disorders, as well as strokes or other spasm attacks, except by an accident. Accidents involving the insured are not covered by the use of aircraft, except for the risk of passengers, as well as accidents at vehicle events where maximum speed is required.

Method of payment

Depending on the contract, you will receive the benefit as a one-time capital payment in case of accident (meaningful if you have to carry out conversions) or as a pension benefit.

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If you agree to a one-off payment, you should also agree on a monthly supplementary pension, which usually pays 50 per cent of the invalidity to be certified by the doctor. This costs more, but to the old age the maintenance is ensured.

Caution: Report accidents on time!

If you have an accident: go to the doctor immediately and report the accident immediately to the insurance company. An accident with death row, such as the life partner, you must even report within 48 hours. Completely complete the accident report sent by the insurer and follow the doctor's instructions. If you violate this, the insurance may refuse performance.

However, the physician often can not immediately determine the disability, for it is often only after a long time that a permanent invalidity exists or the doctor can not immediately make the right diagnosis. As a rule, therefore, the invalidity has occurred within one year after the accident and must be documented in writing and reported to the insurance company within 15 months after the accident. However, if your insurance gives you more time, this is more customer-friendly.

Money depending on the tax

How much money you get depends on the degree of disability. This is determined by the tax on the part, a table which determines the degree of invalidity in the event of the complete loss or incomplete use of certain limbs or sensory organs.

The invalidity is assessed on a percentage basis according to a specific tax rate determined in the terms of the contract.

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Don't come to the insurance company with your private problems: tips for negotiation

An insurance policy that you have taken out to safeguard your business activities is generally not interested in your private problems. Especially not if she should pay for it. And certainly not if you make false statements.

Just like in the case of a taxi driver. She testified that she had clashed with a passenger who did not want to pay for the trip. In the following argument she was pushed against the car, fell and tore a ligament. She wanted to claim this as an accident at the employer's liability insurance association.

Bad luck that the responsible regional court of Hesse looked closer: The supposed passenger was the ex-friend of the insured, who had left them shortly before. In addition, she had reported him to the police for the theft of 1000 euros. The court therefore did not consider the trip to be a conventional taxi ride, but a private ride - and the trade association was not responsible for this. (LSG Hessen, AZ L3U 265/06)

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