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Mastering Accident Insurance Compensation: How to Secure Your Financial Claims Optimally

9 Apr 2025

3

Minutes

Katrin Straub

Managing Director at nextsure

An accident can change your life – the schedule of benefits in your accident insurance plays a crucial role in determining your financial security. Understand this key element to maximise your benefits and avoid financial losses in the event of a claim.

The topic in brief and concise terms

The disability table is a chart in your accident insurance that specifies degrees of disability for body parts in percentage and thus determines the amount of compensation after an accident.

Compare loss of limb compensation carefully: Enhanced compensation often offers significantly higher percentages, resulting in higher benefits – a difference of tens of thousands of euros is possible.

Pay attention to deadlines: In most cases, the disability must be medically determined and reported within fifteen months to avoid losing claims.

Gliedertaxe Quickly Explained – Your Basis for Financial Security

The dismemberment schedule is a central element of every private accident insurance and defines degrees of disability. [2] It lists fixed percentages for the loss or incapacity of limbs and sense organs. [1] This table determines how much compensation you receive after an accident, often amounting to several tens of thousands of euros. [1] Understanding the dismemberment schedule is essential for every policyholder to assess their own benefits from accident insurance. The dismemberment schedule creates a transparent basis for benefit calculation and avoids ambiguities in the event of damage. A clearly defined degree of disability, for instance, seventy percent for an arm, forms the basis of the calculation. [2] This system allows an initial assessment of the expected benefit in the event of specific injuries.

How the limb tax works in practice: Calculation and examples

The calculation of the disability benefit is a two-step process. First, a doctor determines the degree of medical disability. [5] Then, this value is multiplied by the agreed insurance sum to determine the payment. [1] Suppose your insurance sum is 100,000 Euros and the loss of a thumb is assessed at twenty percent according to the schedule of injuries. [2] In this case, you would receive 20,000 Euros as compensation. If several body parts are affected, the respective degrees of disability are added together. [2,1] However, the total disability is usually capped at one hundred percent, even if the sum of the individual degrees is higher. [1] A medical report is crucial for determining the exact loss of function, especially in partial impairments. The costs of accident insurance should always be considered in relation to the quality of the schedule of injuries. Ensure that the deadline for the medical determination of disability, often fifteen months, is met. [1] You will always find the exact values and conditions in your General Accident Insurance Terms (AUB). [2]

Standard vs. Enhanced Sectional Tariff – Secure a performance increase of up to fifty percent

Insurers use different limb tables, which can vary significantly. [1] While the German Insurance Association (GDV) provides recommendations, these are non-binding. [2] Many policies offer an improved limb table that assigns higher disability levels for the same injuries. [6] This can increase your benefit by tens of thousands of euros in the event of a serious incident. For example, the GDV recommendation rates the loss of a hand at fifty-five percent disability. [1] However, a good policy with an improved limb table might set this at seventy percent or more. [1] With a sum insured of 100,000 euros, this means a difference of at least 15,000 euros. An improved limb table is an important criterion when choosing your private accident insurance. Here is a comparison of typical values:

  • Loss of an arm at the shoulder joint: GDV seventy percent, improved limb table often one hundred percent. [5]

  • Loss of a thumb: GDV twenty percent, improved limb table up to forty-five percent. [5,7]

  • Loss of an eye: GDV fifty percent, improved limb table up to sixty percent. [7]

  • Loss of hearing in one ear: GDV thirty percent, improved limb table up to fifty percent. [7]

Therefore, examine the limb table closely before taking out an accident insurance policy. Reading the fine print can be very worthwhile.

Understanding the Legal Basis of the Gliedertaxe: AUB and VVG as the Foundation

The disability scale is firmly anchored in the General Accident Insurance Conditions (AUB), which are part of the contract. [2,1] The AUB, often based on the GDV's model conditions (e.g. AUB 2020), detail the assessment of benefits. [1] Section 2.1.2.2.1 of the AUB 2020, for example, lists the degrees of disability for specific body parts. [1] General legal frameworks can be found in the Insurance Contract Act (VVG). Sections 178 to 191 VVG contain specific regulations on accident insurance. [8] It is crucial to know the exact wording in your individual insurance contract, as deviations from the model conditions are possible and common. [8] These documents also define, whether accident insurance is mandatory (not privately, but often professionally). Thorough knowledge of these fundamentals significantly strengthens your position in the event of a claim. A look into the AUB can already clarify many questions about the disability scale accident insurance.

Den optimalen Schutz wählen: Ihre Handlungsoptionen für die beste Gliedertaxe

The differences in section rate scales between different providers can be considerable. Therefore, a comparison is essential before deciding on an accident insurance. [1] While one provider may set the disability rate for the loss of a thumb at twenty percent, another may offer twenty-five percent or even more. [6] This difference of five percentage points can mean 10,000 euros more or less in benefits with an insured amount of 200,000 euros. Ensure you have an adequate coverage amount and consider potential progression. Progression ensures that at higher disability levels, the benefits increase disproportionately, often by several hundred percent. [3] For example, a 500 percent progression in the case of full disability can mean five times the basic sum. Our expert tip: Have your individual situation analysed to find a tariff with an appropriate section rate scale and progression. A careful reporting of the accident is then the first step to claiming benefits. Also, bear in mind special regulations like DGUV Regulation 1 in a professional context.

Request an individual risk analysis now: Have your insurance situation checked for free and receive specific optimisation suggestions.

FAQ

Wie finde ich die Gliedertaxe meiner Unfallversicherung?

Die Gliedertaxe ist ein fester Bestandteil Ihrer Allgemeinen Unfallversicherungsbedingungen (AUB). Sie finden die Tabelle üblicherweise im Abschnitt zu den Invaliditätsleistungen.

Kann sich der Invaliditätsgrad nach der ersten Feststellung noch ändern?

Ja, sowohl Sie als auch der Versicherer können innerhalb einer bestimmten Frist (oft bis zu drei Jahre nach dem Unfall) eine Neubemessung des Invaliditätsgrads verlangen, wenn sich der Gesundheitszustand maßgeblich verändert hat. [1]

Was passiert, wenn ich mit der Einstufung meines Invaliditätsgrades nicht einverstanden bin?

Wenn Sie mit der ärztlichen Einschätzung oder der Leistungsentscheidung des Versicherers nicht einverstanden sind, können Sie ein zweites Gutachten einholen oder sich anwaltliche Hilfe suchen. Auch der Versicherungsombudsmann kann eine Anlaufstelle sein.

Sind alle Körperteile in der Gliedertaxe versichert?

Die Gliedertaxe listet die häufigsten und klar definierbaren Körperteile und Sinnesorgane auf. Für nicht explizit genannte Körperteile oder bei inneren Organen wird der Invaliditätsgrad danach bemessen, wie stark die normale körperliche oder geistige Leistungsfähigkeit dauerhaft beeinträchtigt ist. [1]

Leistet die Gliedertaxe auch bei Krankheiten?

Nein, die private Unfallversicherung und somit die Gliedertaxe leisten grundsätzlich nur für Unfallfolgen. Bestehende Krankheiten oder Gebrechen, die zu einem Schaden beigetragen haben, können die Leistung mindern oder ausschließen. [1]

Warum gibt es so große Unterschiede zwischen den Gliedertaxen der Versicherer?

Versicherer gestalten ihre Tarife und damit auch die Gliedertaxen im Wettbewerb. Es gibt zwar Empfehlungen (z.B. vom GDV), diese sind aber nicht bindend. Daher bieten einige Versicherer deutlich leistungsstärkere (verbesserte) Gliedertaxen an, um attraktiver für Kunden zu sein.

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nextsure – Your digital platform for health and protection insurance. Transparent comparisons, easy online sign-up, and personal expert support make it possible.

nextsure – Your digital platform for health and protection insurance. Transparent comparisons, easy online sign-up, and personal expert support make it possible.

nextsure – Your digital platform for health and protection insurance. Transparent comparisons, easy online sign-up, and personal expert support make it possible.