Health & Care
Adult Accident Insurance
accident insurance gliedertaxe
Mastering Accident Insurance Compensation: How to Secure Your Financial Claims Optimally
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.
More useful links
Wikipedia offers a comprehensive overview of the classification of injuries, relevant for determining degrees of disability in accident insurance.
The German Social Accident Insurance (DGUV) provides figures and facts about statutory accident insurance.
The Federal Ministry of Labour and Social Affairs (BMAS) provides statistics on statutory accident insurance.
The German Insurance Association (GDV) supplies statistics on the German insurance industry, particularly on accident insurance contracts and claims.
A publication by the German Social Accident Insurance (DGUV) offers detailed information and statistics on accident insurance.
REHADAT Statistics provides data on the benefits of statutory accident insurance.
FAQ
How do I find the schedule of benefits in my accident insurance?
The schedule of benefits is an integral part of your General Accident Insurance Conditions (AUB). You will usually find the table in the section on disability benefits.
Can the degree of disability change after the initial assessment?
Yes, both you and the insurer can request a re-assessment of the degree of disability within a certain period (often up to three years after the accident) if there has been a significant change in the state of health. [1]
What happens if I disagree with my disability rating?
If you disagree with the medical assessment or the insurer's decision, you can obtain a second opinion or seek legal advice. The Insurance Ombudsman can also be a point of contact.
Are all body parts covered by the schedule of benefits?
The schedule of benefits lists the most common and clearly defined body parts and sense organs. For body parts not explicitly mentioned or in the case of internal organs, the degree of disability is assessed according to how severely normal physical or mental performance is permanently impaired. [1]
Does the schedule of benefits also cover illnesses?
No, private accident insurance and hence the schedule of benefits generally only cover accident-related consequences. Existing illnesses or conditions that contributed to a damage may reduce or exclude the benefit. [1]
Why are there such significant differences between insurers' schedules of benefits?
Insurers design their tariffs and thus their schedules of benefits competitively. While there are recommendations (e.g., from the GDV), these are not binding. Therefore, some insurers offer significantly more comprehensive schedules of benefits to be more attractive to customers.
