Gliedertaxe Accident Insurance Mastery: How to Optimally Secure Your Financial Claims
9 Apr 2025
12
Minutes
Katrin Straub
CEO at nextsure
An accident can change your life – the dismemberment schedule of your accident insurance plays a crucial role in your financial security. Understand this central element to maximise your benefits in the event of a claim and avoid financial losses.
The topic in brief and concise terms
The schedule of benefits is a table in your accident insurance that specifies degrees of disability for body parts in percentages and thus determines the compensation amount after an accident.
Compare limb tax rates carefully: Improved limb tax rates often offer significantly higher percentages and therefore higher benefits – a difference of tens of thousands of euros is possible.
Pay attention to deadlines: Disability usually needs to 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 core component of any private accident insurance policy and defines degrees of disability. [2] It lists fixed percentages for the loss or incapacity of limbs and sensory organs. [1] This table determines the amount of 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 in order to assess their accident insurance benefits. The dismemberment schedule provides a transparent basis for benefit calculation and avoids ambiguities in the event of a claim. A clearly defined degree of disability, such as seventy percent for an arm, forms the calculation basis. [2] This system allows an initial assessment of the expected benefit for specific injuries.
How the schedule of compensation works in practice: Calculation and examples
The calculation of the disability benefit is a two-step process. First, a doctor determines the medical degree of disability. [5] This value is then multiplied by the agreed insurance sum to determine the payout. [1] Suppose your insurance sum is 100,000 Euros and the loss of a thumb is evaluated at twenty percent according to the scheduled compensation. [2] In this case, you would receive 20,000 Euros as compensation. If multiple body parts are affected, the respective degrees of disability are added together. [2,1] However, overall disability is usually limited to one hundred percent, even if the sum of the individual degrees is higher. [1] A medical report is crucial for determining the exact functional loss, especially in cases of partial damage. The costs of accident insurance should always be considered in relation to the quality of the scheduled compensation. Make sure 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 Dismemberment Table – Secure a performance boost of up to fifty percent
Insurers use various limb tables, which can differ significantly. [1] The German Insurance Association (GDV) does provide recommendations, but these are non-binding. [2] Many policies offer an enhanced limb table, which assigns higher degrees of disability for the same injuries. [6] This can increase your benefit by tens of thousands of euros in the event of an emergency. For example, the GDV recommendation assesses the loss of a hand with fifty-five percent disability. [1] However, a good policy with an enhanced limb table can set this to seventy percent or more. [1] With an insured sum of 100,000 euros, this means a difference of at least 15,000 euros. An enhanced 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, enhanced limb table often one hundred percent. [5]
Loss of a thumb: GDV twenty percent, enhanced limb table up to forty-five percent. [5,7]
Loss of an eye: GDV fifty percent, enhanced limb table up to sixty percent. [7]
Loss of hearing in one ear: GDV thirty percent, enhanced limb table up to fifty percent. [7]
Therefore, carefully examine the limb table before taking out an accident insurance policy. A look at the fine print can be worth real money here.
Understanding the Legal Foundations of the Schedule of Benefits: AUB and VVG as the Basis
The schedule of benefits is firmly anchored in the General Accident Insurance Conditions (AUB), which are part of the contract. [2,1] The AUB, often based on the sample conditions of the GDV (e.g., AUB 2020), regulate the detailed assessment of benefits. [1] Clause 2.1.2.2.1 of the AUB 2020, for example, lists the degrees of disability for specific body parts. [1] Overarching 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 sample conditions are possible and common. [8] These documents also define whether accident insurance is mandatory (not privately, but often professionally). Knowing these fundamentals precisely strengthens your position significantly in the event of a claim. A glance at the AUB can already answer many questions about the schedule of benefits in accident insurance.
Observe deadlines, cooperation, and exclusions: Avoid pitfalls in the scheduled indemnity accident insurance
For asserting claims from the schedule of payments of your accident insurance, deadlines are crucial. Disability must often have occurred and been medically established within fifteen months after the accident. [1] Notification to the insurer should also take place within this period. [1] If you miss these deadlines, the entitlement to disability benefits may lapse. [1] Additionally, you have obligations to cooperate: illnesses or conditions that contributed to the health impairment may reduce the benefit (Clause 3.2 of AUB 2020). [1] If the degree of contribution is less than twenty-five percent, usually no reduction occurs. [1] Certain causes of accidents or health impairments may be completely excluded from insurance coverage (Clause 5 of AUB 2020). [1] These often include accidents due to consciousness disorders or intentionally committed criminal acts. Our expert tip: Document the accident sequence and all doctor visits comprehensively, and report the damage to your insurance promptly to avoid missing deadlines. Also clarify whether your policy allows for the tax deductibility of accident insurance. This is an important aspect of financial planning.
Choosing the optimal protection: Your options for the best compensation schedule
The differences in compensation rates between various providers can be substantial. A comparison is therefore essential before you decide on an accident insurance. [1] While one provider may set the disability rate at twenty percent for the loss of a thumb, another may set it at twenty-five or even more. [6] This difference of five percentage points can mean 10,000 euros more or less in benefits on an insurance sum of 200,000 euros. Also, ensure adequate coverage and potential progression. Progression ensures that at higher disability levels, benefits increase disproportionately, often by several hundred percent. [3] For example, a 500 percent progression in case of full disability can mean five times the basic sum. Our expert tip: Have your individual situation analyzed to find a plan with the appropriate compensation rate and progression. A careful reporting of the accident is then the first step towards getting benefits. Also, consider special regulations like the DGUV Regulation 1 in a professional context.
Request your individual risk analysis now: Have your insurance situation reviewed for free and receive specific optimization suggestions.
More useful links
Wikipedia provides a comprehensive overview of the schedule of injuries, which is 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 for Labour and Social Affairs (BMAS) offers statistics on statutory accident insurance.
The German Insurance Association (GDV) provides 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 for my accident insurance?
The schedule of compensation is an integral part of your General Accident Insurance Conditions (AUB). You will typically 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 reassessment 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 health condition. [1]
What happens if I disagree with the assessment of my degree of disability?
If you disagree with the medical evaluation or the insurer's decision regarding benefits, you can obtain a second opinion or seek legal assistance. 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 definable body parts and sense organs. For body parts not explicitly mentioned or in the case of internal organs, the degree of disability is assessed based on how severely the normal physical or mental performance capacity is permanently impaired. [1]
Does the schedule of benefits also apply to illnesses?
No, private accident insurance, and therefore the scheduled benefits, generally only cover the consequences of accidents. Pre-existing illnesses or conditions that have contributed to a loss may reduce or exclude benefits. [1]
Why are there such large differences between the policy conditions of insurers?
Insurers design their tariffs, including the dismemberment tables, competitively. While there are recommendations (e.g. from the GDV), they are not binding. As a result, some insurers offer significantly more comprehensive dismemberment tables to be more attractive to customers.
