How to successfully claim daily hospital allowance: Your guide with a sample letter and expert tips
2 May 2025
4
Minutes
Katrin Straub
CEO at nextsure
A hospital stay often brings unexpected costs. With the right application for hospital daily allowance, you secure an important financial support. Find out here how to proceed and make use of our practical sample letters.
The topic in brief and concise terms
A complete application with all documentation (hospital certificate, diagnosis) is crucial for a prompt payout of the hospital daily allowance.
The daily rate (often ten to one hundred and fifty Euros) should cover individual additional costs in the hospital; observe waiting times (usually three months).
Hospital daily allowance covers costs during a hospital stay, whereas sick pay compensates for loss of earnings – two different types of coverage.
Quick Overview: The Essentials of the Hospital Daily Allowance Application
The daily hospital allowance is a benefit provided by your private supplementary insurance or private health insurance. It is paid for each day of a medically necessary, fully inpatient hospital stay. You determine the daily rate, often between ten and one hundred and fifty euros, when you conclude your contract. To apply, proof of the hospital stay and the diagnosis are usually required. Please note the generally three-month waiting period from the start of the contract, which is often waived in the event of accidents.
Practical Guide: How to Apply for Hospital Daily Allowance Step by Step
The application for hospital daily allowance should be submitted shortly after your discharge from the hospital. First, gather all the necessary documents for a smooth process. This includes the hospital's certificate of the duration of stay, which often also contains the diagnosis. Many insurers provide their own forms that you should use. A complete and correct submission speeds up the processing by up to five working days.
Sample Letter: How to Write Your Hospital Daily Allowance Application
A clearly formulated application is crucial for prompt processing. Here is an example that you can adapt to your situation:
Max Mustermann
Musterstraße 1
12345 Musterstadt
Insurance number: 987654321
nextsure Insurance
Claims Department
P.O. Box 10 20 30
54321 Insurance City
Musterstadt, DD.MM.YYYY
Application for Hospital Daily Allowance – Insurance Number: 987654321
Dear Sir or Madam,
I hereby apply for the benefits of my hospital daily allowance insurance. I was in inpatient treatment from [] to [] at [] in []. The duration of stay was [] days.
The medical necessity of the stay was determined due to []. A corresponding hospital certificate and a copy of the discharge report are attached to this letter. My agreed daily rate is [] euros.
I request the transfer of the due amount to the following account:
Account holder: Max Mustermann
IBAN: DE12345678901234567890
BIC: MUSTERBANK
For any questions, I am available at the phone number [] or by email at [--].
Yours faithfully,
[]
Max Mustermann
This sample letter for applying for hospital daily allowance serves as a basis. Adapt the details, such as the duration of stay of, for example, fourteen days, individually. The template helps you present all relevant information in a structured manner.
Required Documents for a Complete Application
To avoid delays in the payout of your hospital daily allowance, the completeness of your documents is crucial. Insurances generally require the following documents:
The completed insurance application form (if available).
A hospital certificate with the duration of the inpatient stay (admission and discharge dates). This should include at least one piece of information about the diagnosis.
Possibly a medical certificate or a discharge report confirming the medical necessity of the stay. For a stay lasting seven days, this is usually standard.
Your insurance number and your bank details for the transfer.
Our Expert Tip: Submit copies and keep the originals for at least two years. Careful documentation is key to quick service delivery.
Expert Knowledge: Understanding Legal Foundations and Key Clauses
The daily hospital allowance insurance is a private supplementary insurance, whose benefits are governed by the Insurance Contracts Act (VVG) and the respective General Insurance Conditions (AVB). A key point is defining the benefit event: payment is made for medically necessary inpatient treatment. This means that outpatient or partial inpatient treatments are often not covered, nor are cure or rehabilitation measures unless explicitly agreed otherwise in the contract. The co-payment in the hospital is a common reason for taking out this insurance.
Waiting times and exclusions: What you need to consider
Most plans provide for a general waiting period of three months. This means that for hospital stays occurring in the first three months after the contract begins, there is no obligation to provide benefits. An exception is often made in the case of an accident, where the waiting period is frequently waived. For childbirths, a special waiting period of eight months usually applies. Certain pre-existing conditions may lead to exclusions or premium surcharges, which are clarified during the health examination before the contract is concluded. A hospital supplementary insurance can be a sensible addition here.
Understanding the differences: Daily hospital allowance vs. daily sickness allowance
It is important not to confuse the daily hospital allowance with the daily sickness allowance. While the daily hospital allowance covers the additional costs during a hospital stay (often up to one hundred euros per day), the daily sickness allowance compensates for loss of earnings due to prolonged incapacity for work, regardless of a hospital stay. Both insurances can be relevant for certain professional groups, such as the self-employed, to bridge financial gaps during illness. The difference between sick pay and daily sickness allowance should also be noted.
Optimising Your Coverage: Review Daily Rate and Contract Details
The amount of the agreed daily rate should reflect your actual needs. Don't just consider the statutory co-payment of ten euros per day (for a maximum of twenty-eight days per year for those with statutory insurance), but also other potential costs. These include telephone charges, internet use, better meals, or travel expenses for relatives, which can quickly add up to an additional thirty to fifty euros per day. A regular review and, if necessary, an adjustment of the daily sickness benefit or hospital daily allowance is sensible, especially if your life circumstances change.
Benefit period and scope: What your contract covers
Generally, the hospital daily allowance is paid for the entire duration of the medically necessary inpatient stay, often without time limit. However, in the case of inpatient psychotherapy, the benefit period may be limited to a certain number of days per calendar year, for example, twenty-five days. Also check the scope of your insurance: Many policies provide unlimited cover throughout Europe and for a specific period, such as up to two months, even worldwide. The question of how long sickness benefit is paid is similarly relevant for planning.
Special cases and pitfalls: When the insurance doesn’t pay
There are situations where the insurance may refuse to pay the hospital daily allowance. This is often the case if the stay is not classified as medically necessary or involves excluded treatments such as addiction treatments or cosmetic surgery. Problems can also arise if the waiting period is not yet fulfilled or obligations, such as providing truthful answers to health questions, are violated. Should your private health insurance not pay the sickness benefit, liaise with your insurer and closely review the contract terms. Sometimes a combination with daily sickness benefit and occupational disability insurance can be advisable to be comprehensively protected, particularly for self-employed individuals with daily sickness benefit.
Your next step: Professional support for your protection
Applying for hospital daily allowance and understanding the contract details can be complex. Expert advice can help you find the right cover for your needs and make your claims correctly in the event of a benefit. Reviewing your existing contracts every three to five years can uncover gaps. Take advantage of the opportunity to have your insurance situation checked for free. A well-written letter to your insurance company can often resolve many uncertainties.
Request an individual risk analysis now: Have your insurance situation checked for free and receive specific optimization suggestions.
More useful links
Wikipedia provides a comprehensive overview of hospital daily allowance insurance.
The Federal Ministry of Health provides information on hospital care under the health insurance framework.
gesund.bund.de provides details on standard and optional services in hospitals.
Destatis offers statistics on hospitals in Germany.
Destatis publishes press releases on hospital statistics.
Destatis provides key figures on hospital discharges in table form.
The Federal Ministry of Health offers general information on the topic of hospitals.
The Federal Clinic Atlas is the official atlas of hospitals in Germany.
The Gabler Business Lexicon defines hospital daily allowance insurance in an economic context.
The Consumer Advice Centre provides information on optional hospital services from a consumer perspective.
FAQ
What is the difference between hospital daily allowance and sickness daily allowance?
Hospital daily allowance covers additional costs during an inpatient hospital stay (e.g. telephone, TV, co-payments). Sickness daily allowance compensates for loss of earnings in case of incapacity for work, even if you are at home.
How much should the hospital daily allowance be?
The amount should cover your individual needs. Consider the statutory co-payment (ten euros per day for a maximum of twenty-eight days for those insured with statutory health insurance) and other possible costs such as comfort services or travel expenses for relatives. Rates between ten and one hundred and fifty euros per day are common.
Is there a waiting period for the hospital daily allowance?
Yes, usually the general waiting period is three months from the start of the contract. In the case of accidents, this is often waived. A special waiting period of eight months may apply for childbirth.
Do I need a template letter for the application for hospital daily allowance?
A template letter is very helpful to ensure that all necessary information is included and the application is formally correct. Many insurers also offer their own forms.
Does the hospital daily allowance also apply for stays abroad?
Many plans offer insurance coverage in Europe (often without any time limit) and worldwide (usually for a limited period, e.g. two months). Please check the exact terms in your contract.
What should I do if my hospital cash benefit application is rejected?
First, review the reason for the rejection and compare it with your contract terms. If there are any uncertainties or suspected unjustified rejection, contact your insurance company. If necessary, it may be advisable to seek advice from consumer protection agencies or specialized lawyers.
