Successfully apply for hospital daily allowance: your guide with sample letter and expert tips
02.05.25
6
Minutes
Katrin Straub
Managing Director at nextsure
A hospital stay often brings unexpected costs. With the right application for hospital daily allowance, you secure 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 supporting documents (hospital certificate, diagnosis) is crucial for the prompt payment of the hospital daily allowance.
The daily rate (often ten to one hundred and fifty euros) should cover individual additional hospital costs; please note waiting periods (usually three months).
Hospital daily benefit covers costs during a hospital stay, whereas sickness daily benefit covers loss of earnings – two different forms of cover.
Immediate overview: The key points about the hospital daily allowance application
Hospital daily allowance is a benefit of your private supplementary insurance or private health insurance. It is paid for each day of medically necessary inpatient hospital treatment. You set the amount of the daily rate, often between ten and one hundred and fifty euros, when you take out the policy. To apply, proof of the hospital stay and the diagnosis are usually required. Please note the usually three-month waiting period from the start of the contract, which is often waived in the event of accidents.
Practical guide: Applying for hospital daily allowance step by step
The claim for hospital cash benefit should be submitted promptly after your discharge from hospital. First, gather all the necessary documents to ensure the process runs smoothly. This includes the hospital certificate confirming the length of stay, which often also includes the diagnosis. Many insurers provide their own forms, which you should use. A complete and correct submission can speed up processing by up to five working days.
Sample letter: How to word your claim for hospital cash benefit
A clearly worded claim is crucial for prompt processing. Here is an example you can adapt to your situation:
Max Mustermann
Musterstraße 1
12345 Musterstadt
Policy number: 987654321
nextsure Versicherungen
Claims Department
Postfach 10 20 30
54321 Versicherungsstadt
Musterstadt, TT.MM.JJJJ
Claim for hospital cash benefit – policy number: 987654321
Dear Sir or Madam,
I hereby claim benefits under my hospital cash benefit insurance. I was receiving inpatient treatment from [] to [] at [] in []. The length of stay was therefore [] days.
The medical necessity of the stay was established due to []. I am enclosing a corresponding hospital certificate and a copy of the discharge summary with this letter. My agreed daily rate is [] euros.
Please transfer the amount due to the following account:
Account holder: Max Mustermann
IBAN: DE12345678901234567890
BIC: MUSTERBANK
For any queries, please contact me on [] or by email at [--].
Yours faithfully
[]
Max Mustermann
This sample letter for claiming hospital cash benefit serves as a template. Adapt the details, such as the length of stay of fourteen days, to your individual circumstances. The template helps you present all the important information in a structured way.
Required documents for a complete claim
To avoid delays in payment of your hospital cash benefit, it is essential that your documents are complete. As a rule, insurers require the following documents:
The completed claim form from the insurer (if available).
A hospital certificate confirming the duration of the inpatient stay (admission and discharge date). This should include at least the diagnosis.
If applicable, a medical certificate or discharge summary confirming the medical necessity of the stay. For a stay of seven days, this is usually standard.
Your policy number and bank details for the transfer.
Our expert tip: Submit copies and keep the originals for at least two years. Careful documentation is the key to fast claims handling.
Expert knowledge: Understanding legal basics and important clauses
Hospital cash benefit insurance is a private supplementary insurance policy whose benefits are regulated in the Insurance Contract Act (VVG) and the respective General Terms and Conditions of Insurance (AVB). A key point is the definition of the insured event: benefits are paid in the event of medically necessary inpatient treatment. This means that outpatient or partial inpatient treatment is often not covered, nor are spa or rehabilitation measures, unless otherwise explicitly agreed in the contract. The co-payment in hospital is a common reason for taking out this insurance.
Waiting periods and exclusions: what you need to know
Most tariffs provide for a general waiting period of three months. This means that no benefits are payable for hospital stays that take place within these first three months after the contract begins. An exception is often an accident, in which case the waiting period is frequently waived. For childbirth, there is usually a special waiting period of eight months. Certain pre-existing conditions can lead to exclusions from cover or risk surcharges; this is clarified during the health assessment before the contract is concluded. Hospital supplementary cover can be a useful addition here.
Know the differences: hospital cash benefit vs sickness cash benefit
It is important not to confuse hospital cash benefit with sickness cash benefit. While hospital cash benefit covers the additional costs during a hospital stay (often up to one hundred euros per day), sickness cash benefit is intended to compensate for loss of earnings during longer periods of incapacity for work, regardless of a hospital stay. Both insurance policies can be relevant for certain occupational groups, such as the self-employed, to bridge financial shortfalls in the event of illness. The difference between sickness benefit and sickness cash benefit should also be noted here.
Optimising your cover: Check daily rate and contract details
The amount of the agreed daily rate should reflect your actual needs. Do not calculate only 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 any additional possible costs. These include telephone charges, internet use, better meals or travel costs for relatives, which can quickly amount to an extra thirty to fifty euros per day. Regular review and, if necessary, an adjustment of the sickness daily allowance or hospital daily allowance is sensible, especially if your personal circumstances change.
Benefit period and scope: What your policy covers
As a rule, hospital daily allowance is paid for the entire duration of the medically necessary inpatient stay, often without any time limit. In the case of inpatient psychotherapy, however, 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 tariffs provide unlimited cover throughout Europe and, for a certain period, for example up to two months, even worldwide. The question of how long sickness daily allowance is paid is similarly relevant here for planning.
Special cases and pitfalls: When the insurer does not pay
There are situations in which the insurer may refuse to pay hospital daily allowance. This is often the case if the stay is not classed as medically necessary or if it involves excluded treatments such as addiction treatment or cosmetic surgery. Problems can also arise if the waiting period has not yet been completed or if obligations, such as answering health questions truthfully, have been breached. If your private health insurance does not pay the sickness daily allowance, seek a discussion with your insurer and check the policy conditions carefully. Sometimes a combination with a sickness daily allowance and occupational disability insurance can also be sensible to ensure comprehensive cover, especially for self-employed people with sickness daily allowance.
Your next step: professional support for your protection
Applying for hospital daily allowance and understanding the contract details can be complex. Expert advice helps you find the cover that suits your needs and assert your claims correctly in the event of a claim. Reviewing your existing policies every three to five years can reveal gaps. Take the opportunity to have your insurance situation checked free of charge. A well-written letter to your insurer can often clear up many uncertainties.
Request an individual risk analysis now: have your insurance situation checked free of charge and receive specific suggestions for improvement.
More useful links
Wikipedia provides a comprehensive overview of hospital daily allowance insurance.
The Federal Ministry of Health provides information on hospital care under health insurance.
gesund.bund.de provides information on standard and elective services in hospitals.
Destatis offers statistics on hospitals in Germany.
Destatis publishes press releases on hospital statistics.
Destatis provides key data on patients discharged from hospitals in tabular form.
The Federal Ministry of Health provides general information on the topic of hospitals.
The Federal Hospital 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 elective services in hospitals from the consumer perspective.
FAQ
What is the difference between hospital daily benefit and sickness benefit?
Hospital daily allowance covers additional costs during an inpatient hospital stay (e.g. telephone, TV, co-payments). Sickness daily allowance replaces loss of earnings in the event 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. Take into account the statutory co-payment (ten euros/day for a maximum of twenty-eight days for insured persons under the statutory health insurance scheme) 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 hospital daily allowance?
Yes, the general waiting period is usually three months from the start of the contract. In the event of accidents, this is often waived. For childbirth, a special waiting period of eight months may apply.
Do I need a sample letter to apply for hospital daily allowance?
A template letter is very helpful in ensuring that all the necessary information is included and that the application is formally correct. Many insurers also provide their own forms.
Is the hospital daily allowance also paid for stays abroad?
Many plans offer insurance cover in Europe (often for an unlimited period) 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 application for hospital daily allowance is rejected?
First, check the reason for the rejection and compare it with your policy terms. If anything is unclear or you suspect the rejection is unjustified, contact your insurer. If necessary, advice from consumer advice centres or specialist lawyers may be helpful.
