Münchener Verein sickness benefit: reliably protect your income in the event of illness
05/04/25
8
Minutes
Katrin Straub
Managing Director at nextsure
A longer illness can quickly become a financial burden if your income stops. Münchener Verein’s daily sickness benefit offers important cover here. Find out how you can protect yourself.
The topic in brief and concise terms
Münchener Verein’s sickness benefit bridges the income gap that arises after six weeks of continued salary payments due to the lower statutory sickness benefit.
For employees, benefits typically start from the 43rd day; self-employed people can choose an earlier start (e.g. from the 22nd day); daily benefits of up to €20 are sometimes available to employees without health questions. [1,3]
Important contractual details include waiting periods (generally three months, waived in the event of an accident), the non-application of the alcohol clause, and the insurer's right to terminate the contract within the first three years under certain conditions. [1,2,3]
Financial security in the event of illness: understanding the need
Loss of earnings due to illness affects many unexpectedly and severely. Employees receive six weeks of continued pay, after which the GKV pays sickness benefit, which often leaves a gap of twenty per cent or more compared with net income. For self-employed people, inability to work often means an immediate loss of income of one hundred per cent. A private daily sickness benefit insurance policy, such as the Münchener Verein daily sickness benefit, is therefore an important financial support for many working people. It covers up to one hundred per cent of net income. This protection helps cover ongoing costs such as rent or loans even during a longer illness. Münchener Verein has been offering insurance solutions for this for over one hundred years. [4] The right daily sickness benefit insurance is sensible to avoid financial shortfalls.
This income gap can quickly amount to several hundred euros per month. Without private provision, ongoing expenses must be covered from savings, if available. The Münchener Verein daily sickness benefit steps in here and compensates for the loss of earnings. This allows you to focus fully on your recovery without financial worries. Understanding the differences between sickness benefit and daily sickness benefit is crucial here.
Münchener Verein’s range of services: benefit from tangible advantages
Münchener Verein offers flexible cover with its daily sickness benefit, for example under tariff 380. For employees, benefits begin from the 43rd day of incapacity for work, in line with the statutory continuation of pay for 42 days. [1] Self-employed people and freelancers can choose an earlier benefit start, for example from the 22nd day. [1] One advantage is that Münchener Verein does not apply the alcohol clause, so incapacity for work caused by alcohol is generally also covered. [1] Employees can insure up to twenty euros per day without answering health questions. [1,3] With a medical assessment, employees can receive up to 198 euros and self-employed people up to 175 euros per day. [1] The premiums include ageing reserves, which leads to more stable premiums in later life. [1] The Münchener Verein daily sickness benefit insurance therefore offers tailored options.
Münchener Verein also pays employees 100 per cent of the insured daily benefit in the event of partial incapacity for work as part of a phased return to work, provided there has previously been at least twelve weeks of full incapacity for work. [1,3] The benefits are tax-free and can be used freely. Worldwide cover is also included. However, waiting periods apply in certain cases: the general waiting period is three months, and in the case of pregnancy and psychotherapy it is eight months; there is no waiting period for accidents. [1,2] It is important to clarify the question How long is daily sickness benefit paid? on an individual basis.
Practical example: How sickness daily allowance closes your income gap
To make the benefits tangible, let us consider an employed office worker with a monthly net income of 2,875 euros. Gross income is assumed to be 3,880 euros. In the event of illness, the statutory health insurance net sickness benefit would amount to around 2,275 euros, which means a monthly shortfall of 600 euros. With sickness benefit cover through Münchener Verein of twenty euros per day (600 euros per month), this gap would be fully closed. Total income in the event of illness would remain at 2,875 euros. This example calculation illustrates the direct benefit of private cover.
For self-employed people, the situation is often even more critical, as they do not receive continued pay. Every day of incapacity for work directly leads to loss of earnings. Münchener Verein enables self-employed people to insure themselves for up to 175 euros per day, starting from the 22nd day of incapacity for work. [1,3] This secures their livelihood and covers ongoing operating costs as well as private expenses. A daily sickness benefits insurance for self-employed people is therefore often essential.
Here are typical situations in which daily sickness benefits apply:
Long-term illness: With a severe flu and weeks of recovery, it secures your income after continued pay ends.
Accident with rehabilitation: After an accident requiring months of rehab, it bridges the loss of earnings.
Chronic illness: With recurring flare-ups, for example due to rheumatism, it offsets income losses.
Pregnancy and childbirth: Benefits are also paid during maternity protection periods and on the day of delivery, after offsetting substitute benefits. [2]
These examples show how varied the need for cover can be.
Contract terms in detail: What you need to look out for
The General Insurance Conditions (AVB/KT 2013) of Münchener Verein set out the precise terms. [2] The insured event is medically necessary treatment with incapacity for work confirmed by a doctor. [2] Incapacity for work means that the professional activity cannot be carried out in any way, even temporarily. [2] The daily sickness benefit, together with other sickness day and sickness benefits, may not exceed the average net earnings of the past twelve months. [2] An important clause concerns the right to terminate: during the first three policy years, Münchener Verein may duly terminate the daily sickness benefit, provided there is no statutory entitlement to an employer subsidy and no full medical expense insurance is held with Münchener Verein. [1,2] Careful review of the terms and conditions before taking out the policy is essential.
Waiting periods are an important aspect: three months generally, eight months for psychotherapy and pregnancy (waived in the event of an accident). [2] When switching from statutory health insurance (GKV) or another private health insurer (PKV), periods of insurance already completed may be credited under certain conditions. [2] Cover ends, among other things, when an old-age pension is drawn, and at the latest upon reaching the age of 67. [2,1] This is a point that must be taken into account in life planning, as also cases in which private health insurance does not pay show. A policy without a waiting period is rare, but Münchener Verein waives it in the event of an accident.
The following points are also relevant in the terms and conditions:
Notification obligations: the start and continuation of incapacity for work must be evidenced in due time by medical certificates. [2]
Net earnings check: any reduction in net earnings that is not merely temporary must be reported to the insurer without delay. [2]
Overseas cover: insurance cover applies in Germany; for temporary stays abroad in Europe, benefits are paid for inpatient treatment. [2]
Adjustment options: employees may apply for an adjustment of the daily sickness benefit in the event of salary increases. [2]
These details illustrate the complexity and importance of a thorough contract review.
Expert knowledge: legal framework and recent rulings
Daily sickness benefit is private insurance and differs from statutory sickness benefit under Section 44 of the German Social Code, Book V (SGB V). [2,3] Statutory sickness benefit amounts to around seventy per cent of gross income, but no more than ninety per cent of net income, and is limited to 78 weeks within three years for the same illness. [3,2] Private daily sickness benefit policies generally pay out for an unlimited period until the insured person is fit to work again or becomes unable to work. [3] A ruling by the Dresden Higher Regional Court (case no. 4 U 2394/22) of 30 July 2024 confirmed that a daily sickness benefit policy may end when a pension is drawn, even if work continues, provided the policy conditions so stipulate. [1] The precise contractual wording is crucial here.
Our expert tip: look for the insurer’s waiver of the ordinary right of termination in the first three years. Münchener Verein reserves this right under certain circumstances. [1] Another important issue is the adjustment of insurance conditions under Section 164 VVG. [1,2] The Federal Court of Justice has issued several rulings on this, for example on the replacement of invalid clauses by the insurer. [1,2] An adjustment of daily sickness benefit may become necessary in certain circumstances. It is advisable to seek legal advice if anything is unclear, particularly when it comes to the combination of daily sickness benefit and occupational disability.
Design optimal cover: your path to the right daily sickness benefit
Choosing the right sickness daily allowance requires a careful analysis of your individual situation. For employees, a benefit start from the 43rd day is usually suitable. [1] Self-employed people should consider an earlier start; Münchener Verein offers the 22nd day here. [1] The amount of the daily benefit should cover the gap between net income and statutory sickness benefit (for those insured under the GKV) or the entire loss of earnings (for self-employed people and those insured under the PKV). [2] Münchener Verein allows daily benefits of up to 198 euros for employees and 175 euros for self-employed people (subject to medical underwriting). [1] A needs calculation, as offered by Münchener Verein, is an important first step.
Please also take waiting periods and exclusions into account. [1,2] Münchener Verein waives the standard three-month waiting period in the event of accidents. For tariffs without health questions (up to twenty euros daily benefit for employees), there are restrictions regarding pre-existing conditions from the previous twelve months or longer periods of incapacity for work in the last three years. [1] An honest answer to the health questions is crucial for higher daily benefits. We at nextsure will be happy to support you in selecting the right cover. The sickness daily allowance insurance in general has many facets that need to be considered.
Checklist for choosing your sickness daily allowance:
Determine the correct daily benefit amount (close the net income gap).
Choose the appropriate benefit start (day 43 for employees, earlier for self-employed people).
Check waiting periods and exclusions in the tariff.
Understand the conditions for cancellation and contract adjustments.
Note options for premium stability in old age (ageing reserves). [1]
Check whether benefits during a phased return to work are included. [1,3]
Check the alcohol clause provision (Münchener Verein does not apply it). [1]
Clarify the rules for disability and retirement. [1,1]
Comprehensive advice helps to tailor these points optimally to your needs.
Protecting your income in the event of illness is an important element of your financial planning. Münchener Verein’s daily sickness allowance offers flexible and high-performing options for various occupational groups. [3,1] With careful planning and by choosing the right tariff, you can effectively protect yourself and your family from the financial consequences of prolonged incapacity for work. Take the opportunity to obtain comprehensive information and find a solution tailored to your needs. Early protection pays off many times over in an emergency.
Request your individual risk analysis now: Have your insurance situation checked free of charge and receive concrete optimisation suggestions.
More useful links
The Federal Statistical Office provides official data on sickness absence in Germany.
The National Association of Statutory Health Insurance Physicians (KBV) provides health data and statistics on contracted outpatient medical care.
The University of Duisburg-Essen offers a comprehensive data collection on working conditions, including sickness absence.
The National Association of Statutory Health Insurance Funds (GKV-Spitzenverband) provides current key figures and statistics on statutory health insurance.
The Federal Ministry of Health provides information on the rules and benefits of sickness benefit.
The IGES Institute offers analyses and research findings, including on OECD data about sickness absence.
FAQ
Is the daily sickness benefit from Münchener Verein tax-free?
Yes, the benefits from Münchener Verein's daily sickness allowance insurance are tax-free.
Does Münchener Verein’s sickness allowance also apply in the event of incapacity for work due to alcohol?
Yes, Münchener Verein does not apply the so-called alcohol clause, so alcohol-related incapacity for work is also generally co-insured. [1]
Can I take out sickness benefit cover with Münchener Verein without a health assessment?
Yes, employees can apply to Münchener Verein for daily sickness benefit of up to €20 per day without health questions. However, certain restrictions apply regarding pre-existing conditions. [1,3]
How long does Münchener Verein pay sickness allowance?
The sickness benefit is paid without time limit for the duration of incapacity for work, including on Sundays and public holidays, until the ability to work is restored or occupational disability occurs, or the age limit specified in the contract is reached. [3,2]
What is the difference between statutory sickness benefit and the sickness daily allowance from Münchener Verein?
Statutory sickness benefit is a benefit of statutory health insurance (GKV), covers around 70 per cent of gross salary and is limited in duration. [3,2] The private daily sickness allowance from Münchener Verein is supplementary insurance that can close this gap, potentially covering up to 100 per cent of net income and generally pays out without time limit. [3,3]
What cancellation rights does Münchener Verein have for sickness daily allowance?
Münchener Verein can ordinarily terminate the daily sickness allowance insurance in the first three policy years if there is no statutory entitlement to an employer subsidy and no comprehensive health expense insurance is held with Münchener Verein. [1,2]
