Services from accident insurance: Your comprehensive guide for financial security after an accident
3 May 2025
3
Minutes
Katrin Straub
CEO at nextsure
An accident can change your life from one second to the next. Do you know what financial benefits are available to you through accident insurance and how to make the most of them? This article explains everything you need to know.
The topic in brief and concise terms
The statutory accident insurance (GUV) covers work accidents, commuting accidents, and occupational diseases, while the private accident insurance (PUV) provides coverage for leisure accidents and global protection.
Important benefits of the personal accident insurance include disability benefits, accident pensions, and death benefits; the schedule of benefits and progression determine the payout amount.
In the event of damage, an immediate consultation with a doctor, accurate documentation, and timely reporting to the insurance company are crucial for processing the claim.
Understand accident insurance benefits at a glance
Accident insurance provides financial support following an accident, with the nature and scope of benefits varying significantly. Basically, a distinction is made between statutory accident insurance (GUV) and private accident insurance (PUV). The GUV primarily covers occupational and commuting accidents as well as occupational diseases. Private accident insurance, on the other hand, applies to accidents during leisure and in the home, where around seventy percent of all accidents occur. Both systems offer different benefit modules, which can range from medical treatment and pension payments to survivor benefits. A fundamental understanding of these differences is the first step towards comprehensive coverage. Contributions to statutory accident insurance are paid solely by employers.
Statutory Accident Insurance: Basic Protection for Employees and Other Groups
The statutory accident insurance (GUV) is an important pillar of the German social security system and protects a wide range of people. The insured include not only employees but also pupils, students, and children in day care facilities. The GUV provides benefits in the event of work-related accidents, accidents on the direct way to or from work (commuting accidents), and recognised occupational diseases. An essential advantage is that the benefits are generally determined ex officio; an application is usually not necessary. The costs for medical treatment and rehabilitation are covered to restore health and work capacity. This includes, for example, medical treatments, medicines and dressings, as well as physiotherapy. The statutory accident insurance is therefore a fundamental protection. However, this protection does not cover leisure accidents, highlighting the need for additional private insurance.
Financial benefits of the statutory accident insurance: From injury benefit to accident pension
If an insured person is temporarily unable to work after a workplace accident or due to an occupational illness, the GUV pays injury benefits. This amounts to eighty percent of the regular gross pay but must not exceed the net pay. If the ability to earn is reduced in the long term—beyond the 26th week after the accident—by at least twenty percent, there is an entitlement to an accident pension. The amount of this pension is determined by the degree of reduction in earning capacity (MdE) and the annual earnings (JAV) of the insured before the accident. An example: With a JAV of 36,000 euros and an MdE of thirty percent, the monthly partial pension amounts to 600 euros. It is important to know that the GUV does not pay pain and suffering compensation. However, the accident pension is also intended to partially compensate for non-material damage. For comprehensive coverage that can also cover pain and suffering claims, a private accident insurance is often indispensable. The GUV also provides benefits in the case of need for care and for dependents, such as funeral expenses and widow's or orphan's pensions.
Private accident insurance: Essential protection for leisure and home
As statutory accident insurance primarily applies in the professional context, a significant protection gap arises in the private sector. Most accidents, around two-thirds, occur during leisure time or at home. This is where private accident insurance (PAI) comes in, offering individual protection, 24 hours a day, worldwide. It is particularly important for groups not enjoying statutory protection or only to a limited extent, such as housewives, retirees, and self-employed individuals who are not legally insured. The core service of the PAI is the disability benefit, a capital payment, the amount of which depends on the agreed insured sum and the degree of accident-related disability. The degree of disability is determined medically, often with the help of a schedule of injuries. This accident insurance can be supplemented by additional modules. This way, you can protect yourself against the financial consequences of an accident, which can quickly become life-threatening.
Additional Benefit Modules of Private Accident Insurance
In addition to the central disability benefit, private accident insurance often offers a range of other sensible benefit modules. These can be selected individually as needed to optimise insurance coverage:
Accident pension: A monthly pension payment in cases of severe disability, often from a disability degree of fifty per cent.
Death benefit: A capital payment to the bereaved if the insured dies within a year due to the consequences of the accident.
Hospital daily allowance and recovery allowance: Financial support during a hospital stay and the subsequent recovery phase.
Transitional benefit: Quick financial assistance if the determination of the final degree of disability takes longer.
Salvage costs: Coverage of costs for search, rescue, or recovery operations.
Cosmetic surgery: Coverage of medically necessary cosmetic procedures after an accident.
The exact costs of accident insurance depend on the selected benefits and the insured sum. A careful comparison and needs analysis are therefore essential.
Experts' insights: Understanding structured tariffs, progression, and key deadlines
In the event of a claim under a private accident insurance policy, technical terms such as disability scale and progression play a crucial role in determining the payout amount. The disability scale is a table that specifies the degree of disability to be applied in the event of loss or incapacity of certain body parts or sense organs. For instance, the loss of a thumb may be assessed as twenty per cent disability. Progression is an agreement that leads to a disproportionately high increase in benefits at higher degrees of disability. A progression of 350 per cent, for example, means that in the case of full disability, 3.5 times the basic insurance sum is paid out. Our expert tip: Ensure that you have a sufficiently high basic sum and good progression to be truly covered in an emergency. It is also important to take note of the deadlines for reporting an accident and claiming disability benefits; these are set out in the terms of the insurance policy and often range from several months to over a year. As for the question of whether accident insurance is mandatory, the answer is no for the private variant, but its importance is unquestionable. Carefully examining the contract details is crucial here.
Recommendations: How to Secure Your Entitlement to Benefits
After an accident, quick and correct action is important to secure claims from your accident insurance. Document the course of the accident and any injuries as precisely as possible, ideally with photos and witness statements. Visit a doctor immediately, even for seemingly minor injuries; in the case of work-related accidents, this is usually a designated medical examiner. Report the accident to your insurance company immediately – both statutory (usually by the employer or doctor) and private. Adhere to all deadlines mentioned in your insurance terms, especially for the medical determination and notification of disability. Our expert tip: Keep a detailed health diary tracking the recovery process and all medical visits. This can be very helpful during later assessments. Find out to what extent you can deduct your accident insurance from taxes. Careful preparation and documentation greatly facilitate a smooth claims process.
Checklist: What to Do in the Event of a Claim
To be optimally prepared in the event of an accident and to enforce your claims on accident insurance benefits as effectively as possible, you should take the following points into account:
Immediate medical treatment: Visit a doctor immediately (a designated medical examiner for work-related accidents).
Accident documentation: Secure evidence of the accident course (photos, witnesses).
Timely accident reporting: Inform your private accident insurance and if applicable to the employer (for statutory accident insurance) immediately.
Accurate information: Provide complete and correct information about the course of the accident and the injuries.
Observe deadlines: Adhere to all contractually agreed deadlines for claiming disability.
Collect medical documents: Retain all medical reports, diagnoses, and treatment records carefully.
Communication with the insurance company: Maintain regular contact and submit requested documents promptly.
These steps help speed up the process and secure your rightful benefits from accident insurance.
nextsure: Your partner for tailored accident protection
Choosing the right accident insurance and understanding the diverse benefits can be complex. At nextsure, we see ourselves as your partner, helping you find the right protection for your individual life situation. We analyse your needs and show you which benefits from accident insurance are truly relevant to you. With our digital approach, we make insurance simple and transparent. Benefit from our expertise in niche insurance and secure optimal coverage. Good protection gives you the necessary financial security to focus on what is most important: your recovery. The question, do you need accident insurance, can be clearly answered with a yes for most people, in order to minimise financial risks.
Request an individual risk analysis now: Have your insurance situation reviewed for free and receive concrete optimisation proposals.
More useful links
The DGUV provides a comprehensive overview of the German Statutory Accident Insurance.
The DGUV University offers detailed information on the insurance and benefits provided by the German Statutory Accident Insurance.
Here you will find information on the rehabilitation benefits of the DGUV.
Frequently asked questions about the benefits for insured individuals are answered by the DGUV in their FAQ section.
The DGUV provides information on the financial aspects of statutory accident insurance.
Learn more about the responsibilities within the DGUV.
Wikipedia offers a comprehensive article on Statutory Accident Insurance in Germany.
The Federal Ministry of Labour and Social Affairs (BMAS) provides information on occupational accidents and diseases.
FAQ
What deadlines do I need to consider in the event of an accident to receive benefits?
Report the accident to your private accident insurance without delay. For claiming disability benefits, there are deadlines for the medical determination of disability (often within one year after the accident) and its notification to the insurance (often 15 to 18 months). Exact deadlines are listed in your insurance conditions.
What is the difference between statutory and private accident insurance?
Statutory accident insurance is a compulsory insurance for employees, students, etc. and provides benefits in the event of work-related accidents, commuting accidents, and occupational illnesses. Private accident insurance is voluntary and covers accidents in private life (leisure, household) worldwide.
Does the accident insurance also pay in case of partial fault in the accident?
The benefits of statutory accident insurance are independent of fault, meaning they are granted even in cases of contributory negligence, provided the accident was not caused intentionally. In private accident insurance, it depends on the exact contractual terms, but usually a certain degree of personal negligence (carelessness) is covered, whereas gross negligence or intent can lead to exclusion of benefits.
Are children covered by statutory accident insurance?
Yes, children are covered by statutory accident insurance during visits to daycare facilities, schools, and on the direct routes to and from these places. However, for accidents occurring during leisure time, they need private accident insurance.
