Accident insurance: your comprehensive protection against the financial consequences of accidents optimise
10.05.25
8
Minutes
Katrin Straub
Managing Director at nextsure
An accident happens unexpectedly and can change your life in a split second. Often, more than seventy per cent of all accidents happen during leisure time, where statutory cover usually does not apply. [11] A private accident insurance policy closes this gap and provides you with financial protection.
The topic in brief and concise terms
Private accident insurance provides worldwide, round-the-clock protection against the financial consequences of accidents, particularly leisure accidents, which account for over seventy per cent of all accidents. [11]
The core benefit is the disability payment, the amount of which depends on the insured sum, disability scale and progression; a progression of at least 350 per cent is often recommended. [4,5]
Self-employed people, children and people without other cover benefit particularly; personal accident insurance complements, but does not replace, more comprehensive occupational disability insurance. [8,10,1]
Understanding accident insurance: The key facts for your cover
A private accident insurance policy provides financial protection in the event of permanent physical or mental impairment following an accident. It pays out regardless of whether the accident happened at work, during leisure time or at home, and worldwide, 24 hours a day. [1] Its core benefit is a one-off capital payment, known as invalidity benefit, the amount of which depends on the agreed insured sum and the degree of disability. For young adults and families in particular, this protection is often essential. By contrast, statutory accident insurance (GUV) primarily covers accidents at work, accidents on the direct route to work and occupational diseases. [2] It is anchored in Book Seven of the German Social Code (SGB VII) and is funded by the employer. [2] For the self-employed, housewives/househusbands, pensioners and children involved in leisure accidents, there is often a gap that a private accident insurance policy can fill. This gap is significant, as statistically around eighty per cent of all accidents occur in the private sphere. [11] Private cover thus becomes an important component of personal provision. The following section looks at the specific benefits in more detail.
Benefits in detail: What does accident insurance really pay?
The core benefit of private accident insurance is disability benefit, a lump-sum payment. Its amount is determined by the sum insured and the degree of disability, which is calculated using the schedule of impairments. [4] The schedule of impairments is a table that specifies what percentage of the sum insured is paid in the event of loss or loss of function of certain body parts or sensory organs. For example, the loss of an arm at the shoulder joint can mean seventy per cent disability, an eye fifty per cent. [3] With a sum insured of €100,000, this would correspond to €70,000 or €50,000 respectively. Many policies offer progression: from a certain degree of disability (often 25 per cent), the benefit increases disproportionately. [5] A progression of 350 per cent can increase the payout to €350,000 in the event of total disability with a basic sum of €100,000. Make sure the basic sum insured is sufficiently high and the progression is good. In addition to the disability benefit, other components can also be useful:
Accident pension: A monthly pension from a certain degree of disability (e.g. fifty per cent).
Death benefit: A lump sum for surviving dependants in the event of death resulting from an accident.
Daily hospital cash and convalescence benefit: Financial support during hospital stays.
Recovery costs: Coverage of costs for search, rescue or recovery operations, often up to €10,000 or more. [10]
Cosmetic operations: Coverage of medically necessary cosmetic surgery after an accident, for example up to €75,000. [10]
Some policies also cover poisonings in children or health damage caused by tick bites. [4] The benefits of accident insurance are varied. But not every benefit is suitable for everyone, as the next section shows.
Practical examples and costs: How accident insurance affects you
Imagine a DIY enthusiast falling from a ladder and suffering a complicated fracture that leads to a permanent restriction in movement in his leg. Doctors determine a degree of disability of twenty per cent. With a sum insured of 150,000 euros and no progression, the accident insurance would pay 30,000 euros. With progression of 225 per cent, the benefit could already be higher, depending on the scale. Another example: a child has an accident while playing, resulting in a fifty per cent degree of disability. With a sum insured for a child of 100,000 euros and 350 per cent progression, up to 350,000 euros (in the event of full disability) or a proportionate amount in the case of partial disability could be paid, plus possibly an accident annuity. [4] The cost of private accident insurance varies greatly. For an adult aged forty, with a sum insured of 150,000 euros, 500 per cent progression and 10,000 euros death benefit, monthly premiums are often between seven and 22 euros. [7] For children, good cover (e.g. 100,000 euros basic sum, 350 per cent progression) can already be available from around three euros per month. [10] Do not compare only the price, but above all the terms and conditions such as the disability scale and progression. The costs of accident insurance also depend on individual factors such as occupation and hobbies. Skiing, for example, causes average accident costs of 7,900 euros per claim. [,3] The exact policy details are crucial, as we will see in the expert section.
Expert knowledge: legal foundations, rulings and pitfalls
Statutory accident insurance is governed by the Seventh Book of the Social Code (SGB VII). [2] For private accident insurance, the Insurance Contract Act (VVG) applies, supplemented by the General Accident Insurance Conditions (AUB) of the respective insurer. These AUB define precisely what counts as an accident: “An accident occurs when the insured person suffers an involuntary impairment to their health as a result of a sudden external event acting on their body.” [3] Our expert tip: Report an accident to your insurer without delay and strictly observe all deadlines for medical certificates and for asserting disablement. The OLG Saarbrücken ruled in October 2023 (case no. 5 U 41/23) that, if a deadline is missed, the claim to benefits may lapse, even without any fault on the part of the insured person. [9] Another ruling by the OLG Karlsruhe from May 2024 (case no. 12 U 175/23) confirmed the exclusion of benefits for accidents caused by psychologically induced suicide attempts where free will had been impaired. [9] Common exclusions concern accidents under the influence of alcohol (usually from 1.1 per mille), drugs, participation in racing events, or mental and consciousness disorders. Psychological reactions to an accident are often only covered if they have an organic cause. [3] Since a legislative change in 2021, in home offices, trips to the toilet or kitchen are also covered under statutory accident insurance, as are trips for childcare. [6] For self-employed people who are not automatically covered by statutory insurance, private accident insurance is particularly important; a basic sum insured of at least 200,000 euros is recommended here. [8] A careful review of the insurance conditions is essential. The question now is for whom such insurance is particularly worthwhile.
Target groups in focus: Who benefits most from accident insurance?
A private accident insurance policy is not equally important for everyone, but certain groups of people benefit particularly. Self-employed people and freelancers often do not have statutory accident cover and should definitely protect themselves privately against the risk of loss of earnings due to an accident. [8] For them, an accident can quickly become a threat to their livelihood, as their ability to work is the main source of income. A sum insured of at least 200,000 euros is advisable here. [8] Children are another important target group. It is true that they are covered by statutory insurance in nursery school, at school and on the direct routes there, but most accidents – around ninety per cent – happen during leisure time or at home. [10] A children's accident insurance policy with a sum insured from 75,000 euros and progression of at least 350 per cent is recommended. [4] Housewives and househusbands, as well as pensioners, are also often not covered by statutory accident insurance and can benefit from a private policy. [3] People with dangerous hobbies (e.g. extreme athletes, motorcyclists) or occupations with a high risk of accidents should review their insurance cover and adjust it if necessary. People who cannot take out occupational disability insurance because of pre-existing conditions may also find accident insurance to be an alternative, albeit a limited one. However, it only pays out in the event of disability caused by an accident, not illness. [1] More than eighty per cent of all accidents happen during leisure time, so private cover is a sensible addition for many people. [11] The decision in favour of accident insurance should always be based on an individual needs assessment.
Accident insurance vs. occupational disability insurance: Making the right choice
It is often asked whether accident insurance or occupational disability insurance (BU) is the better choice. Both types of insurance have their place, but they cover different risks. As the name suggests, accident insurance only pays out after an accident that leads to permanent disability. Occupational disability insurance, on the other hand, pays an annuity if, for health reasons — whether due to an accident or, far more commonly, an illness — you are unable to carry on in your profession to at least fifty per cent for an expected period of at least six months. Statistics show that illnesses (e.g. mental health conditions, cancer, disorders of the musculoskeletal system) are the cause of occupational disability in around nine out of ten cases, with accidents accounting for only around ten per cent of cases. [1] Occupational disability insurance therefore offers more comprehensive protection for your earning capacity. The premiums for a BU are usually higher than for accident insurance, and the health assessment is stricter. Accident insurance can be a useful addition to BU, but not a substitute. For example, it can cover high one-off costs after an accident (e.g. for modifications). For people who cannot obtain BU (e.g. because of pre-existing conditions or high-risk occupations), accident insurance can at least cover the risk of accidents. A careful assessment of your own risks is crucial here. Weigh your individual needs up carefully.
Contributions to private accident insurance can be claimed for tax purposes under certain conditions. The occupational portion of the insurance, if available and evidenced (e.g. in the case of a pure occupational accident insurance policy or a clearly separable portion), can be claimed as income-related expenses or business expenses. The private portion can be declared as part of other provision expenses in the supplementary schedule for pension expenses in the tax return. [4] However, the maximum amounts for provision expenses must be observed (EUR 1,900 for employees and civil servants, EUR 2,800 for self-employed people), which are often already used up by health and long-term care insurance contributions. [4] Our expert tip: Review your policy regularly, every three to five years, or when major life changes occur (marriage, children, building a house, job change) and adjust the cover accordingly if necessary. An indexation clause in the contract ensures that the sum insured and premiums increase annually to offset inflation. This can be useful to preserve the value of the cover in the long term. Pay attention to the cancellation periods, usually three months before the end of the contract term. A tax advantage can influence the decision. With this information, you are well equipped to optimise your cover.
Your next step towards optimal protection
Choosing the right accident insurance is an important decision that can significantly influence your financial future after an unforeseen event. As this article has shown, there are many aspects to consider – from the appropriate sum insured and progression to important additional benefits and the differences between statutory and private cover. A careful analysis of your personal life situation and risks is the first step towards insurance cover tailored to your needs. At nextsure, we understand that every situation is unique. That is why we offer you personalised advice to find the optimal solution for you. Use our expertise to close gaps in your cover and protect yourself comprehensively. Request an individual risk analysis now: Have your insurance situation checked free of charge and receive specific suggestions for optimisation.
More useful links
German Statutory Accident Insurance (DGUV) provides comprehensive information on figures and facts relating to accidents at work and commuting accidents.
The Federal Statistical Office (Destatis) provides detailed data and information on road traffic accidents in Germany.
The Federal Ministry of Labour and Social Affairs (BMAS) provides information on Book Seven of the Social Code (SGB VII), which governs statutory accident insurance.
The Federal Institute for Occupational Safety and Health (BAuA) offers valuable information and resources on the prevention of accidents and health damage in the workplace.
Wikipedia provides a general overview of the topic of accident insurance.
The German Statutory Accident Insurance (DGUV) explains the various rehabilitation services provided after an accident at work or an occupational disease.
The Accident Research Unit of Insurers (UDV) publishes current research reports and studies to improve road safety.
The German Medical Association provides information on the assessment and evaluation of injuries.
The Accident Atlas of the Statistics Portal offers interactive maps and detailed statistics on accident events in Germany.
FAQ
How high should the sum insured be for accident insurance?
The ideal sum insured depends on your personal circumstances. For self-employed people, at least €200,000 is recommended. [8] For children, often from €75,000 to €100,000. [4] It is also important to have a high progression rate (e.g. 350 per cent or 500 per cent), as this multiplies the benefit in the event of severe levels of disability.
What do the disability scale and progression mean?
The disability scale is a table that specifies which degree of disability (as a percentage) is applied in the event of loss or loss of function of body parts or senses. [4] Progression increases the insurance benefit disproportionately at higher degrees of disability, often starting from 25 per cent disability. [5]
Which additional benefits are important in accident insurance?
Useful additional benefits can include an accident pension (from 50 per cent disability), death benefit, daily hospital allowance, convalescence benefit, as well as the coverage of rescue costs and costs for cosmetic surgery. [4,10]
Does accident insurance also cover working from home?
Statutory accident insurance was expanded in 2021 and now also covers certain routes in the home office, e.g. to the kitchen or the toilet, as well as journeys relating to childcare. [6] Private accident insurance provides benefits regardless of where the accident occurs.
Can I deduct accident insurance contributions from my taxes?
Yes, private portions can be claimed as other precautionary expenses, and professional portions as work-related expenses/business expenses. However, the maximum amounts are often already used up by health/long-term care insurance. [4]
Do I still need personal accident insurance if I already have income protection insurance?
Personal accident insurance can usefully complement disability insurance (BU), but it cannot replace it. BU pays out in the event of disability due to illness (the most common cause) and accidents, while personal accident insurance only pays out in the event of disability caused by an accident. [1]
