Accident insurance: When is it really worthwhile and which benefits are decisive?
03.06.25
11
Minutes
Katrin Straub
Managing Director at nextsure
An accident happens unexpectedly and can change your life in an instant. Find out when private accident insurance makes sense for you and how it can provide financial security after an accident, which often results in follow-up costs of more than €10,000.
The topic in brief and concise terms
Private accident insurance makes sense, as around 80 percent of all accidents happen during leisure time, where statutory insurance often does not apply.
Important benefits include a high disability sum, a good benefit scale for loss of limbs, accident pension and additional benefits such as rescue costs or hospital daily allowance.
In particular, self-employed people, homemakers, children and retirees, as well as people with risky hobbies, should consider private accident insurance.
Assessing accident risks correctly: Understanding the need for private cover
Approximately 80 per cent of all accidents happen during leisure time, where statutory accident insurance usually does not provide cover. Private accident insurance steps in precisely here and offers financial protection in the event of disability. For many groups of people, it is an important supplement, as statutory cover often only covers a fraction of the risks. Private cover protects against financial consequences that can quickly reach five-figure sums. This makes it possible to maintain your standard of living after an accident resulting in lasting damage.
Key benefits in focus: What a good accident insurance policy must offer
The main benefit is the disability benefit, a lump-sum payment in the event of permanent impairment. Good policies pay out from as little as one per cent disability. A sufficiently high sum insured, often recommended at three to five times gross annual income, is crucial. Look for a good limb tariff, which determines the degree of disability applied in the event of loss or loss of function of parts of the body. Many policies offer additional benefits such as an accident pension from 50 per cent disability. This secures a regular income.
Additional benefits can optimise cover:
Recovery costs: Cover for search, rescue or recovery operations, which can quickly amount to several thousand euros.
Cosmetic operations: Cover for accident-related aesthetic corrections up to an agreed sum, often EUR 5,000 or more.
Hospital daily allowance and convalescence benefit: Financial support during a hospital stay, for example EUR 30 per day.
Immediate benefit for serious injuries: A one-off payment, for example EUR 10,000, for certain severe injuries.
These building blocks help to cover the wide range of financial burdens after an accident. A comprehensive benefits overview is therefore important before you take out a policy.
Public versus private: Understanding the key differences for your protection
The statutory accident insurance (GUV) is compulsory insurance for employees and provides benefits in the event of accidents at work, commuting accidents and occupational diseases. It is financed by the employer. By contrast, private accident insurance (PUV) is voluntary and covers accidents worldwide and around the clock, i.e. also at home and in leisure time. The scope of cover is a key difference: GUV covers only about 20 per cent of accidents. PUV usually pays a one-off capital sum, while GUV often pays pensions or rehabilitation measures. For self-employed people, homemakers and retirees, PUV is often the only accident cover. You can find more about the details of cover in our blog.
Target groups in focus: Who is accident insurance particularly useful for?
Certain groups of people benefit particularly from private accident insurance. For self-employed people and freelancers, it is often essential, as they are usually not covered by statutory accident insurance and an accident can quickly lead to loss of earnings. Housewives and househusbands are also not covered by statutory accident insurance, even though many accidents, some with serious consequences, happen in the home. For children, a special children’s accident insurance policy is important, as statutory accident insurance only applies in nursery, school and on the direct routes there and back. In the case of leisure accidents, which are common among children, only private cover pays out, often from as little as €2.42 per month. Retirees and senior citizens lose their statutory protection when they retire and often have an increased risk of falling. Accident insurance can cover costs for home adaptations or domestic help. Protection is also recommended for people with dangerous hobbies or physically demanding jobs. An individual needs analysis is advisable here.
Understanding the impairment table: How disability is assessed and calculated
The limb schedule is a central component of every private accident insurance policy. It is a table that sets out which percentage of the sum insured applies as the degree of disability in the event of loss or complete loss of function of certain parts of the body or sensory organs. For example, the loss of a thumb may be assessed at 20 per cent, an arm above the elbow at 70 per cent. The level of limb schedule values can vary between insurers, so comparing them is important. In the event of partial loss or partial loss of function, the corresponding proportion of the limb schedule value is used. A medical expert determines the exact degree of disability if several injuries are present or pre-existing damage must be taken into account. The amount paid out is calculated from the degree of disability multiplied by the sum insured. A cost-benefit assessment of the sum insured is therefore central.
Progression and sum insured: Designing optimal cover
The right sum insured is crucial for cover tailored to your needs. Experts often recommend a base sum that corresponds to three to five times annual gross income. A progression can significantly increase the benefit at high levels of disability. With a progression of, for example, 350 per cent, 3.5 times the base sum is paid out in the event of total disability. A higher progression leads to higher premiums, but in an emergency offers significantly more financial resources. Many tariffs offer progression scales of up to 500 per cent. Weigh up your individual needs and financial situation in order to find the optimal combination of sum insured and progression. Advice on accident annuities can be useful here.
Before taking out accident insurance, you should check a few points carefully. Pay attention to the extended definition of an accident, which also includes health damage caused by your own movement or increased physical exertion. Also important are contributory factors: pre-existing conditions can reduce the benefit if they have contributed to the consequences of the accident; here, the deduction should be as low as possible (often under 25 per cent). Our expert tip: clarify whether accidents caused by loss of consciousness (e.g. due to medication or a heart attack) are covered, which is especially relevant for seniors. The deadlines for reporting an accident (often just a few days) and for medical assessment of disability (usually 15 months) must be observed. Compare the terms carefully before signing. Tax deductibility of the premiums may also be a factor.
Important aspects when choosing a tariff are:
Scope: worldwide cover around the clock is standard.
Exclusions: Certain risks, such as accidents under the influence of alcohol (usually from 1.3 per mille) or while committing criminal offences, are often excluded.
Indexation: Dynamic adjustment of the insured sum and premium can counteract loss of purchasing power.
Health questions: These are usually less extensive than for income protection insurance, but should still be answered truthfully.
Careful review of these points ensures you receive the cover you want in an emergency. More information on the question of whether personal accident insurance is compulsory can be found here.
Legal foundations and recent rulings: What you should know
Private accident insurance is based on the Insurance Contract Act (VVG) and the General Accident Insurance Conditions (AUB) of the respective provider. Statutory accident insurance is governed by Book Seven of the Social Code (SGB VII). This defines, among other things, the workplace accident (§ 8 SGB VII) and the occupational disease (§ 9 SGB VII). Current court rulings can influence the interpretation of insurance conditions, for example in relation to the question of when an accident event is considered “sudden”. It is advisable to familiarise yourself with fundamental rulings that may be relevant to your own policy. For example, the Federal Court of Justice has ruled several times on the significance of the schedule of body parts and on the assessment of the degree of disability. An understanding of the legal framework strengthens your position vis-à-vis the insurer. For a detailed introduction to accident insurance, read our main article.
Your personalised risk analysis: Get free advice now
The decision for or against personal accident insurance and the choice of the right tariff depend heavily on your personal life situation, your professional risks and your leisure activities. A blanket recommendation is hardly possible. Take advantage of individual advice. At nextsure, we analyse your specific situation and help you find the optimal cover. Request your individual risk analysis now: Have your insurance situation checked free of charge and receive specific recommendations for improvement. This ensures that, in the event of a claim, you are optimally covered and do not pay more than necessary for your protection.
More useful links
DGUV provides an overview of the rehabilitation benefits of the German Social Accident Insurance.
Federal Ministry of Labour and Social Affairs (BMAS) provides an overview of the German statutory accident insurance.
Wikipedia provides an article on statutory accident insurance in Germany.
DGUV explains the principles of rehabilitation benefits.
DGUV provides statistics and facts on occupational accidents and commuting accidents.
Federal Statistical Office (Destatis) provides statistics on fatal occupational accidents.
DGUV provides a publication (PDF) on accident prevention and occupational safety.
Federal Statistical Office (Destatis) provides statistics on non-fatal occupational accidents.
Federal Institute for Occupational Safety and Health (BAuA) provides a publication (PDF) on safety and health at work.
BG Verkehr provides statistics, data and facts on the employers' liability insurance association for the transport, postal logistics and telecommunications sector.
FAQ
When does private accident insurance not pay out?
Typical exclusions are accidents caused by intoxication (usually from a certain blood alcohol level), drug use, the commission of criminal offences, war events or psychological reactions. Health damage caused by poisoning (except in children, often covered as standard) or infections (except, for example, through a tick bite, if included) are also often not covered.
What is the difference between disability benefit and accident pension?
The disability benefit is a one-off capital payment, the amount of which depends on the degree of disability and the insured sum. The accident annuity is a regular, usually monthly payment that is often paid for life from a degree of disability of 50 per cent.
Do I need accident insurance if I have occupational disability insurance?
Personal accident insurance can also be worthwhile if you already have occupational disability insurance (BU). BU pays out in the event of occupational disability caused by illness or an accident, while personal accident insurance pays out for disability resulting from an accident, regardless of your ability to work. The benefits can complement each other.
How high should the sum insured be in accident insurance?
Experts often recommend three to five times gross annual income as the basic disability sum. In the event of full disability, progression should provide a significantly higher sum.
What does progression mean in accident insurance?
Progression means that the insurance benefit increases disproportionately in the event of serious consequences of an accident. In the event of a high level of disability (e.g. 80 per cent), a multiple of the basic sum insured is then paid out, depending on the agreed progression scale (e.g. 225 per cent, 350 per cent, 500 per cent).
Are contributions to accident insurance tax deductible?
Contributions to private accident insurance may, under certain conditions, be claimed as special expenses or business expenses in your tax return. This depends on your individual tax situation and the type of insurance cover.
