Accident insurance: Understand and optimise comprehensive protection in the event of accidents
21/05/25
6
Minutes
Katrin Straub
Managing Director at nextsure
An accident often happens unexpectedly and can change your life in an instant. Many people ask themselves: what does my accident insurance actually cover? This article explains the benefits and helps to cushion the financial consequences.
The topic in brief and concise terms
Private accident insurance primarily covers the financial consequences of accidents that result in permanent disability and applies worldwide and around the clock, unlike statutory accident insurance.
Key benefits include disability benefit (often with progression), accident annuity, death benefit, hospital daily allowance and rescue costs.
Exclusions (e.g. intentional acts, alcohol, criminal offences) and policy details (sum insured, notification deadlines, scale of benefits) must be carefully checked to ensure optimum cover.
Understanding the basics: What personal accident insurance generally covers
Private accident insurance provides financial protection in the event of accidents that lead to permanent health impairment. Unlike statutory accident insurance, which primarily applies to accidents at work and on the way to and from work, private cover generally applies worldwide and around the clock – including the more frequent accidents in leisure time. More than eighty per cent of accidents do not happen at the workplace. Private cover therefore fills an important gap. It pays agreed lump sums or pensions to mitigate the financial consequences of an accident, such as conversion costs or loss of income. The exact benefits depend on the individual contract. A comprehensive accident insurance policy is therefore an important component of personal provision. This cover is particularly relevant for people who have no or only limited cover through statutory accident insurance, such as housewives, self-employed people or retirees. Understanding the basic areas of cover helps you better assess your own needs.
Core services in detail: These payments you can expect
The central benefit of personal accident insurance is the disability benefit, a lump-sum payment in the event of permanent impairment. The amount is based on the degree of disability, which is determined using a schedule of benefits, and the agreed sum insured. For example, the loss of a thumb may be assessed as 20 per cent disability. Many tariffs offer progression, whereby the benefit increases disproportionately for higher degrees of disability; in the event of 100 per cent disability, the payout can amount to five times the basic sum. Another important benefit is the accident pension, which is paid monthly for life from a certain degree of disability, often 50 per cent. In the event of death, a death benefit can be agreed, which is paid to the surviving dependants if death occurs within one year of the accident. The sum for this is often between EUR 5,000 and EUR 100,000. In addition, benefits such as hospital daily allowance, recovery benefit and the covering of rescue costs of up to, for example, EUR 25,000 may be included. Costs for cosmetic surgery following an accident are also often covered up to a certain amount, for example EUR 25,000. These benefits of accident insurance are crucial for financial stability after a serious accident. The exact design of these benefits varies widely between providers and tariffs.
Limits of cover: When accident insurance does not pay
There are situations in which private accident insurance does not pay benefits despite an accident. A key exclusion is intent; if the insured intentionally causes the accident, there is no claim. Accidents under the influence of alcohol or drugs that led to a disturbance of consciousness are also often excluded, unless the disturbance itself was the result of an insured accident event. If the insured person commits a criminal offence and is injured in an accident, the insurance also does not pay. Many policies exclude accidents occurring during participation in motor races or certain extreme sports, or at least impose restrictions. Accidents resulting from war or civil war events are generally not covered either, although there are often exceptions here for unexpectedly occurring events abroad for a limited period, for example ten days. Health impairments caused by illnesses such as epileptic seizures or strokes are not considered accidents unless the seizure itself was triggered by an accident. It is therefore important to check the insurance terms and conditions carefully. These exclusions are intended to keep the risk for the insurance community predictable.
Covering specific needs: accident protection for children and seniors
Children and seniors often have specific needs that require tailored accident insurance. For children, children's accident insurance is particularly important, as statutory accident insurance only covers accidents at nursery, school and on the direct routes there. Around sixty per cent of all children's accidents, however, happen at home or during leisure time. A children's policy can cover typical accident consequences such as poisoning (except food poisoning in children under ten) or choking incidents and cover the costs of rooming-in or necessary retraining. For seniors, age-related risks such as falls can occur more frequently. Some insurers offer special senior tariffs tailored to these needs and, for example, include assistance services such as meal delivery or household help after an accident. Pay attention to age-appropriate loss-of-limb scales and benefit limits. Many policies also provide benefits in the event of a fractured femoral neck, regardless of the cause of the accident. It is advisable to review cover regularly and adapt it to the relevant stage of life. This ensures that protection remains optimal even when circumstances change.
In addition to the standard benefits, the following modules can often be useful:
Improved loss-of-limb scale for certain occupational groups
Increased death benefit to protect the family
Inclusion of accidents caused by one's own movement
Benefits for infections following animal bites (e.g. Lyme disease from a tick bite)
Coverage of costs for psychological support after an accident
Rooming-in benefits for parents when a child is in hospital (often up to €25 per night)
These extensions allow for even more individualised cover. The next section deals with important policy details.
Mastering contract details: expert tips for optimal protection
To ensure the best possible protection, certain contract details are crucial. The agreed insured sum for disability should be sufficiently high; experts often recommend three to five times gross annual income. A progression of, for example, five hundred per cent can significantly increase the benefit in the event of total disability. Pay attention to reporting deadlines: an accident usually has to be reported immediately, and disability must be medically determined and reported within a certain period (often twelve to fifteen months after the accident). The scope of cover of private accident insurance is generally worldwide and applies twenty-four hours a day. Our expert tip: check the definition of "accident" in your policy conditions carefully. Some tariffs expand the classic definition of accident and also provide cover for health damage caused by increased physical exertion. Also compare the benefit schedules of different providers, as these can vary. Careful review of these aspects ensures you receive the benefit you want in the event of a claim. The General Accident Insurance Conditions (AUB) form the basis of the contract.
Choosing suitable cover: strategies for the right accident insurance
Selecting the right personal accident insurance starts with an honest assessment of your needs. Take into account your profession, leisure activities and financial commitments. Someone with high-risk hobbies or a family may need more comprehensive cover than a single office worker. Compare not only premiums, but above all the benefits and terms of the various providers. Pay attention to the level of the base disability sum insured and sensible progression, for example 350 per cent or more. Check which additional benefits are relevant for you, such as an accident pension from a disability rating of 50 per cent or hospital daily allowance. Read the General Accident Insurance Terms and Conditions (AUB) carefully, especially the sections on exclusions and obligations. nextsure supports you as a digital insurance portal in finding tailored and easy-to-understand insurance solutions. Personal advice can help you choose the optimal tariff. That way, you are as well protected as possible in the event of an accident.
Key steps for choosing:
Determine personal needs (life situation, risks, financial goals).
Set the minimum disability cover amount (often 3 to 5 times annual income).
Choose sensible progression (e.g. 225%, 350% or 500%).
Check whether additional benefits such as accident pension or death benefit are necessary.
Compare offers from at least three different insurers.
Pay particular attention to the disability scale and exclusions.
Check whether contributions are tax-deductible.
Request an individual risk analysis now: Have your insurance situation checked free of charge and receive concrete suggestions for optimisation.
More useful links
The DGUV provides comprehensive statistics and up-to-date figures on statutory accident insurance in Germany.
The BMAS provides detailed statistics and open data on statutory accident insurance in Germany.
Statista summarises relevant data and facts on the subject of accident insurance.
The GDV provides insights into the number of policies and claims in the property and casualty insurance sector in Germany.
Wikipedia explains the basics and how statutory accident insurance works in Germany.
The BMAS provides a comprehensive overview of statutory accident insurance and its benefits.
The DGUV provides information on measures and strategies for accident prevention in various areas of life.
The BG Bau answers frequently asked questions about the employers' liability insurance association and accident insurance in the construction industry.
The Verbraucherzentrale assesses the necessity and benefits of private accident insurance from a consumer perspective.
The BAS provides a detailed overview of the tasks and benefits of accident insurance in the German social security system.
FAQ
What exactly does personal accident insurance cover?
Private personal accident insurance primarily covers the financial consequences of an accident that results in a permanent physical or mental impairment (disability). It can also include benefits such as accident annuity, death benefit, hospital daily benefit, convalescence benefit and rescue costs.
When does accident insurance not pay?
No benefit is usually paid for accidents intentionally caused, accidents under the significant influence of alcohol or drugs, during the commission of criminal offences, in the event of warlike events, or for health damage caused by illnesses that are not due to an accident.
Is private accident insurance worthwhile if I already have occupational disability insurance?
Yes, personal accident insurance can also make sense. It provides a lump-sum payment in the event of disability caused by an accident, regardless of your ability to work, whereas income protection insurance pays a pension if you are unable to work due to illness or an accident. The benefits can complement each other.
How high should the disability sum insured be in personal accident insurance?
The disability benefit amount should be chosen so that, in the event of a claim, it is sufficient to bridge financial shortfalls (e.g. for alterations, care, loss of income). It is often recommended to take out three to five times gross annual income.
What does progression mean in accident insurance?
Progression means that the insurance benefit increases disproportionately in the case of severe degrees of disability. With progression of, for example, 500%, you receive five times the agreed basic disability sum in the event of total disability (100% degree of disability).
Are children also covered under the accident insurance?
Children are not automatically covered under their parents’ policy unless it is a family plan or a separate children’s accident insurance policy has been taken out. Separate cover for children is important, as most accidents happen during leisure time.
