Berlin – Just not paying attention and the accident happened. Good, if you are insured then. When taking out accident insurance, however, consumers should always ensure that they have adequate protection.
An accident insurance pays money if the customer has an accident in his free time. “An accident is covered by insurance law if an event acts suddenly, involuntarily and externally on humans,” explains Rüter de Escobar. Depending on the accident and insurance contract, the injured person will receive a daily allowance, a pension or a one-off capital benefit. Essentially, private accident insurance covers costs incurred after an accident, such as house remodeling, home help or a life-long pension in the event of incapacity for work.
Limits tax and degree of disability
How much money is paid to the policyholder depends on several factors. In addition to the individual contract terms, it depends mainly on the injury. “Insurers afford according to the extent of health damage,” says Michael Nischalke, insurance expert of the journal “Finanztest” Stiftung Warentest. “There is the member’s tax.” This determines the value of the damaged body parts and determines the degree of disability.
An example: the insured person drops a flower pot from the third floor onto his foot. If he loses thereby a toe, the member tax lies with two per cent. If he has signed a contract for 100,000 euros insured sum, he receives for his toe therefore 2000 euros. Is it the big toe, there are five percent, that is 5000 euros. If he loses his whole foot, the member tax provides 40 percent, 40,000 euros. If the foot is only partially damaged, the insurance benefit will be adjusted to the severity of the disability. The physical damage and thus the degree of disability must be determined within 15 months by a doctor, submitted to the insurer and claimed, says Rüter de Escobar.
Pay attention to progression
“Important in an accident insurance is a progression in the contract,” explains Peter Grieble of the consumer center Baden-Württemberg. “That means that at higher levels of disability or in case of total disability the insurance benefit increases.” In the case of a progression of 300, 300% would be paid out for 100% disability.
After a serious accident, it is sometimes not possible for those affected to work. Since such an emergency would also be covered by the disability insurance, the two insurance companies are often compared.
Accident versus occupational disability insurance
Many experts prefer the five to ten times as expensive occupational disability insurance, because the accident insurance insures only the accident. “The most important part of the insurance does not take over, because 90 percent of those affected by a disease invalid and only 10 percent from an accident,” says Thorsten Rudnik from the Association of insured in Henstedt-Ulzburg near Hamburg. In children, the numbers are even clearer. “More than 99 percent of children are disabled by illness, only 0.65 percent are severely disabled by an accident,” says consumer advocate Grieble.
But accident insurance also has advantages. “The performance of the accident insurance is not linked to incapacity for work,” explains Michael Nischalke. A journalist who lost both legs in an accident could do his job but still receive a large sum of capital depending on the sum insured.
An accident insurance can therefore be a sensible thing. The case of emergency must be insured in a sufficient amount. “A sufficient basic sum is important because the progression usually only starts at a disability level of 26 percent,” explains Rudnik. An accident insurance over 100,000 euros with the progression 350 costs less than 100 euros a year. But the right accident insurance does not exist. The situation and the needs of the individual play too large a role. Michael Nischalke of “Finanztest” advises to make oneself smart on the basis of insurance tests and to carry out an accident insurance comparison of several providers.
Tip: Pay attention to sufficient disability sum
Important for an accident insurance is a sufficient basic disability. Because even with a lower degree of disability, which can already restrict a significant in daily life, then a sufficient amount will be paid, explains the Confederation of insured in Henstedt-Ulzburg near Hamburg. For a 30-year-old, the disability amount should be six times that of a 40-year-old and five times the gross annual income for a 40-year-old. If the sum is too low, insured persons should cancel the accident insurance or adjust the amount.