Private accident insurance
A private accident insurance pays the policyholder a lump sum and / or an accident pension for the person (s) insured in the contract . In contrast to statutory accident insurance, unless otherwise agreed, insurance cover applies to accidents worldwide and around the clock.
Distinctions
A distinction is made between accident insurance
- against a single payment or against regular contributions
- with lump-sum benefits and / or pension benefits
Accident insurance is sometimes offered with the following additional options
- with progression with higher degrees of disability
- with improved link tax
- with premium refund (premium refund)
In many cases, additional benefits are also insured
- Accidental death
- Daily hospital allowance
- Cosmetic operations
- Rescue costs
- Health resort allowance
- Immediate service in the event of severe injuries
- Bone fracture benefits
In addition, the specific scope of services of the various insurance companies differs in some cases considerably. In many places, insurance cover can be extended against a premium increase. In this way, a so-called eco - benefit can sometimes be included in the insurance , which is incurred in the event of an accident while using public transport. Often there are also performance restrictions, such as in the case of alcohol-related (traffic) accidents, or different reporting deadlines apply. Because of this practice, it is very difficult to compare insurance offers.
case of insurance
The insured event in private accident insurance is the accident . Essential characteristics of the accident in the sense of the insurance are the sudden external impact on the insured and the injury caused by it. In Section 178 (2) sentence 1 VVG , the term accident is defined as follows:
- An accident occurs when the insured person involuntarily suffers damage to his health as a result of an external event that suddenly affects his or her body.
As a rule, accident insurers also offer insurance cover for cases in which a joint in a limb or spine is dislocated or muscles, tendons, capsules or ligaments tear, which is an accident in the sense of an accident, as a result of increased exertion - i.e. without sudden external impact this extended definition is.
Some insurers offer to extend insurance coverage to include additional cases due to special conditions. This allows z. B.
- Illnesses typical for diving (for example the so-called caisson disease ) can be equated with an accident
- the first occurrence of certain diseases such as heart attack or cancer can be treated as an accident.
- an extension to child disability protection can be agreed for children. This pays in the event of disability, regardless of the cause. Illness is thus also insured.
Insurance benefit
The core benefit of accident insurance aims to provide financial security in the event of permanent impairment of physical or mental performance as a consequence of an accident ( disability ). The protection usually takes the form of a one-off capital payment or a lifelong annuity. Progression agreements can ensure that the amount of the disability benefit increases disproportionately with higher degrees of disability. The assessment of the disability is based on the contractual link tax .
According to the limb tax, the loss or inability to function of a functionally higher rated limb closer to the trunk includes the loss or inability of the limb further away from the trunk. The individual degrees of disability are not added together. If the inability to function of the limb further away from the trunk leads to a higher degree of disability than the inability to function in the limb closer to the body, the disability benefit for the limb further away from the body represents the lower limit of the disability benefit owed.
In addition to the risk of disability, other consequences of accidents can also be insured against additional premiums. So z. B. a fixed lump sum can be agreed in the event of accidental death of the insured person (death benefit). The death benefit is due if the insured person dies from the consequences of the accident within one year of the accident. Agreeing on a death benefit in addition to the disability benefit makes sense, among other things, because otherwise there would be no entitlement to benefits if the insured person dies as a result of an accident despite serious injuries. Because according to the insurance conditions, disability benefits can usually be requested no earlier than 12 months after the accident. If a death benefit is insured in addition to the disability benefit, an advance payment for the disability benefit can be requested before the disability benefit is due. The maximum amount of the advance payment is due in the amount of the insured death benefit.
In order to bridge the financial requirements in the period up to the due date of the disability benefit, a transitional benefit can also be agreed. This is a fixed lump sum that is due in the event of serious injuries if the insured person is significantly impaired in his performance over a certain period of time due to the consequences of the accident (for example three months 100%; 6 months at least 50%).
In addition, a large number of other types of services can be agreed. This includes the daily hospital allowance and the convalescence allowance due after discharge from the hospital, which is usually paid for the same number of days as the daily hospital allowance. Furthermore, the daily accident allowance, which mainly serves to protect the self-employed. It is due in percent according to the degree of impairment of the ability to work.
Many insurers also offer so-called immediate benefits. These include fixed capital amounts for certain types of serious injury. Many insurance companies also offer contractual compensation for pain and suffering. This includes fixed percentages of the insured compensation for pain and suffering for precisely defined injuries.
As a further type of service, the insurance market offers the compensation of costs for cosmetic operations. B. to remedy disfigurements after an accident or the partial reimbursement of accident-related rescue costs that are not or only partially covered by the health insurances (e.g. personal contributions for rescue transport by ambulance or helicopter rescue flights abroad after a skiing accident).
In the context of so-called senior citizens' policies, certain time-limited services such as housekeeping, housekeeping, "meals on wheels" etc. are increasingly being offered as insurable benefits if the insured person is unable to do so due to the consequences of the accident.
Cutout covers
In addition to all-round 24-hour coverage, there is also so-called cut-out coverage. This includes in particular the passenger accident insurance , which is taken out in connection with the vehicle insurance , the boat passenger accident insurance or the construction worker accident insurance . Another example of this is the travel accident insurance that is included in package tours or that can be taken out separately .
Credit card companies often offer transport accident insurance as an additional service, which only applies to accidents when using transport or in a hotel if the credit card has been agreed as a means of payment.
Accident insurance with premium refund
A special form of private accident insurance is accident insurance with premium or premium refund (abbreviated: UBR or UPR). This form of insurance is a combination of accident and life insurance (to be precise: an increasing mixed insurance).
In the case of accident insurance with premium reimbursement, significantly higher premiums are due, as the life insurance component must also be covered in addition to the pure accident component. The costs for covering the accident risk as well as the insurance’s acquisition and administration costs are paid with the investment income of the life insurance component, in this way it is possible for the insurance company to guarantee the premiums paid after the contract expires or in the event of death (minus statutory insurance tax and any installment surcharges ) plus non-guaranteed bonus shares.
Like all accident insurance, UBR can also be taken out for other people. For example, parents can combine accident insurance for their children or grandparents for their grandchildren with a savings plan to finance studies, for example, whereby in the event of the death of the provider, all outstanding premiums are considered to have been paid.
market
Germany
The total premium income of private accident insurance in Germany was € 6.487 billion in 2011; in the previous year it was € 6.411 billion. In 2011, German insurers paid a total of € 3.07 billion in 847,000 privately insured accidents; In 2010 benefits amounted to € 3.04 billion in 848,000 privately insured accidents. According to the Assekuranz customer monitor of Psychonomics AG for 2008, 31% of all German households have a private accident policy. Allianz is the market leader in Germany with a market share determined by Psychonomics for 2008 of 22.2% by number of units, followed by HUK-Coburg and Ergo Lebensversicherung with a market share of 5.0% each.
Austria
In 2010, total private accident insurance premiums in Austria amounted to € 829 million, an increase of 3.5% compared to the previous year (2009: € 801 million). According to statistics from the insurance association, only every second Austrian is insured with private accident insurance for leisure accidents.
criticism
Accident insurance / disability insurance
Consumer advocates criticize the fact that accident insurance is oriented towards the trigger (the accident) and not the effect (the loss of income). Around 90 percent of all cases of occupational disability are not caused by accidents but by illness.
Cutout covers
In particular, partial insurance policies are criticized because they only offer insurance cover for certain, clearly defined accidents (e.g. in passenger accident insurance: accidents while using the insured motor vehicle).
Unisex tariff
Some insurance companies set the insurance premium differently depending on gender. With reference to the EU Equal Opportunities Regulation , the ECJ sees this as discrimination. Unisex tariffs have been mandatory for all new insurance contracts since December 21, 2012.
Accident probability (risk)
The likelihood of becoming disabled as a result of an accident is comparatively low. Most accidental injuries heal without leaving a disability.
Price-performance ratio
In accident insurance, the proportion of insurance benefits paid out to insured persons in relation to the premium income generated is regularly 60%. The loss ratio of the 50 largest providers is only 43.53%. In contrast to life insurance, profits made by the insurer in property and accident insurance are not paid out to the community of insured persons.
literature
- Wolfgang Grimm: Accident Insurance. Comment on the General Accident Insurance Conditions (AUB) with special conditions. 4th edition. Beck, Munich 2006, ISBN 3-406-53781-2 .
- Markus Jacob: Accident insurance AUB 2010 taking into account AUB 2008/99 and AUB 94/88. 1st edition. NOMOS, Baden-Baden 2013, ISBN 978-3-8329-7605-7
- André Naumann, Christian Brinkmann: The private accident insurance in the consulting practice. 2nd Edition. Deutscher Anwaltverlag / Verlag Versicherungswirtschaft, Bonn / Karlsruhe 2012, ISBN 978-3-8240-1173-5 / ISBN 978-3-89952-653-0
- Andreas Kloth: Private accident insurance . Beck, Munich 2008, ISBN 978-3-406-56966-1 .
Individual evidence
- ^ Association of the Insured - Information Sheet Accident , May 24, 2012.
- ↑ BGH, judgment of December 14, 2011 , Az. IV ZR 34/11, full text.
- ^ Contributions to private accident insurance , figures from GDV.
- ^ German market for private accident insurance
- ↑ The most popular accident insurers from the consumer's point of view , article from October 20, 2008 in the VersicherungsJournal.
- ^ Contributions to private accident insurance (Austria) , figures from the VVO.
- ↑ ECJ, judgment of March 1, 2011 , Az. C-236/09, full text.
- ↑ GDV: Facts & Figures on Accident Insurance , accessed on September 24, 2015
- ↑ Accident Insurance: Good Business. Accessed November 19, 2013
