Can I get permanent disability benefits?

Section tax and disability: How much is a body worth?

When is a disability present?

Disability exists if the physical and / or mental performance of the insured person is permanently impaired as a result of an accident. An impairment is considered permanent if it is likely to exist for more than three years and a change in condition is not expected. It must have occurred within a certain time after the accident and within a further certain period of time after the accident it must have been determined in writing by a doctor and submitted to the private accident insurance company. The exact deadlines can vary, as each insurer determines this itself.

What is the degree of disability based on? - The link tax

The degree of disability is based on the value listed in the link tax. It is the basis of the benefits in private accident insurance. The link tax describes the physical impairment in percent in a table. The percentage depends on which part of the body is restricted and how severely. The higher the degree of disability, the more money the accident insurance pays the injured party.

Who will determine the disability?

The first treating doctor or the family doctor determine the degree of disability of the injured party. There is the possibility that the insurer consults an independent expert for a second opinion. According to the guidelines of the GDV, both the insured and the policyholder have the right to annual follow-up examinations.

To what extent are the body parts secured?

Section taxes and degrees of disability can vary and are different for every private accident insurance company. For example, the loss of a hand with one provider can be calculated at 55%, while another uses a calculation of 75%.

However, there is a standard member tax of the General Association of the German Insurance Industry (GDV), according to which many basic tariffs of accident insurance companies are based:

Section tax AUB as of 2014:

  • Arm in shoulder joint 70%
  • Arm up to above the elbow joint 65%
  • Arm below the elbow joint 60%
  • Leg over mid-thigh 70%
  • Leg to mid-thigh 60%
  • Leg below the knee 50%
  • Leg to mid-lower leg 45%
  • Foot in ankle 50%
  • Hearing in one ear 30%
  • Loss of taste 5%
  • Index finger 10%
  • Thumb 20%
  • other finger 5%
  • a big toe 5%
  • another toe 2%
  • Eye 50%
  • Odor loss 10%
  • Hand in wrist 55%

How is the disability calculated in the event of partial inability to function and partial loss?

An accident can result in partial functional impairment. This can manifest itself, for example, through injured nerves that make an arm partially inoperable. In this case, the full degree of disability will not be recognized. The percentage of disability is then calculated on the basis of a medical report prepared by a doctor. If this determines that the arm is 20% impaired, 20% of 70% will be charged according to the ABU-Gliedertaxe. This results in a degree of disability of 14%.

How is the degree of disability calculated if several parts of the body are affected?

The percentages of the affected body parts are added up. However, a disability can amount to a maximum of 100 percent and no more.

How can I increase my accident insurance benefits?

Many private accident insurances are equipped with a progression. It increases the insured benefit from a certain degree of disability.

In principle, accident insurance can be taken out with or without progression. Without it, the tariff only consists of the so-called basic sum. Anyone who has agreed a basic sum of 100,000 euros and suffers a disability of 50% due to an accident will receive 50,000 euros from the insurer. In the case of accident insurance with progression, the benefit increases from a degree of disability of over 25 percent.

Disability benefit from DFV-UnfallSchutz

DFV-UnfallSchutz pays out from a degree of disability of 1%. If an accident of the insured person leads to a degree of disability of at least 80%, the disability benefit even increases by the agreed amount. While other accident insurances only rate the loss of an arm at 70% disability, the DFV 100%.

Member tax of the German family insurance:

  • Arm 100%
  • Arm above elbow joint 100%
  • Arm below elbow joint 100%
  • Hand 90%
  • Thumb 45%
  • Index finger 30%
  • Other finger 20%
  • Leg over mid-thigh 100%
  • Leg to mid-thigh 100%
  • Leg below knee 100%
  • Leg to mid-lower leg 100%
  • Foot 70%
  • Big toe 20%
  • Other toe 10%

Sense organs

  • Vote 100%
  • Eye 70%
  • Hearing in one ear 50%
  • Sense of smell 25%
  • Sense of taste 25%

organs

  • Kidney 30%
  • both kidneys or second kidney, if one kidney has already been lost 100%
  • a lung 50%
  • Duodenum, small intestine, large intestine, rectum 30% each
  • Stomach 20%
  • Liver 20%
  • Pancreas 20%
  • Spleen 20%
  • Gall bladder 20%

How does DFV-UnfallSchutz calculate the benefits according to the member tax?

If several parts of the body or sensory organs are impaired by the accident, the determined degrees of disability are added together. For example, if an affected person suffers the loss of a thumb and another finger, the percentages add up. The thumb is calculated with 45%, the index finger in turn with 30%. So there is a total disability of 75%.

What about impairments that are not listed in the link tax?

For body parts, organs or sensory organs that are not listed in the limb tax, the calculation of the disability is based on the extent to which normal physical or mental performance is permanently impaired. The standard is an average person of the same age and gender. The dimensioning is based on medical criteria. A medical report is decisive here for the percentage of disability.

Checklist: You should pay attention to this with a private accident insurance!

  • Sufficient sum insured - the higher the better!
  • Progression - it can increase the insurance benefits in the event of a claim, especially if there is a high degree of disability.
  • The underlying link tax - it should at least be at the level of the GDV guidelines. An improved link tax is an advantage.
  • Death benefit - this should be included in the tariff.