Prerequisites for benefits. 2.1.1.1 The insured person's physical or mental capacities have been permanently impaired as a result of the accident (disability). The disability - has occurred within 18 months of the accident and - has been diagnosed by a physician in writing within 24 months of the accident, and the insured person has submitted a claim to us. This time period is deemed to have been adhered to when a physician has been commissioned to provide the necessary information in a timely manner, even if he does not provide his information by the required date.
2.1.1.2 There is no entitlement to disability benefits if the insured person dies one year after the accident as a result of the accident.
Prerequisites for benefits. The insured person died as a result of the accident within 24 months of the accident. If compensation was already provided during this time period pursuant to 2.1, then such compensation will be offset against the death compensation. The insurer will waive the claim for the return of disability benefits that have been paid, if these exceed the death benefit. We hereby advise of the special obligations according to 5.5.
Prerequisites for benefits. The insured person has suffered an accident during a stay abroad that does not exceed one year. The treatment of the effects of this accident has resulted in costs that have not been paid by a private or public health insurance company.
Prerequisites for benefits. As a result of the accident, the insured person has worn a cast on the instructions of a doctor for more than 21 days.
Prerequisites for benefits. The insured person has been discharged from inpatient treatment and was entitled to hospital per diems according to 2.2.
Prerequisites for benefits. 2.2.1.1 The insured person is undergoing medically required inpatient treatment due to an accident.
2.2.1.2 Subsequent treatment or subsequent inpatient treatment through the employer's liability insurance association (BGSW) immediately following a hospital stay (within 30 days) is considered medically required inpatient treatments at an objective level.
2.2.1.3 Health resort measures such as stays in sanatoriums, convalescence homes and rehabilitation clinics are not considered medically required inpatient treatments on an objective level, as long as 2.2.1.2 does not apply.
2.2.1.4 If the insured person has suffered an accident that falls under the insurance contract, the insurer will pay the costs required for return transport to a hospital at the home location or near the home location after a 14-day hospital stay at the accident location, for a maximum amount of EUR 3,500.00.
2.2.1.5 Different from 2.2.1.1 to 2.2.1.4, hospital per diems are also paid for ambulant operations due to an accident, insofar as such operations are usually performed on an inpatient basis. In these cases, the agreed hospital per diem will be paid for five days.
Prerequisites for benefits. The insured person has suffered physical or mental damages as a result of a criminal restriction of his personal freedom, which was caused by third parties.
Prerequisites for benefits. 1.12.1.1 The insured person's physical or mental capabilities have been permanently impaired as a result of an accident insured under this contract (disability). Because of this disability, the insured person is not able to pursue his occupation without restrictions, or lead a normal life without restrictions. The conversion of a workplace makes it possible to resume work activities either in full or in part, or makes it easier to live a normal life.
1.12.1.2 A claim for conversion costs is submitted to the insurer within two years after the accident.
1.12.1.3 In the case of accession by another party required to provide compensation, only the remaining costs may be claimed from the insurer for reimbursement. Where another party required to pay compensation disputes their obligation, you may call on us directly.
Prerequisites for benefits. 1.7.1.1 The insured person has undergone medically necessary rehabilitation - after an accident that falls under the contract - as a result of health problems or their effects which were caused by the accident event - within three years (calculated from the accident date) - for a continuous time period of at least three weeks. These requirements are verified by the insured person by submission of a doctor's discharge report and approval documents for the rehabilitation measure by the pension insurance agency, statutory or private health insurance of the social security or pension office.
1.7.1.2 Day-patient rehabilitation measures during which the insured person receives a treatment programme similar to that received by inpatient patients (with the exception of overnight stays) are also insured. - subsequent treatment (AHB) after a hospital stay, - subsequent inpatient treatment through the employer's liability insurance association (BGSW), - other inpatient treatments for which hospital per diems (from an accident or health insurance policy) are received from us or another company.
Prerequisites for benefits. As a result of the accident in terms of 1.2, the insured person has suffered one of the following serious injuries, and has submitted a claim for these injuries to the insurer within six months of the accident by submission of a doctor's certificate:
1.10.1.1 Paraplegia following an injury to the spinal chord
1.10.1.2 Amputation of at minimum the entire foot or entire hand
1.10.1.3 Head/brain injury with unquestionable contusion or cerebral haemorrhage
1.10.1.4 Serious multiple injuries / poly trauma
1.10.1.4.1 Fracture on two long bones (combination of upper/lower arm, upper/lower thigh)
1.10.1.4.2 Damages to two internal organs which lead to the destruction of tissue
1.10.1.4.3 Combination of at least two of the following injuries: - Fracture of one long bone - Pelvic fracture - Fracture of one or more vertebra - Damages to an internal organ that results in the destruction of tissue
1.10.1.4 Second or third degree xxxxx of more than 30% of the body's surface.
1.10.1.5 Blindness or serious visual impairment of both eyes; in the case of visual impairments, visual capacity is no more than five percent.
