“I’m insured through work – why would I need anything else?” True – but only for part of the day.
Statutory cover: work, school and the commute only
The statutory scheme (gesetzliche Unfallversicherung), paid by employers via the accident insurance funds, covers employees, trainees, children in day care, pupils, students, volunteers, first-aiders and family carers (§ 2 SGB VII) – for accidents at work, on the direct commute and occupational diseases (§ 8 SGB VII).
Not covered: leisure, household, sport, holidays, traffic outside the commute. That is where most accidents happen: the last complete statistics of the Federal Institute for Occupational Safety and Health (BAuA, 2015) counted about 9.7 million people injured, 3.9 million of them in leisure time and 3.2 million at home – roughly seven out of ten outside statutory cover. The figures are estimates and not recent; no newer all-areas statistic exists.
Private cover: a lump sum for permanent consequences
Private accident insurance applies around the clock, worldwide. Its key benefit is the disability payment (Invaliditätsleistung): a one-off sum if an accident leaves a permanent impairment – expected to last more than three years without improvement. Deadlines for diagnosis are set in the contract.
When is an accident an accident?
A sudden event acting on the body from outside, causing involuntary bodily harm. A fall from a ladder qualifies; a heart attack is an illness; a slipped disc from lifting usually counts only with an “extended accident definition”. You must prove the accident – see a doctor promptly.
Limb schedule and progression
The payout depends on the sum insured, the degree of disability and the progression:
- Limb schedule (Gliedertaxe): a percentage per body part. Consumer advice example: one eye = 50 %; with 300,000 € insured, 150,000 €. Schedules differ – compare them, not just premiums.
- Progression: higher payouts for severe injuries. Example: 100,000 € with 225 % progression – at 50 % disability you receive 112,500 € instead of 50,000 €. It does not help with minor injuries.
- Pre-existing conditions contributing more than 25 % to the outcome reduce the benefit proportionally.
Not a substitute for disability income insurance
Accident cover pays only after an accident. Most people become unable to work through illness – and that is not an accident. Disability income insurance (Berufsunfähigkeitsversicherung, BU) pays a monthly pension whatever the cause. If you live on your income, sort out the BU first.
Who should consider it
- Self-employed without an accident fund – no statutory cover at all.
- Homemakers – no employer, no fund.
- Children – covered at school, not in free time; consumer advice centres rate a children’s invalidity policy (including illness) as more important.
- Retirees – falls become more frequent; senior tariffs add practical assistance.
- Employees with BU cover need it least.
Typical exclusions: illness, psychological reactions, strain injuries, alcohol or medication, intent, racing.
How to proceed
- Clarify your status: accident fund behind you or not?
- Check disability income insurance first.
- Set the sum insured from what aids and a transition would cost; then choose progression.
- Compare limb schedules and exclusions.
General information, not legal, tax or investment advice. Sources: German Social Code Book VII (§§ 2, 8 SGB VII), Federal Institute for Occupational Safety and Health (baua: Fakten “Unfallstatistik 2015”), consumer advice centres, Finanztip – as of October 2026. Want to know whether you have a gap? Get in touch.
