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Disability scale: how accident insurance assesses invalidity

Private accident insurance pays an invalidity benefit in case of permanent impairment. How high it is depends on the degree of invalidity, which is determined for the loss or the loss of function of body parts via the so-called disability scale.

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Your chances of getting your money back

The disability scale sets fixed degrees of invalidity for the loss or the loss of function of certain body parts (e.g. hand, leg, eye). The benefit is calculated from the degree of invalidity and the sum insured.
The determined degree of invalidity can be reviewed. Medical reports and a precise assessment of the functional impairment can lead to a higher benefit. Deadlines for the determination and assertion are important.

What you should do now

  1. 1

    1. Report the accident

    Report the accident on time and submit medical documents.

  2. 2

    2. Observe deadlines

    Watch the deadlines for determining and asserting the invalidity.

  3. 3

    3. Check the report

    Have the determined degree of invalidity and the report reviewed.

  4. 4

    4. Use reassessment

    Use the possibility of reassessment if the condition changes.

How to spot the scam

  • Deadlines for determining the invalidity are missed.
  • A degree of invalidity that is too low is accepted without examination.
  • Pre-existing conditions are taken into account in an excessively benefit-reducing way.

Frequently asked questions

What is the disability scale?

A table in the terms of the accident insurance that provides fixed degrees of invalidity for the loss or the loss of function of certain body parts. From this degree and the agreed sum insured, often with a progression, the invalidity benefit results.

Can I contest the degree of invalidity?

You can have the assessment reviewed. What matters are the medical findings on the permanent functional impairment. A differing report can lead to a higher degree and thus a higher benefit. Observe the contractual deadlines in doing so.

Which deadlines apply?

The invalidity must usually have occurred within certain deadlines after the accident, be medically determined, and be asserted with the insurer. If these deadlines are missed, the claim can lapse. So submit documents in good time.

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General information for self-help, not legal advice (RDG). In case of a high loss or uncertainty: contact a consumer advice center or a lawyer.