Practice interruption insurance: keeping your practice afloat while you are ill
In a single-handed practice in Germany, income depends on one person. If the doctor, dentist or therapist is off sick, fees stop, but salaries, rent, equipment leases and loan repayments do not. Practice interruption insurance (Praxisausfallversicherung) pays an agreed daily amount or the proven fixed costs during that time. It sits between two other policies and replaces neither of them.
How is this different from daily sickness benefit?
Daily sickness benefit (Krankentagegeld) is health insurance for your personal income, the money you live on. Practice interruption insurance covers the running costs of the practice: staff, rent, leases and interest. Both pay when you cannot work, but into different pots, and daily sickness benefit can only be insured up to your actual income. Business interruption insurance (Betriebsunterbrechung) is different again: it only pays after physical damage such as a fire or a burst pipe, not when you are ill.
Three policies, three purposes
Practice owners in Germany often mix up three contracts that all deal with loss of income. Daily sickness benefit is part of health insurance and protects your own earnings. Business interruption cover is property insurance and pays lost profit after a fire, flood or burglary. Practice interruption insurance covers what neither of them does: the running costs of the practice when the person who generates the fees is absent.
A fourth product, business closure insurance (Betriebsschließungsversicherung), pays if the authorities close the practice because of infectious disease. It does not depend on your own illness. Which gap is most expensive for you depends on how high your fixed costs are and whether anyone else can keep treating patients.
Setting the daily amount
Start with what leaves your account each month even when no patient comes in: salaries including employer contributions, rent and service charges, equipment leases, interest and repayments, fees to the medical chamber and professional pension scheme, software and lab contracts. A common rule of thumb divides the monthly total by 30 and adds a buffer. If you also want part of your lost profit covered, that has to be agreed explicitly.
The waiting period is the other lever: the shorter it is, the higher the premium. Short illnesses can usually be bridged from reserves; long ones are the real danger. In a group practice each partner should be insured separately, with a daily amount matching their share of the costs.
Quarantine, staff and health questions
Whether an official quarantine order or a ban on practising under the German Infection Protection Act is covered varies from policy to policy, often as an optional extra. Several insurers rewrote these clauses after 2020. The cover applies to the owner, not the team: if the practice closes because your staff are in quarantine, this policy will normally not pay.
Because the benefit depends on your health, insurers ask health questions when you apply, may exclude known conditions and sometimes restrict cover for mental illness. Many tariffs price by entry age, often with a step at 50. On tax, the Federal Fiscal Court separates the risks (ruling of 19 May 2009, VIII R 6/07): premiums for your own illness are private, premiums for quarantine or physical damage are business expenses. Ask your tax adviser how your contract is treated.
What is covered
Running costs of the practice such as salaries, rent, leases and interest
A fixed daily amount without itemised proof, depending on the policy
Inability to work through illness
Inability to work after an accident, sometimes with a shorter waiting period
Official quarantine or a ban on practising, if included
Standstill after physical damage to the practice, if included
Part of the lost profit, if agreed
What is not covered
Your private living costs beyond the agreed benefit, which is what daily sickness benefit is for
Absence because staff are ill or in quarantine
An official closure of the practice without the owner being ill
Conditions known at application and excluded
The days of the waiting period
Benefits beyond the indemnity period, for example in permanent disability
Depending on the policy, mental illness or the effects of addiction
Who needs it
Doctors running a single-handed practice in Germany
Dentists with high costs for staff, treatment units and leases
Psychotherapists and physiotherapists with their own premises and employees
Partners in a group practice
Founders repaying a loan for buying or equipping a practice
Who does not need it
Employed doctors without their own practice, who rely on continued pay and daily sickness benefit
Practices where a partner or locum can keep things running without a real drop in income
Wheel of misfortune
Spin the wheel of bad luck
Six things that really happen. The wheel picks yours and shows who pays.
Cost:
Budget policy Strong policy
See all six cases
Doctor breaks her wrist on the stairs, fixed costs for several weeks, often five figures. Budget policy: pays, Strong policy: pays. Full incapacity after an accident is the core case. Benefits start after the waiting period, sooner with some insurers after an accident.
Therapist off with burnout, fixed costs for months. Budget policy: pays in part, Strong policy: pays. Mental illness is restricted or excluded by some insurers. Strong policies treat it like any other illness.
Health office orders quarantine, fixed costs for one to two weeks. Budget policy: does not pay, Strong policy: pays. Official orders against the owner are a separate extra. Without it, the policy only pays for genuine incapacity.
Whole team in quarantine, lost income while the practice is shut. Budget policy: does not pay, Strong policy: does not pay. Practice interruption cover depends on the owner, not the staff. Business closure insurance is the product for this.
Burst pipe shuts the practice, fixed costs until reopening. Budget policy: does not pay, Strong policy: pays. Physical damage only triggers payment if the policy includes it. Otherwise a separate business interruption policy is needed.
Dentist still ill after 14 months, fixed costs beyond the indemnity period. Budget policy: pays in part, Strong policy: pays. With 12 months of indemnity, payments end before recovery. A 24 month policy carries this case too.
What it costs
The premium depends mainly on the daily amount, the waiting period, the indemnity period, your entry age and your specialty. German intermediaries quote typical premiums for doctors of EUR 100 to 400 a month. A reliable figure needs your fixed costs and health details.
What drives the premium
Daily amount or insured fixed costs
Waiting period before benefits start
Indemnity period, for example 12 or 24 months
Entry age and state of health
Specialty and type of practice
Included triggers such as quarantine and physical damage
We do not quote sample premiums, as they mean little without a health assessment. Your premium is set in the quote we obtain from your details.
The policy levels on the market
01
Illness and accident
Daily amount when the owner is fully unable to work, longer waiting period, 12 months indemnity. Covers the core risk of a single-handed practice at a moderate premium.
02
With quarantine and practice bans
Adds official orders against the owner, often pays for partial incapacity and allows a shorter waiting period. For practices with close patient contact.
03
Owner and premises in one policy
Illness, accident and quarantine plus standstill after fire, water or burglary, indemnity up to 24 months. For practices with expensive equipment and high fixed costs.
How to recognise a good policy
Criterion
Minimum standard
Strong policy
Why it matters
Daily amount
covers the running fixed costs
fixed costs plus a buffer, adjustable later
A daily amount that is too low only narrows the gap.
Waiting period
matched to your reserves
short, reduced after an accident or hospital stay
The waiting period is how many weeks you pay out of your own pocket.
Indemnity period
12 months
24 months
Serious illness or surgery with rehabilitation often lasts more than a year.
Degree of incapacity
pays only at 100 % incapacity
pays proportionally from 50 %
Working half days means full costs and half the income.
Quarantine and practice bans
not included
included, even for orders without your own illness
Health professionals face infections and official orders more often than others.
Mental illness
restricted or excluded
covered like any other illness
Burnout and depression are among the common causes of long absences.
Group practice
only one owner insured
each partner with their own daily amount
Otherwise the healthy partners carry the costs of the sick one.
Insurers on the German market
In Germany, practice interruption cover is offered by a number of property and health insurers, sometimes as a product of its own, sometimes as owner absence cover for the self-employed or within a practice package. Which triggers are included only becomes clear in the quote. The list describes the German market; it says nothing about which insurers we work with.
Insurer
Background
INTER
dedicated practice interruption policy with a choice of indemnity period, insurer with a focus on health professions
SIGNAL IDUNA
owner absence cover for the self-employed, sold through agents and brokers
HDI
part of the Talanx group, practice interruption with a quarantine clause for health professions
Allianz
practice package for doctors with loss of income after physical damage
AXA / Deutsche Ärzteversicherung
the AXA group serves health professions through Deutsche Ärzteversicherung
Daily amount or fixed costs when the owner cannot work through illness or accident, with quarantine depending on the policy. The core cover for any single-handed practice.
Combined owner and premises cover
Owner absence and loss of income after physical damage in one contract, with the same waiting period and daily amount, so no gap opens between two policies.
Daily sickness benefit
Protects your private income and complements practice interruption cover rather than replacing it.
Business closure insurance
For official closures because of infectious disease, whether or not the owner is ill.
Myth or truth
True or false?
Five things people say about this insurance. Guess first, then see the answer.
If I have daily sickness benefit, I do not need practice interruption cover.
This is false.
False. Daily sickness benefit is limited by your income and meant for living costs. Practice salaries and rent come on top.
Business interruption insurance pays when the owner is ill.
This is false.
False. Standard business interruption cover needs physical damage. Your own illness is excluded there and is exactly what practice interruption cover is for.
Policies usually do not pay for the first days of illness.
This is true.
True. Benefits start after the waiting period, and the shorter you make it, the higher the premium.
Premiums for the illness part are not a business expense in Germany.
This is true.
True. The Federal Fiscal Court treats protection against your own illness as private. Premiums for quarantine or physical damage are business expenses.
If a nurse is quarantined, practice interruption cover pays.
This is false.
False. The cover depends on the owner. Staff absence needs a different contract, such as business closure insurance.
Common mistakes
Setting the daily amount when you open and never adjusting it after hiring or expanding
Assuming daily sickness benefit will also pay the practice costs
Assuming business interruption cover pays when you are ill
Giving incomplete answers to the health questions
Insuring only one partner in a group practice
Frequently asked questions
Questions and answers
Frequently asked
Does practice interruption insurance cover lost profit?
Only if it is explicitly included.
The core is the fixed costs.
Some insurers let you build part of your profit into the daily amount, others do not,
because that is the job of daily sickness benefit.
How high should the daily amount be?
High enough to carry the monthly fixed costs of the practice divided by 30, plus a buffer.
Add up salaries with employer contributions, rent, leases, interest and repayments,
chamber and pension scheme fees and ongoing contracts.
When do payments start?
After the agreed waiting period, which you choose when you take out the policy,
for example from day 4, 8 or 15.
Some insurers shorten or waive it after an accident.
How long does it pay?
Until you can work again, at most for the indemnity period,
usually 12 months per claim and 24 months with some policies.
It is not designed for permanent disability; that needs disability insurance.
Am I covered if the health office puts me in quarantine?
Only if your policy includes quarantine or practice bans,
which is not always the case and is often an optional extra.
Many of these clauses were rewritten after 2020, so read the wording.
Can I deduct the premiums for tax?
The part for business risks such as quarantine or physical damage, yes.
The part for your own illness is treated as private by the Federal Fiscal Court,
so it is not a business expense,
and benefits from it are not taxed as business income.
Your tax adviser can classify your contract.
I work in English with international patients. Does that matter?
Not for the cover itself, which depends on your practice costs and health.
It matters for the paperwork: policy wordings and claims run in German,
and we can explain both to you in English.
Why use a broker?
Because the differences lie in the waiting period, indemnity period,
quarantine clause and health questions.
We work out the daily amount with you,
align it with daily sickness benefit and business interruption cover,
and compare the wordings.
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