Does accident insurance pay for a stroke or heart attack in Germany?
In short
Does accident insurance pay for a stroke or heart attack in Germany? As a rule no, because both are illnesses, not accidents. The model terms even exclude falls caused by a stroke. Some policies still pay for such falls. With around 270,000 strokes and over 300,000 heart attacks a year in Germany, occupational disability insurance is the better protection.
Occupational disability insurance, age 30, office, EUR 1,500 pension
around EUR 70 a month
As of October 2026, from the sources named.
The figures in the example are guide values from our quoting practice.
Whether your policy includes accidents caused by a heart attack or stroke is set out in the
exclusions of your terms.
Worked example
Age 58, stroke on the stairs, broken thigh
How differently accident insurance pays depending on whether the policy includes accidents caused by a stroke.
Permanent damage to the leg under the limb schedule, half of 70 percent
35 percent
Sum insured
EUR 100,000
Benefit under the model terms
EUR 0, exclusion in clause 5.1.1
Benefit with a policy that includes accidents caused by a stroke
EUR 35,000 before progression and contribution
Effects of the stroke itself, such as paralysis
EUR 0 in both cases
The difference for the fall is EUR 35,000. No accident insurance pays for paralysis caused by the stroke; that needs disability or critical illness cover.
Why a stroke or heart attack is not an accident
Under the model terms an accident (Unfall) is a sudden event acting on the body from outside that involuntarily damages health. A stroke (Schlaganfall) or heart attack (Herzinfarkt) happens inside the body, through narrowed vessels, a clot or a bleed. There is no outside event, so accident insurance pays no disability benefit for it.
That also applies if the heart attack comes while shovelling snow or doing sport. The extension for increased physical effort only covers dislocated joints and strained or torn muscles, tendons, ligaments and capsules, not the heart.
The fall after a stroke
The fall is the tricky part: you have a stroke, fall down the stairs and break your thigh. The fracture comes from outside, yet the model terms exclude accidents caused by strokes, disturbances of consciousness and seizures. They even name a fall caused by a circulatory problem as an example.
There is an exception if the disturbance itself goes back to an earlier insured accident, such as a seizure after a brain injury. Some policies also go beyond the model terms and include accidents caused by a heart attack or stroke. Whether yours does is in the exclusions section.
Situation
Under the model terms
Note
Stroke without a fall
not covered
illness, no accident event
Heart attack while jogging
not covered
not increased effort within the meaning of the terms
Fall on the stairs after a stroke, broken leg
excluded, clause 5.1.1
included in some policies
Brain haemorrhage after falling off a bike
covered if the accident is the main cause
clause 5.2.1, more than 50 percent
Seizure after an earlier insured brain injury, then a fall
covered
exception in clause 5.1.1
Brain haemorrhage after an accident
Unlike a stroke out of the blue, a brain haemorrhage can be the result of an accident, for example after hitting your head in a fall. The model terms exclude brain haemorrhages and internal bleeding, but make an exception: if the accident caused the bleed by more than 50 percent, you are covered.
Disputes then turn on medical reports: did the fall cause the brain haemorrhage, or did a vascular disease cause the bleed and then the fall? Keep the emergency report, scans and witness statements.
When pre-existing conditions contribute to a real accident
The heart also matters in genuine accidents. If illness or infirmity contributed at least 25 percent to the consequences, the degree of disability is reduced by that share. Someone with vascular damage after a heart attack who falls and is injured should expect this reduction, even if the fall itself is covered.
If you take out new accident insurance after a heart attack or stroke, answer the health questions fully. Incorrect answers can later endanger all your cover, including accidents with no link to the heart.
What protects against a stroke or heart attack instead
Occupational disability insurance (Berufsunfähigkeitsversicherung) helps against loss of income after a stroke or heart attack because it also pays for illness. Heart and vascular disease account for about 6 percent of claims, accidents just under 7 percent.
Critical illness cover (Schwere-Krankheiten-Versicherung) pays a lump sum for a heart attack or stroke if the diagnosis meets the policy definition. Benefits often start only after a waiting period of several months, and the sum has to be high to replace an income. Basic abilities cover (Grundfähigkeitsversicherung) pays when abilities such as walking or gripping are lost.
Step by step
Read the section of your terms on exclusions and disturbances of consciousness.
Check whether accidents caused by a heart attack or stroke are expressly included.
After a fall, keep the emergency report and findings so the cause can be established.
Report the accident anyway, even if an exclusion seems likely.
Check disability or critical illness cover for illness.
Checklist
Inclusion of accidents caused by heart attack and stroke checked
Inclusion of disturbances of consciousness caused by medication checked
Reduction for contributing illness only from 25 percent or higher
Occupational disability insurance in place or checked
Reports and findings collected after a fall
Common mistakes
Thinking accident insurance protects against a heart attack
Not reporting a fall after a dizzy spell because an exclusion seems likely
Not having the difference between a brain haemorrhage after a fall and a stroke medically clarified
Taking out new accident insurance after a heart attack without full health answers
Questions and answers
Frequently asked
Does accident insurance pay for a heart attack during sport?
No.
A heart attack is an illness, even if it happens during exertion.
Does it pay if I fall after a stroke?
Not under the model terms.
Some policies include accidents caused by a stroke; your terms will say.
Is a brain haemorrhage after a fall covered?
Yes, if the accident caused the bleed by more than 50 percent.
A medical report decides.
Can I still get accident insurance after a heart attack?
Often yes, depending on the insurer's health questions.
Contributing heart disease can later reduce benefits.
Which insurance pays after a stroke?
Occupational disability insurance if you can no longer do your job,
and critical illness cover if the diagnosis is met.
Does statutory accident insurance pay for a heart attack at work?
It also requires an event acting on the body from outside (section 8 Social Code VII).
A heart attack alone usually does not meet that;
the employers' liability insurance association decides each case.
