Does accident insurance pay for a torn ligament or cruciate ligament in Germany?
In short
Yes, German private accident insurance pays for a torn ligament or cruciate ligament if an accident or increased physical exertion caused it and lasting harm remains. If the knee heals completely, there is no disability benefit. If it stays unstable by a tenth, that is 7 percent at a leg value of 70 percent, so EUR 7,000 on a EUR 100,000 sum. Wear and tear contributing 25 percent or more reduces it.
the actual disability degree comes from the medical report.
Premiums from publicly quoted tariff examples, as of July 2026.
Worked example
ACL torn at indoor football, age 44
An amateur player tears his anterior cruciate ligament when stopping abruptly. Basic sum EUR 100,000. After surgery and rehab the knee stays slightly unstable, and the expert also finds wear.
Accident
yes, increased exertion when stopping
Disability
a tenth of a 70 percent leg value, so 7 percent
Contribution from wear
30 percent, reduced to 4.9 percent
Disability benefit
EUR 4,900
He receives EUR 4,900. Without the wear it would have been EUR 7,000, and nothing had the knee healed fully.
When a torn cruciate ligament counts as an accident
Under the German model terms, an accident is a sudden event acting on the body from outside that causes involuntary harm to health. For a torn cruciate ligament (Kreuzbandriss) that is clear if you fall, are fouled or catch your ski on a bump.
It is harder when the ligament tears without an outside cause, such as when braking and turning on the pitch. Here the extended accident definition helps: if increased exertion strains or tears muscles, tendons, ligaments or capsules in the limbs, it counts as an accident. Exertion is increased if the muscle effort goes beyond normal everyday movements, judged by your own physique.
Torn ankle and hand ligaments
A torn ankle ligament after twisting your foot is the most common case. Twisting on a kerb or a stone is an external event, so the torn ligament is covered.
Whether money is paid almost always depends on whether something remains. A well healed outer ligament tear usually leads to no disability. If the ankle stays unstable, a share of the foot value in the limb schedule is used, 40 percent for the whole foot under the model terms.
Injury
Covered as an accident?
Disability benefit
Cruciate ligament torn in a fall or foul
yes
only with lasting harm
Cruciate ligament torn when braking with increased force
yes, through the exertion rule
only with lasting harm
Outer ankle ligament torn after twisting
yes
usually none if fully healed
Meniscus tear without an external event
not through the exertion rule
depends on the policy terms
Wear and tear: the most common reduction
In people over 40, medical experts often find wear in the knee joint. If this prior damage contributed at least 25 percent to the injury or its consequences, the insurer cuts the disability degree by exactly that share (clause 3.2 AUB 2020).
The insurer has to prove the share. Do not accept a contribution of 50 percent without clear imaging before getting your own medical opinion.
How much money you get
The disability benefit is the basic sum times the disability degree. In the model limb schedule (Gliedertaxe) the leg is worth 45 to 70 percent depending on the level. Which leg value the expert uses for the knee follows your own limb schedule.
After a torn cruciate ligament, small degrees often remain, such as a tenth or a fifteenth of the leg value. A progression usually does not apply at such small degrees. Only a high basic sum makes a real difference here.
Deadlines where claims fail
The disability must have occurred within 15 months of the accident, been confirmed in writing by a doctor, and you must claim it from the insurer within that period (clause 2.1.1 AUB 2020). With surgery and long rehab after a torn ligament, that time passes quickly.
So get a doctor to confirm in good time before 15 months that lasting harm is expected, even if rehab is still ongoing.
Step by step
Write down exactly what happened straight away: outside cause or forceful movement.
Report the accident to the insurer.
Collect doctors' reports, MRI and surgery report.
Before 15 months, have the lasting harm confirmed in writing and claim it.
Have a high contribution share checked with your own medical opinion.
Checklist
What happened recorded with witnesses
MRI soon after the accident, it shows fresh injury and prior damage
15 month deadline in the calendar
Your limb schedule for leg and foot checked
Report checked for the contribution share
Common mistakes
Describing it as twisting for no reason when a collision or a forceful stop caused it
Missing the 15 month deadline because rehab is still running
Accepting a large cut for wear and tear without checking
Expecting a payment although the knee healed completely
Questions and answers
Frequently asked
Does accident insurance pay for ACL surgery?
No, treatment is paid by your health insurer,
or by the Berufsgenossenschaft after a workplace accident.
Private accident insurance pays for lasting harm.
Is a torn ligament from twisting an ankle an accident?
Yes, twisting on an edge or uneven ground is an external event.
What matters then is whether lasting harm remains.
What about a torn meniscus?
The model terms do not include the meniscus in the exertion rule.
With an external event such as a fall it is covered, otherwise it depends on the terms.
Is there a lump sum for a torn ligament?
Only if your tariff has an add-on for it.
The model terms do not provide a lump sum for torn ligaments.
Is accident insurance worth it for footballers?
For lasting knee damage yes, if the basic sum is high enough.
