First work out what was rejected. For an application it is about underwriting: ask for the reasons in writing, counter the findings with a medical report, make anonymous pre-enquiries elsewhere, negotiate an exclusion instead of a refusal. For a claim it is about your contract: file access, your own medical report, the ombudsman, court. Only about 3 percent of applications are rejected.
What the routes cost and what the alternatives cost. Guide figures for EUR 1,500 monthly benefit until age 67, as of September 2026.
Example
Typical range
BU for comparison, age 30, office job
around EUR 70 a month
Loading for pre-existing conditions
usually 20 to 100 percent on the standard premium
Basic abilities cover, EUR 1,000 benefit, trade job at age 26 to 28
around EUR 38 to 41 a month
Basic abilities cover, range across all profiles
about EUR 25 to over 400 a month
Your own medical report
four figures, close to EUR 4,000 in one decided case
Complaint to the insurance ombudsman
EUR 0, binding up to a value of EUR 10,000
As of September 2026, from publicly quoted examples.
The loading range is a guide value from quoting practice.
Lawyer and court fees follow the amount in dispute, which is calculated from the benefit claimed,
so they can only be quantified once the benefit and term are known;
we work it out for you beforehand.
Worked example
Roofer, age 46, claim rejected for a degree below 50 percent
How a more precise description of the working day turned the decision around.
First entry on the form
roofer, work on the roof no longer possible
Insurer's answer
rejected, measuring and office work still possible
Working day supplied afterwards, with hours
roof and scaffold 6.5 hours, measuring and office 1.5 hours
Supplementary statement from the orthopaedist
work at height and lifting permanently ruled out, prognosis over twelve months
81 percent of working time was gone and the six month prognosis was on file: the insurer accepted the benefit without court proceedings. Illustrative calculation.
First question: application or claim?
Rejection covers two entirely different situations, and the right route differs. If your application was rejected, the insurer declined you before any contract existed. This is about medical findings, your job and other insurers.
If your claim was rejected, you have a contract and the insurer says the conditions are not met. This is about evidence, deadlines and, if necessary, court. Do not mix them up: applying again after a claim rejection wastes months, and hiring a lawyer after an application rejection buys you nothing.
Application rejected: the order that matters
Ask for the reasons in writing first. Usually one single finding is named, and often it is one you can clear up: a suspected diagnosis never confirmed, a treatment long since completed, an entry that came from billing and never was an illness.
Then obtain a medical report that addresses exactly that point: reason, course, end, current state, prognosis. With that report, make anonymous pre-enquiries elsewhere. Ask explicitly for an exclusion of the one diagnosis instead of a refusal, and for a deferral with a fixed date instead of a final no. Also check the route through your employer: company schemes and group contracts (Kollektivvertrag) often use simplified underwriting.
Why the anonymous pre-enquiry comes first
A rejection, a loading or a deferral is recorded in the insurance industry's information system (Hinweis- und Informationssystem, HIS), which other insurers can query. Applying to one insurer after another collects entries and narrows your own options.
So the rule is: after a rejection, no second application, but an anonymous pre-enquiry (anonyme Risikovoranfrage) through a broker. Your findings go to several underwriters without your name, you collect verdicts and apply only where the verdict works. Once a year you can ask the operator of the file, free of charge, what is stored about you. Do that before you go on.
The real alternatives if no BU is available
None of these is as good as a BU. Each covers less, and that has to be said before you sign. Weaker cover is still better than none, especially if your income carries a family.
Check them in this order: basic abilities cover first, then earning capacity cover, then serious illness cover, and accident cover last. Accident cover is the weakest substitute, because most disability cases come from illness, not accidents.
a far higher hurdle than 50 percent of your own job
Serious illness cover (Dread Disease)
one lump sum for listed diagnoses
no monthly benefit, anything off the list is not covered
Accident cover (Unfallversicherung)
pays only after accidents
most cases arise from illness, not accidents
Company scheme or group contract
access often with simplified health questions
tied to the employer, changing jobs can cost the cover
Claim rejected: the reasons and what lies behind them
Published analyses of claim reviews show insurers base just under 37 percent of rejections on the required degree of disability not being reached, and almost 15 percent on wrong answers given when the contract started. The notorious referral to another job, together with reorganisation of your work, accounts for under one percent.
Read the rejection letter sentence by sentence. It almost always reveals which piece of evidence the insurer is missing, and that is exactly what you can supply. A rejection is not a judgment, it is an assertion with reasons.
Stated reason
What lies behind it
Next step
Degree below 50 percent
your work was recorded too roughly
supply a working day with hours per task, name colleagues as witnesses
Six month prognosis not proven
the medical report says nothing about duration
request a supplementary statement on the expected duration
Referral to another job
the contract allows abstract referral (abstrakte Verweisung)
check the wording, dispute comparability of income and standing
Breach of the duty of disclosure
a finding was missing from the application
check causation and deadlines, demand the notice under section 19 (5) VVG
An exclusion applies
the excluded diagnosis is said to be the cause
prove another cause, have a specialist clarify causation
The route against a rejected claim
Ask for access to your claim file, including reports and internal notes. Then check whether the insurer applied its own policy wording and whether the letter even names the contractual conditions. Without a reasoned decision, the rejection is open to challenge on form alone.
Three routes follow. Your own medical report costs money but is taken seriously by the courts. A complaint to the insurance ombudsman (Versicherungsombudsmann) is free, admissible up to a value of EUR 100,000 and binding on the insurer up to EUR 10,000. If that does not settle it, sue: analyses put roughly 2.7 percent of claims in court, around two thirds of those cases end in a settlement and insurers lose about 11 percent. Use a lawyer specialising in insurance law (Fachanwalt für Versicherungsrecht) and check legal expenses insurance and legal aid first.
Extra points if German is not your first language
Claim forms, questionnaires and rejection letters come in German, and the German wording is what counts. Have the rejection translated properly before you answer it, and put your own answers in writing rather than settling anything by phone.
Medical reports from abroad usually need a translation before the insurer will accept them. Ask which format it requires, and send everything by a traceable route. If you are living outside Germany, name a German address for service or keep your broker as the contact point, so a letter with a deadline in it does not reach you late.
Step by step
Work out what was rejected: the application or the claim.
Ask for the reasons in writing, naming the finding or the missing condition.
For an application: obtain a medical report countering that point and have a broker run anonymous pre-enquiries.
For a claim: demand access to the file, including reports and internal notes.
Supply the missing evidence: working day with hours, a prognosis on duration, a specialist report.
Only then escalate: ombudsman, then court, after checking legal expenses insurance and legal aid.
Checklist
Written reasons received
Difference between application and claim rejection clarified
No further real application made without a pre-enquiry
Working day documented with hours per task
Legal expenses insurance checked for cover
Deadlines from the rejection letter noted
Common mistakes
Applying again straight away after a rejection
Accepting a rejection without written reasons
Turning down an offered exclusion and ending up with no cover at all
Treating accident cover as a full substitute for a BU
Letting months pass after a claim rejection instead of requesting the file
Answering a German rejection letter without having it translated properly
Questions and answers
Frequently asked
How often is a BU application rejected?
About 3 percent of applications.
Around 14 percent are accepted with a loading or exclusion.
A rejection is the exception, but it leaves a trace in the industry file.
Can I take out a policy with another insurer after a rejection?
Yes, underwriters judge the same finding differently.
Go through an anonymous pre-enquiry so no further entry is created.
Must I declare an earlier rejection in a new application?
If you are asked, yes.
That is exactly why the anonymous pre-enquiry is the better route:
it creates no application and no rejection.
What does the insurance ombudsman achieve?
It reviews free of charge.
The procedure is admissible up to EUR 100,000 and the decision binds the insurer up to EUR 10,000.
You stay free to go to court afterwards.
Who pays for a medical report?
The insurer pays for its own.
A report you commission you pay for first; in court proceedings it can be recoverable.
Is it worth going to court?
Few cases get there, and around two thirds of those settle.
With legal expenses insurance or legal aid the risk is manageable; without either,
have the amount in dispute calculated first.
Does it matter that all the letters are in German?
Yes.
The German wording is what binds you and deadlines run from the German letter.
