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Swiss Life Option: the policy wording in full
Zusatzversicherung zur Berufsunfähigkeitsversicherung, die bei zehn schweren Krankheiten ein Kapital vom 12-, 24- oder 36-fachen der monatlichen BU-Rente nach 28 Tagen Überlebensfrist zahlt, weltweit und auch für mehrere Krankheiten nacheinander.
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Everything about this policy
What the policy covers: 70 points, each with its clause
Quotes are shortened.
The full German wording of each point is on the German page for Swiss Life Option.
Basics and benefit
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Sum insured (lump sum on diagnosis of a covered critical illness) | as stated in the policy schedule | „in Höhe der 12-, 24- oder 36-fachen garantierten monatlichen Berufsunfähigkeitsrente“ | A, page 3 |
| Benefit as an annuity instead of or in addition to the lump sum | not addressed | ||
| Multiple claims: benefit also for a second, different critical illness | yes | „Wenn bei der Versicherten Person nacheinander mehrere versicherte schwere Krankheiten …“ | 1.2, page 3 |
| Partial benefit for less severe forms or early stages (for example carcinoma in situ, minor procedures) | not addressed | ||
| Survival period: benefit only if the insured person survives a set period after diagnosis | yes | „Der Anspruch auf die Kapitalleistung entsteht grundsätzlich 28 Tage nach Diagnose einer …“ | 1.1, page 3 |
| Death benefit (lump sum or premium refund on death without prior claim) | not addressed | ||
| Benefit for terminal illness with limited life expectancy (for example under 12 months) | not addressed | ||
| Premium waiver on occupational disability or inability to work | not addressed | ||
| Cover for children of the insured person | not addressed | ||
| Minimum entry age | not addressed | ||
| Maximum entry age | not addressed | ||
| Maximum age at end of cover | yes | „Spätestens wenn der Versicherungsschutz aus der ... endet, erlischt auch die“ | 14, page 16 |
| Worldwide cover and moving abroad | yes | „Unser Versicherungsschutz besteht weltweit.“ | 2.4, page 8 |
| Standalone contract (not only as a rider to a life or disability policy) | no | „Unsere Schwere-Krankheiten-Option ist eine Zusatzversicherung“ | A, page 3 |
Cancer, heart and circulation
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Number of covered illnesses and procedures in the list | yes | „Die nachstehend aufgeführten Krankheiten gelten als schwere Krankheiten, wenn Sie die …“ | 1, page 3 |
| Cancer (malignant tumour, histologically confirmed) | yes, up to the sum insured | „Versicherungsschutz besteht nur, wenn ein Tumor ab einer Tumorgröße T2 nach der …“ | 1.5, page 4 |
| Early stage cancer and carcinoma in situ | no | „Carzinoma in situ, das heißt alle prämalignen Erkrankungen oder nicht-invasiven …“ | 1.5, page 4 |
| Skin cancer (melanoma from which stage, other skin cancer) | yes, up to the sum insured | „Maligne Melanome der Haut nach TNM Klassifikation T1a N0 M0 und T1b N0 M0 und T2a N0 M0“ | 1.5, page 4 |
| Prostate cancer in early stages (Gleason, TNM) | no | „früher Prostatakrebs nach TNM Klassifikation T1a N0 M0 und T1b N0 M0“ | 1.5, page 4 |
| Heart attack | yes, up to the sum insured | „Dabei muss die Diagnose durch die folgenden Kriterien gesichert sein: Typische …“ | 1.6, page 5 |
| Stroke | yes, up to the sum insured | „eine der folgenden neurologischen Ausfallerscheinungen mindestens drei Monate …“ | 1.7, page 5 |
| Transient ischaemic attack (TIA) | no | „Ausdrücklich vom Versicherungsschutz ausgeschlossen sind vorübergehende ... (TIA, PRIND)“ | 1.7, page 5 |
| Coronary artery bypass surgery | not addressed | ||
| Balloon angioplasty or stent (PTCA) | not addressed | ||
| Heart valve surgery or replacement | not addressed | ||
| Surgery of the aorta | not addressed | ||
| Cardiomyopathy and severe heart failure | not addressed | ||
| Benign brain tumour | yes, up to the sum insured | „ein Gehirntumor ab WHO II“ | 1.5, page 4 |
Nerves, organs and consequences of accidents
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Multiple sclerosis | yes, up to the sum insured | „Symptome über einen Zeitraum von ... mindestens sechs Monaten vorliegen.“ | 1.8, page 5 |
| Parkinson's disease | not addressed | ||
| Alzheimer's and other dementias (with age limit) | not addressed | ||
| Motor neurone disease (for example ALS) | not addressed | ||
| Coma | yes, up to the sum insured | „mit Hilfe der Glasgow Coma Scale (GCS) mindestens 96 Stunden lang ein Wert von maximal …“ | 1.10, page 6 |
| Paralysis of limbs | yes, up to the sum insured | „Eine Querschnittslähmung im Sinne dieser Bedingungen liegt vor bei einem kompletten und …“ | 1.9, page 6 |
| Blindness | yes, up to the sum insured | „die Sehschärfe des besseren Auges 3/60 (bzw. 0,05) oder weniger auf der …“ | 1.11, page 6 |
| Deafness | yes, up to the sum insured | „Hörverlust von mindestens 60 Dezibel bei einer Tonfrequenz von 2-kHz vorliegt.“ | 1.12, page 6 |
| Loss of speech | yes, up to the sum insured | „Der Verlust der Sprache muss über einen Zeitraum von sechs Monaten bestehen und durch …“ | 1.13, page 7 |
| Loss of limbs | not addressed | ||
| Severe burns | not addressed | ||
| Kidney failure (permanent dialysis) | not addressed | ||
| Transplant of a vital organ or waiting list | not addressed | ||
| Chronic liver or lung failure | not addressed | ||
| Bacterial meningitis and encephalitis with permanent damage | not addressed | ||
| HIV infection through blood transfusion or at work | not addressed | ||
| Further critical illnesses outside the list (open clause) | not addressed |
Diagnosis and claims assessment
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Diagnosis by a specialist in the relevant field | yes | „Die Diagnose muss durch einen Facharzt der entsprechenden Fachrichtung mit den nach …“ | 1.3, page 4 |
| Histology report or specific measurements as mandatory proof | yes | „wenn ein solider Tumor durch eine feingewebliche Untersuchung (Histologie) eindeutig …“ | 1.5, page 4 |
| Recognition of diagnoses made abroad | not addressed | ||
| Deadline for reporting the illness with reduced benefit if missed | yes | „Hierfür sind uns unverzüglich einzureichen“ | 5.1, page 9 |
| Deadline for the insurer's decision on the claim | yes | „erklären wir innerhalb von vier Wochen, ob und ab wann wir Leistungen aus der …“ | 3, page 8 |
| Period in which the insurer may withdraw for breach of the duty of disclosure | yes | „Die genannten Rechte können wir nur innerhalb von fünf Jahren seit Vertragsabschluss …“ | 5.3.5, page 11 |
Waiting periods and exclusions
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| General waiting period from start of cover | not addressed | ||
| Separate waiting period for cancer | yes | „zwischen Versicherungsbeginn“ | 1.5, page 4 |
| Exclusion of illnesses with symptoms or diagnosis before the start of the contract | not addressed | ||
| Exclusion of deliberately caused illness and self-harm | yes | „durch absichtliche Herbeiführung von Krankheit, Kräfteverfall oder Pflegebedürftigkeit …“ | 4, page 9 |
| Exclusion for alcohol, drug or medication abuse | yes | „Koma in Folge von absichtlicher Selbstverletzung oder Alkohol- oder Drogenmissbrauch“ | 1.10, page 6 |
| Cover for passive involvement in war (for example when travelling) | yes | „denen sie während eines Aufenthalts außerhalb der Bundesrepublik Deutschland ausgesetzt …“ | 4, page 9 |
| Exclusion for nuclear, biological or chemical weapons and radiation | yes | „durch den vorsätzlichen Einsatz von atomaren, biologischen oder chemischen Waffen“ | 4, page 9 |
| Exclusion of illnesses resulting from HIV or AIDS | not addressed | ||
| Exclusion of dangerous sports or activities | not addressed |
Contract and premium
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Premium guaranteed for the whole term | not addressed | ||
| Insurer waives ordinary termination | yes | „Auf unser Anpassungs- und Kündigungsrecht, geregelt in § 19 VVG, verzichten wir dann …“ | 5.3.5, page 11 |
| Increase without new health check on life events (marriage, birth, property) | not addressed | ||
| Automatic indexation of premium and sum | not addressed | ||
| Policyholder's right to terminate | yes | „Sie können Ihre Zusatzversicherung jederzeit zum Schluss einer Versicherungsperiode …“ | 15, page 17 |
| Paid-up option or surrender value | yes | „Bei Kündigung wird kein Rückkaufswert fällig und die Zusatzversicherung erlischt.“ | 16, page 17 |
| Additional services such as medical second opinion or support after diagnosis | yes | „Wir beraten und unterstützen Sie während der Vertragslaufzeit.“ | 2.3, page 8 |
Austria and Spain specifics
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Austria: only as a rider to a term or unit-linked life policy | not addressed | ||
| Spain: reimbursement of treatment costs for critical illnesses instead of a lump sum (health branch) | not addressed | ||
| Spain: limiting clauses highlighted and signed separately (Art. 3 LCS) | not addressed |
Evaluated by NAMMERT from published policy wordings.
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Policy wordings and provider
- Legal entity
- Swiss Life Lebensversicherung SE
- Distribution
- available through brokers
- Bedingungen für die Dread-Disease-Zusatzversicherung (Schwere-Krankheiten-Option), AVB_BC_SKZ_2025_01 Edition: AVB_BC_SKZ_2025_01, Stand 01.2025 Original from the insurer (PDF, German)
Full text of the wording
The full text exists only in German.
It is printed on the German page for Swiss Life Option and available as plain text.
Volltext Swiss Life Option Schwere-Krankheiten-Versicherung · As text (Markdown) Swiss Life Option