Insurance broker / Group accident insurance for employees in Germany / Policy wording archive
R+V Gruppen-Unfallversicherung: the policy wording in full
Zusatzbedingungen zur Gruppenunfallversicherung mit oder ohne Namensangabe, Beitrag nach monatlicher Kopfzahl; Leistungen richten sich nach den R+V AUB, die hier nicht vorliegen.
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Everything about this policy
What the policy covers: 64 points, each with its clause
Contract form and insured persons
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Contract form (named, unnamed, groups of persons, flat rate by payroll or headcount) | yes | „Die Gruppen-Unfallversicherung kann mit oder ohne Angabe der Namen der versicherten Personen abgeschlossen werden.“ | Vorbemerkung, page 1 |
| Insurable persons (employees, owners, family members working in the business, apprentices, temporary staff, club members, volunteers) | yes | „Versicherungsschutz besteht für die Personen, die der im Vertrag bezeichneten Gruppe angehören.“ | 1.1, page 1 |
| New persons covered automatically (provisional cover, notification period) | yes | „Für die hinzukommenden Personen besteht Versicherungsschutz im vereinbarten Umfang ab Eingang Ihrer Anmeldung bei uns.“ | 2.2, page 1 |
| End of cover when leaving the company or club | yes | „Der Versicherungsschutz der einzelnen versicherten Person erlischt, wenn sie aus dem mit Ihnen bestehenden Dienstverhältnis oder aus der Vereinigung ausscheidet.“ | 1.6, page 1 |
| Right of the insured person to continue cover as an individual policy after leaving | not addressed | ||
| Who exercises the rights and who is paid (policyholder or insured person, direct claim) | not addressed | ||
| Maximum age or change of benefits from a certain age | not addressed | ||
| Uninsurable persons (persons in need of care, serious illness, clause and consequences) | not addressed |
Time and place of cover
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Around the clock (work and leisure) or occupational accidents only | not addressed | ||
| Territorial scope (worldwide, limits on longer stays abroad) | not addressed | ||
| Commuting accidents between home and workplace (with occupational cover only) | not addressed | ||
| Business trips, company events, company sports | not addressed | ||
| Club events, training, competitions and travel to them (club version) | not addressed |
Permanent disability
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Basic sum insured for permanent disability per insured person | not addressed | ||
| Disability table: arm (percentage) | not addressed | ||
| Disability table: hand at the wrist (percentage) | not addressed | ||
| Disability table: thumb and index finger (percentage) | not addressed | ||
| Disability table: leg and foot (percentage) | not addressed | ||
| Disability table: eye (percentage) | not addressed | ||
| Disability table: hearing in one ear (percentage) | not addressed | ||
| Progression (higher payout at high disability degrees, scale) | not addressed | ||
| Contribution of pre-existing illness (percentage from which benefits are reduced) | not addressed | ||
| Deadlines for occurrence and medical certification of disability | not addressed | ||
| Deadline for claiming disability | not addressed | ||
| Reassessment of the degree of disability (period, who may request it) | not addressed | ||
| Minimum degree of disability for a payout | not addressed |
Further benefits
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Accidental death benefit | not addressed | ||
| Daily allowance for incapacity to work (amount, duration, waiting period) | not addressed | ||
| Hospital daily benefit (amount, maximum duration) | not addressed | ||
| Convalescence benefit after hospital stay | not addressed | ||
| Accident annuity (from which degree of disability) | not addressed | ||
| Transitional benefit for prolonged impairment | not addressed | ||
| Medical costs, dental prostheses, aids (where no other payer covers them) | not addressed | ||
| Search, rescue and repatriation costs | not addressed | ||
| Cosmetic surgery after an accident | not addressed | ||
| Immediate payment for severe injuries or fractures | not addressed | ||
| Rehabilitation management, help with return to work | not addressed |
Definition of accident and extensions
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Injuries from increased exertion or own movement | not addressed | ||
| Damage from gases, vapours, substances (sudden, also at the workplace) | not addressed | ||
| Infections from accident injuries, tick bites, insect stings | not addressed | ||
| Spinal disc damage and abdominal hernias | not addressed | ||
| Heart attack and stroke | not addressed | ||
| Psychological reactions after an accident (also assault at work) | not addressed | ||
| Disturbances of consciousness, alcohol (blood alcohol limit), seizures | not addressed | ||
| Occupational diseases (expressly excluded or included) | not addressed |
Exclusions
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Motor sport and racing | not addressed | ||
| Aviation (passenger, pilot, parachute, hang gliding) | not addressed | ||
| Passive war risk and civil unrest | not addressed | ||
| Nuclear energy and radiation (exception for occupational X-ray and radiation work) | not addressed | ||
| Excluded or surcharged activities (risk groups, work at height, explosives, diving) | not addressed | ||
| Accidents while committing a deliberate criminal offence | not addressed |
Contract, premium and obligations
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Premium basis (headcount, payroll, membership, risk group) and adjustment | yes | „Aufgrund Ihrer Angaben errechnen wir den zu zahlenden Beitrag für den zurückliegenden und für den laufenden Zeitabschnitt, und Sie erhalten von uns eine Abrechnung.“ | 1.5, page 1 |
| Policyholder's reporting duties (additions and departures, annual statement) | yes | „Diese Angabe muss nach Monaten und nach dem höchsten Stand jeden Monats erfolgen. Eine Durchschnittsberechnung ist nicht zulässig.“ | 1.3, page 1 |
| Change of occupation or risk group of an insured person | not addressed | ||
| No offsetting of statutory accident insurance benefits (employers' liability insurance associations, AUVA, Seguridad Social) | not addressed | ||
| Indexation or adjustment of sums insured | not addressed | ||
| Obligations after the accident (notification period, doctor, documents) | not addressed | ||
| Term, renewal and cancellation (also after a claim) | yes | „Wir können den Versicherungsschutz der einzelnen versicherten Person durch Mitteilung Ihnen gegenüber beenden, wenn wir nach einem Unfall eine Leistung für sie erbracht haben oder gegen uns Klage auf eine Leistung erhoben worden ist.“ | 3.1, page 1 |
Spain specifics
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Cover meets the mandatory benefits of the collective agreement (convenio colectivo), adjustment for a new agreement | not addressed | ||
| Absolute permanent disability and severe disability as lump sum | not addressed | ||
| Total permanent disability for one's own occupation | not addressed | ||
| Assessment by baremo (policy table or statutory table) | not addressed | ||
| Funeral costs | not addressed | ||
| Extraordinary risks via the Consorcio de Compensación de Seguros | not addressed |
Evaluated by NAMMERT from published policy wordings. Despite care, a value may be misread; legally only the wording of your own contract in the edition stated there applies. Please report errors, we correct them the same day.
Policy wordings and provider
- Legal entity
- R+V Allgemeine Versicherung Aktiengesellschaft
- Distribution
- through tied agents
- Zusatzbedingungen für die Gruppen-Unfallversicherung 2008 (R+V ZB Gruppen-UV 2008) Edition: R+V ZB Gruppen-UV 2008 Copy hosted by an intermediary, not by the insurer
Full text of the wording
Converted from the insurer's PDF, page numbers in square brackets. Tables may have shifted; if in doubt, the original applies. As text (Markdown)