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AXA Krankenhaustagegeld: the policy wording in full
Krankenhaustagegeld der AXA nach MB/KK 2009 und Tarifbedingungen TB 2012, ohne Kostennachweis, mit Verzicht auf Wartezeiten und halbem Tagegeld bei teilstationärer Behandlung; der Tarif selbst mit der Tagessatzhöhe liegt nicht vor.
German market: tariffs for people living in Germany.
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Everything about this policy
What the policy covers: 61 points, each with its clause
Quotes are shortened.
The full German wording of each point is on the German page for AXA Krankenhaustagegeld.
Basics
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Insurable daily rate per day in hospital (maximum) | not addressed | ||
| Selectable benefit levels (minimum and steps) | not addressed | ||
| Benefit from the first day in hospital | not addressed | ||
| Minimum length of stay required (e.g. 24 hours or overnight) | none | „Krankenhaustagegelder und Ersatzleistungen werden in halber tariflicher Höhe gezahlt.“ | Nr. 24 (1) TB 2012, page 5 |
| Admission and discharge days count as full days | not addressed | ||
| Limit on benefit duration (days per claim or policy year) | not addressed | ||
| Paid without proof of costs, free to use | yes | „Das Krankenhaustagegeld wird ohne Nachweis von Kosten gezahlt.“ | Nr. 40 (3) TB 2012, page 7 |
| Reduction for benefits from other insurers or schemes | not addressed | ||
| Daily rate capped at income or need (also with other policies) | yes | „Eine weitere Krankenhaustagegeldversicherung darf nur mit Einwilligung des Versicherers …“ | § 9 Abs. 6 MB/KK, page 9 |
Covered stays
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Inpatient treatment for illness | yes | „Der Versicherer bietet Versicherungsschutz für Krankheiten, Unfälle und andere im …“ | § 1 Abs. 1 MB/KK, page 1 |
| Inpatient treatment after an accident | yes | „Der Versicherer bietet Versicherungsschutz für Krankheiten, Unfälle und andere im …“ | § 1 Abs. 1 MB/KK, page 1 |
| Benefit only after accidents (accident-only tariff) | none | „Der Versicherer bietet Versicherungsschutz für Krankheiten, Unfälle und andere im …“ | § 1 Abs. 1 MB/KK, page 1 |
| Inpatient childbirth | yes | „Schwangerschaft und die Entbindung“ | § 1 Abs. 2 a MB/KK, page 1 |
| Day-patient treatment (day clinic) | yes, up to the sum insured | „Krankenhaustagegelder und Ersatzleistungen werden in halber tariflicher Höhe gezahlt.“ | Nr. 24 (1) TB 2012, page 5 |
| Outpatient surgery replacing an inpatient stay | not addressed | ||
| Follow-up rehabilitation in hospital | not addressed | ||
| Spa and sanatorium stays | no | „für Kur- und Sanatoriumsbehandlung sowie für Rehabilitationsmaßnahmen der gesetzlichen …“ | § 5 Abs. 1 d MB/KK, page 7 |
| Inpatient treatment of mental illness | not addressed | ||
| Mixed institutions (acute and cure) without prior approval | yes | „Der Versicherer beruft sich auf die fehlende vorherige schriftliche Leistungszusage …“ | Nr. 26 TB 2012, page 5 |
| Inpatient hospice and palliative care | not addressed | ||
| Higher daily rate in intensive care | not addressed | ||
| Higher daily rate after an accident | not addressed | ||
| Benefit for a parent staying with a child in hospital | not addressed | ||
| Newborns covered from birth without waiting period | yes | „beginnt der Versicherungsschutz ohne Risikozuschläge und Wartezeiten“ | Nr. 7b TB 2012, page 2 |
| Stays abroad (territorial scope, duration) | yes | „Während der ersten 6 Monate besteht der Versicherungsschutz ohne besondere Vereinbarung.“ | Nr. 6 TB 2012, page 1 |
Additional benefits
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Recovery benefit after discharge | not addressed | ||
| Minimum stay required for the recovery benefit | not addressed | ||
| Lump sum for surgery (also graded by severity) | not addressed | ||
| Rising daily rate for long stays | not addressed | ||
| Replacement daily benefit when private room or chief physician is waived | not addressed | ||
| Benefit for home care replacing a hospital stay | not addressed | ||
| Increase of the daily rate without new health check | not addressed |
Waiting periods
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| General waiting period (months) | none | „Der Versicherer verzichtet auf die Einhaltung aller Wartezeiten, sofern der Tarif …“ | Nr. 8 TB 2012, page 2 |
| Special waiting period (childbirth, psychotherapy, certain illnesses) | none | „Der Versicherer verzichtet auf die Einhaltung aller Wartezeiten, sofern der Tarif …“ | Nr. 8 TB 2012, page 2 |
| No waiting period for accidents | yes | „Die allgemeine Wartezeit beträgt drei Monate. Sie entfällt a) bei Unfällen“ | § 3 Abs. 2 MB/KK, page 2 |
| Credit for prior cover or waiver after medical exam | yes | „wird die nachweislich dort ununterbrochen zurückgelegte Versicherungszeit auf die …“ | § 3 Abs. 5 MB/KK, page 2 |
Exclusions
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Exclusion of known or ongoing illnesses at inception | not addressed | ||
| Exclusion of war and civil unrest | yes | „die durch Kriegsereignisse verursacht oder als Wehrdienstbeschädigung anerkannt“ | § 5 Abs. 1 a MB/KK, page 6 |
| Exclusion for intent, addiction and withdrawal | yes | „für auf Vorsatz beruhende Krankheiten und Unfälle einschließlich deren Folgen sowie für …“ | § 5 Abs. 1 b MB/KK, page 6 |
| Exclusion of cosmetic and non-necessary procedures | not addressed | ||
| Exclusion of hazardous sports or motor racing | not addressed | ||
| Exclusion of purely custodial or nursing care stays | yes | „für eine durch Pflegebedürftigkeit oder Verwahrung bedingte Unterbringung“ | § 5 Abs. 1 h MB/KK, page 7 |
| Exclusion when travel abroad is for treatment | yes | „sofern der Versicherte zum Zwecke der Heilbehandlung ins Ausland gereist ist“ | Nr. 39 (1) TB 2012, page 7 |
| Exclusion of treatment by spouse, parents or children | yes | „für Behandlungen durch Ehegatten“ | § 5 Abs. 1 g MB/KK, page 3 |
| Exclusion of epidemics, pandemics or nuclear energy | not addressed |
Contract and duties
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Maximum entry age | not addressed | ||
| Cover ends at a certain age | not addressed | ||
| Health questions at application (scope, period) | not addressed | ||
| Insurer waives ordinary right to cancel | no | „Das verbleibende Kündigungsrecht kann vom Versicherer nur zum Ende des 3 …“ | Nr. 55 TB 2012, page 10 |
| Premium adjustment after inception (conditions) | yes | „beträgt für die diesen Allgemeinen Versicherungsbedingungen zugrunde liegenden Tarife …“ | Nr. 48 TB 2012, page 9 |
| Deductible or excess days before benefit | not addressed | ||
| Deadline to report the hospital stay | none | „Auf die Meldung einer Krankenhausbehandlung wird verzichtet.“ | Nr. 49 TB 2012, page 9 |
| Proof required (admission and discharge certificate, diagnosis) | yes | „Es ist eine Bescheinigung des Krankenhauses in Urschrift einzureichen, in der Name und …“ | Nr. 40 (3) TB 2012, page 7 |
| Policy can be suspended or held dormant | yes | „das Ruhen der beiderseitigen Rechte aus dem Versicherungsvertrag“ | Nr. 46 TB 2012, page 8 |
| Minimum term and policyholder notice period | yes | „Der Vertrag wird für zwei Jahre fest geschlossen und verlängert sich stillschweigend um …“ | Nr. 52 TB 2012, page 10 |
| Premium waiver during a long hospital stay | not addressed |
Specifics Spain
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Franchise days: first days without benefit | not addressed | ||
| Scheduled modality: benefit per table instead of actual days | not addressed | ||
| Family policy for all household members | not addressed | ||
| For self employed, combinable with temporary incapacity | not addressed | ||
| Consequences of incorrect health declaration (Art. 10 LCS) | 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.
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Policy wordings and provider
- Legal entity
- AXA Krankenversicherung Aktiengesellschaft
- Distribution
- brokers and direct
- AXA Teil II Tarifbedingungen TB 2012 für die Krankheitskosten- und Krankenhaustagegeldversicherung Edition: MB/KK 2009 Stand Dezember 2020, TB 2012 Copy hosted by an intermediary, not by the insurer
Full text of the wording
The full text exists only in German.
It is printed on the German page for AXA Krankenhaustagegeld and available as plain text.
Volltext AXA Krankenhaustagegeld Krankenhaustagegeld · As text (Markdown) AXA Krankenhaustagegeld Hospital cash