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DKV Krankenhaustagegeld KHT: the policy wording in full
Krankenhaustagegeld der DKV als Ergänzung zur Vollversicherung; das Werk enthält nur die Muster- und Tarifbedingungen (Teil I und II), die Tagessatzhöhe steht im gesonderten Tarifblatt.
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 DKV Krankenhaustagegeld KHT.
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) | not addressed | ||
| 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 | not addressed | ||
| 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 8 |
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 | „wegen Schwangerschaft und die Entbindung“ | § 1 Abs. 2 a MB/KK, page 2 |
| Day-patient treatment (day clinic) | not addressed | ||
| Outpatient surgery replacing an inpatient stay | not addressed | ||
| Follow-up rehabilitation in hospital | no | „Ein (Ersatz-)Krankenhaustagegeld wird nicht gewährt.“ | § 5 Abs. 1.2, page 5 |
| Spa and sanatorium stays | no | „für Kur- und Sanatoriumsbehandlung sowie für Rehabilitationsmaßnahmen der gesetzlichen …“ | § 5 Abs. 1 d MB/KK, page 5 |
| Inpatient treatment of mental illness | not addressed | ||
| Mixed institutions (acute and cure) without prior approval | yes | „Der Versicherer wird sich abweichend von Absatz 5 auf eine fehlende Leistungszusage …“ | § 4 Abs. 5.1, page 4 |
| 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 | not addressed | ||
| Stays abroad (territorial scope, duration) | yes | „Bei vorübergehendem Aufenthalt (bis zu drei Monaten) im außereuropäischen Ausland …“ | § 1 Abs. 4.1, page 2 |
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) | yes | „Die allgemeine Wartezeit beträgt drei Monate.“ | § 3 Abs. 2 MB/KK, page 3 |
| Special waiting period (childbirth, psychotherapy, certain illnesses) | yes | „Die besonderen Wartezeiten betragen für Entbindung“ | § 3 Abs. 3 MB/KK, page 3 |
| No waiting period for accidents | yes | „Die allgemeine Wartezeit beträgt drei Monate. Sie entfällt a) bei Unfällen“ | § 3 Abs. 2 MB/KK, page 3 |
| Credit for prior cover or waiver after medical exam | yes | „Die Wartezeiten können für alle Tarife auf Antrag erlassen werden, wenn für die zu …“ | § 3 Abs. 4.1, page 3 |
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 5 |
| 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 4 |
| 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 5 |
| Exclusion when travel abroad is for treatment | not addressed | ||
| Exclusion of treatment by spouse, parents or children | yes | „für Behandlungen durch Ehegatten“ | § 5 Abs. 1 g MB/KK, page 5 |
| 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 | yes | „Dies gilt auch für eine Krankenhaustagegeldversicherung, die neben einer …“ | § 14 Abs. 1, page 10 |
| Premium adjustment after inception (conditions) | yes | „werden alle Beiträge dieser Beobachtungseinheit vom Versicherer überprüft und, soweit …“ | § 8b Abs. 1 MB/KK, page 8 |
| Deductible or excess days before benefit | not addressed | ||
| Deadline to report the hospital stay | none | „Abweichend von Absatz 1 wird auf die Anzeige einer Krankenhausbehandlung verzichtet.“ | § 9 Abs. 1.1, page 8 |
| Proof required (admission and discharge certificate, diagnosis) | yes | „Wird nur Krankenhaustagegeld gewährt, genügt statt der Rechnung eine entsprechende …“ | § 6 Abs. 1.1, page 6 |
| Policy can be suspended or held dormant | not addressed | ||
| Minimum term and policyholder notice period | yes | „Der Vertrag wird pro Person und Tarif erstmals für zwei Versicherungsjahre abgeschlossen“ | § 13 Abs. 1.1, page 9 |
| 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
- DKV Deutsche Krankenversicherung Aktiengesellschaft
- Distribution
- through tied agents
- AVB für die VollMed-Tarife und den Tarif KHT (B 270) Edition: B 270 (12.24) 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 DKV Krankenhaustagegeld KHT and available as plain text.
Volltext DKV Krankenhaustagegeld KHT Krankenhaustagegeld · As text (Markdown) DKV Krankenhaustagegeld KHT Hospital cash