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ottonova Krankenhaustagegeld KHT: the policy wording in full
Krankenhaustagegeld als Vielfaches von 5 Euro (mindestens 10 Euro) für jeden Tag akutstationärer Behandlung oder Anschlussheilbehandlung, nur neben einer Krankheitskostenversicherung mit stationären Leistungen bei ottonova und nur im EWR.
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 ottonova Krankenhaustagegeld KHT.
Basics
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Insurable daily rate per day in hospital (maximum) | yes, up to the sum insured | „Das Krankenhaustagegeld kann nur als Vielfaches von 5 Euro abgeschlossen werden und …“ | Abschnitt 2.3.2, page 6 |
| Selectable benefit levels (minimum and steps) | yes | „Das Krankenhaustagegeld kann nur als Vielfaches von 5 Euro abgeschlossen werden und …“ | Abschnitt 2.3.2, page 6 |
| Benefit from the first day in hospital | yes | „Der Versicherungsfall beginnt mit dem ersten Tag der stationären Heilbehandlung“ | Abschnitt 2.1, page 5 |
| Minimum length of stay required (e.g. 24 hours or overnight) | not addressed | ||
| Admission and discharge days count as full days | yes | „Aufnahme- und Entlassungstag gelten dabei jeweils als volle Tage.“ | Abschnitt 2.3.1, page 6 |
| 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, die nicht ausschließlich bei …“ | Abschnitt 12.4, page 14 |
Covered stays
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Inpatient treatment for illness | yes | „Der Versicherungsfall ist die medizinisch notwendige stationäre Heilbehandlung einer …“ | Abschnitt 2.1, page 5 |
| Inpatient treatment after an accident | yes | „Der Versicherungsfall ist die medizinisch notwendige stationäre Heilbehandlung einer …“ | Abschnitt 2.1, page 5 |
| Benefit only after accidents (accident-only tariff) | none | „Der Versicherungsfall ist die medizinisch notwendige stationäre Heilbehandlung einer …“ | Abschnitt 2.1, page 5 |
| Inpatient childbirth | yes | „wegen Schwangerschaft und Entbindung“ | Abschnitt 2.1, page 6 |
| Day-patient treatment (day clinic) | not addressed | ||
| Outpatient surgery replacing an inpatient stay | not addressed | ||
| Follow-up rehabilitation in hospital | yes, up to the sum insured | „ottonova erstattet für jeden Tag einer akutstationären Behandlung oder einer …“ | Abschnitt 2.3.1, page 5 |
| Spa and sanatorium stays | not addressed | ||
| Inpatient treatment of mental illness | not addressed | ||
| Mixed institutions (acute and cure) without prior approval | not addressed | ||
| 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 Risikoprüfung und ohne Wartezeit ab dem Tage der …“ | Abschnitt 3.4.2, page 7 |
| Stays abroad (territorial scope, duration) | yes | „Der Versicherungsschutz erstreckt sich auf die medizinisch notwendige stationäre …“ | Abschnitt 2.3.3, page 5 |
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.“ | Abschnitt 3.1.1, page 6 |
| Special waiting period (childbirth, psychotherapy, certain illnesses) | yes | „Für Entbindung und Psychotherapie gilt die besondere Wartezeit von acht Monaten.“ | Abschnitt 3.1.2, page 6 |
| No waiting period for accidents | yes | „Erfolgt die Behandlung aufgrund eines Unfalls, der nach Versicherungsbeginn eingetreten …“ | Abschnitt 3.1.1, page 7 |
| Credit for prior cover or waiver after medical exam | yes | „Sofern die Krankenhaustagegeldversicherung gleichzeitig mit einer …“ | Abschnitt 3.1.3, page 7 |
Exclusions
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Exclusion of known or ongoing illnesses at inception | yes | „Für Versicherungsfälle, die vor Abschluss des Versicherungsvertrages eingetreten sind …“ | Abschnitt 3.2.1, page 6 |
| Exclusion of war and civil unrest | not addressed | ||
| Exclusion for intent, addiction and withdrawal | not addressed | ||
| 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 | not addressed | ||
| Exclusion when travel abroad is for treatment | not addressed | ||
| Exclusion of treatment by spouse, parents or children | not addressed | ||
| 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 | „Eine Kündigung ist jedoch ausgeschlossen, wenn die Krankenhaustagegeldversicherung …“ | Abschnitt 11.1, page 12 |
| Premium adjustment after inception (conditions) | yes | „Dementsprechend vergleicht ottonova zumindest jährlich für jeden Tarif die …“ | Abschnitt 7.1.1, page 11 |
| Deductible or excess days before benefit | not addressed | ||
| Deadline to report the hospital stay | not addressed | ||
| Proof required (admission and discharge certificate, diagnosis) | yes | „ottonova ist zur Leistung nur verpflichtet, wenn die von ihr geforderten Nachweise …“ | Abschnitt 5.2, page 8 |
| Policy can be suspended or held dormant | yes | „in Form einer Anwartschaftsversicherung fortzuführen“ | Abschnitt 11.6, page 8 |
| Minimum term and policyholder notice period | yes | „Die Mindestvertragsdauer beträgt zwei Versicherungsjahre.“ | Abschnitt 9.2, page 12 |
| 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
- ottonova Krankenversicherung AG
- Distribution
- direct from the insurer only
- Tarif KHT, Tarif- und Versicherungsbedingungen für die Krankenhaustagegeldversicherung Edition: Ausgabe 12/2021 (on-tbbkht-0004) 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 ottonova Krankenhaustagegeld KHT and available as plain text.
Volltext ottonova Krankenhaustagegeld KHT Krankenhaustagegeld · As text (Markdown) ottonova Krankenhaustagegeld KHT Hospital cash