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Union Krankenversicherung Krankenhaustagegeld: the policy wording in full
Allgemeine Versicherungsbedingungen (MB/KK 2009 und Tarifbedingungen) der Union Krankenversicherung für die Krankenhaustagegeldversicherung, mit Verzicht auf die Anzeige des Krankenhausaufenthalts und auf das ordentliche Kündigungsrecht; Tagessatz und Tarifleistungen stehen im Tarif, der nicht vorliegt.
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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 Union Krankenversicherung
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) | 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 | none | „unbeschadet der Ansprüche des Versicherungsnehmers auf Krankenhaustagegeld“ | § 5 Abs. 3 MB/KK, page 3 |
| Daily rate capped at income or need (also with other policies) | yes | „Eine weitere Krankenhaustagegeldversicherung darf nur mit ... des Versicherers …“ | § 9 Abs. 6 MB/KK, page 5 |
Covered stays
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Inpatient treatment for illness | yes | „Versicherungsfall ist die medizinisch notwendige Heilbehandlung einer versicherten …“ | § 1 Abs. 2 MB/KK, page 1 |
| Inpatient treatment after an accident | yes | „Versicherungsfall ist die medizinisch notwendige Heilbehandlung einer versicherten …“ | § 1 Abs. 2 MB/KK, page 1 |
| Benefit only after accidents (accident-only tariff) | none | „Versicherungsfall ist die medizinisch notwendige Heilbehandlung einer versicherten …“ | § 1 Abs. 2 MB/KK, page 1 |
| Inpatient childbirth | yes | „Untersuchung und medizinisch notwendige Behandlung wegen Schwangerschaft und die …“ | § 1 Abs. 2 a MB/KK, page 1 |
| Day-patient treatment (day clinic) | not addressed | ||
| Outpatient surgery replacing an inpatient stay | not addressed | ||
| Follow-up rehabilitation in hospital | no | „für Kur- und Sanatoriumsbehandlung sowie für Rehabilitationsmaßnahmen der gesetzlichen …“ | § 5 Abs. 1 d MB/KK, page 2 |
| Spa and sanatorium stays | no | „für Kur- und Sanatoriumsbehandlung sowie für Rehabilitationsmaßnahmen der gesetzlichen …“ | § 5 Abs. 1 d MB/KK, page 2 |
| Inpatient treatment of mental illness | not addressed | ||
| Mixed institutions (acute and cure) without prior approval | no | „werden die tariflichen Leistungen nur dann erbracht, wenn der Versicherer diese vor …“ | § 4 Abs. 5 MB/KK, page 2 |
| 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 | „Bei Neugeborenen beginnt der Versicherungsschutz ohne Risikozuschläge und ohne …“ | § 2 Abs. 2 MB/KK, page 2 |
| Stays abroad (territorial scope, duration) | yes | „Der Versicherungsschutz erstreckt sich auf Heilbehandlung in Europa.“ | § 1 Abs. 4 MB/KK, 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) | yes | „Die allgemeine Wartezeit beträgt drei Monate.“ | § 3 Abs. 2 MB/KK, page 2 |
| Special waiting period (childbirth, psychotherapy, certain illnesses) | yes | „Die besonderen Wartezeiten betragen für Entbindung ... Zahnbehandlung, Zahnersatz und …“ | § 3 Abs. 3 MB/KK, 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 | „können erlassen werden, wenn der Antragsteller ... ein ärztliches Zeugnis über den …“ | Teil II zu § 3 Abs. 4, page 2 |
Exclusions
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Exclusion of known or ongoing illnesses at inception | yes | „Für Versicherungsfälle, die vor Beginn des Versicherungsschutzes eingetreten sind, wird …“ | § 2 Abs. 1 MB/KK, page 1 |
| Exclusion of war and civil unrest | yes | „die durch Kriegsereignisse verursacht oder als Wehrdienstbeschädigung anerkannt und …“ | § 5 Abs. 1 a MB/KK, page 3 |
| 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 3 |
| 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 3 |
| Exclusion when travel abroad is for treatment | not addressed | ||
| Exclusion of treatment by spouse, parents or children | yes | „für Behandlungen durch Ehegatten, Eltern oder Kinder“ | § 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 | yes | „Der Versicherer verzichtet auch in der Krankenhaustagegeldversicherung und in der …“ | Teil II zu § 14 Abs. 2, page 7 |
| Premium adjustment after inception (conditions) | yes | „Dementsprechend vergleicht der Versicherer zumindest jährlich für jeden Tarif die …“ | § 8b Abs. 1 MB/KK, page 5 |
| Deductible or excess days before benefit | not addressed | ||
| Deadline to report the hospital stay | none | „Auf die Anzeige einer Krankenhausbehandlung nach Absatz 1 wird verzichtet.“ | Teil II zu § 9 Abs. 1, page 6 |
| Proof required (admission and discharge certificate, diagnosis) | yes | „Der Versicherer ist zur Leistung nur verpflichtet, wenn die von ihm geforderten …“ | § 6 Abs. 1 MB/KK, page 4 |
| Policy can be suspended or held dormant | yes | „das Versicherungsverhältnis in eine Anwartschaftsversicherung umzuwandeln“ | § 15 Abs. 3 MB/KK, page 7 |
| Minimum term and policyholder notice period | yes | „Der Versicherungsvertrag wird zunächst auf die Dauer von zwei Versicherungsjahren …“ | Teil II zu § 13 Abs. 1, page 7 |
| 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.
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Policy wordings and provider
- Legal entity
- UNION KRANKENVERSICHERUNG AKTIENGESELLSCHAFT
- Distribution
- through tied agents
- Allgemeine Versicherungsbedingungen AVB/VT unisex (Krankenhaustagegeld) Edition: Stand 01.10.2012 (SAP 331409) 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 Union Krankenversicherung Krankenhaustagegeld and available
as plain text.
Volltext Union Krankenversicherung Krankenhaustagegeld Krankenhaustagegeld · As text (Markdown) Union Krankenversicherung Krankenhaustagegeld Hospital cash