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Continentale Heilwesen: the policy wording in full
Berufshaftpflicht für Heilpraktiker, Psychotherapeuten und medizinische Heil- und Hilfsberufe auf Basis der AHB mit fünf Jahren Nachhaftung bei Praxisaufgabe oder Tod, Vermögensschäden, erweitertem Strafrechtsschutz und Umwelthaftpflicht-Basisversicherung.
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Everything about this policy
What the policy covers: 70 points, each with its clause
Quotes are shortened.
The full German wording of each point is on the German page for Continentale Heilwesen.
Basics and sums insured
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Sum insured for bodily injury per claim | not addressed | ||
| Sum insured for property damage per claim | not addressed | ||
| Sum insured for financial loss per claim | not addressed | ||
| Annual aggregate limit (multiple of the sum insured per insurance year) | not addressed | ||
| Meets the statutory insurance duty (Germany section 95e SGB V and chamber acts, Austria section 52d ÄrzteG and 26c ZÄG, Spain art. 46 LOPS) | not addressed | ||
| Trigger: occurrence or act committed (instead of claims made) | yes | „aus Schadenereignissen, die während der Wirksamkeit der Versicherung eingetreten sind“ | Teil II Ziffer 4.1, page 5 |
| Retroactive cover for acts before inception that were unknown at inception | not addressed | ||
| Extended reporting period after the policy ends | yes | „nicht aus irgendwelchen anderen Gründen wie etwa Änderung der beruflichen Fachrichtung …“ | Teil I Ziffer 5, page 5 |
| Run-off cover on closing the practice, retirement or death (also for heirs) | yes | „besteht Versicherungsschutz auf Grundlage dieser Versicherungsbedingungen 5 Jahre nach …“ | Teil I Ziffer 5, page 5 |
| Serial loss clause (several losses from the same cause count as one claim) | yes | „Mehrere während der Wirksamkeit der Versicherung eintretende Versicherungsfälle gelten …“ | Teil II Ziffer 9.3, page 9 |
| Defence and legal costs count against the sum insured | yes | „Aufwendungen des Versicherers für Kosten der gerichtlichen und außergerichtlichen …“ | Teil II Ziffer 5.2.2, page 6 |
| Defence against unfounded claims as a benefit | not addressed |
Insured activity
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Outpatient examination and treatment within the own specialty | yes | „Versichert sind alle Tätigkeiten und Behandlungen, die der Versicherungsnehmer und …“ | Teil I Ziffer 1.2, page 3 |
| Outpatient surgery and invasive procedures | not addressed | ||
| Inpatient activity (attending physician with hospital beds, consultant, fee-based hospital doctor) | not addressed | ||
| Obstetrics (by doctors; for midwives freelance birth assistance including home birth) | no | „aus der Durchführung aktiver Geburtshilfe (ausgenommen Erste-Hilfe-Leistung)“ | Teil III Ziffer 3.1.2, page 12 |
| Cosmetic and aesthetic procedures without medical indication | no | „aus Piercing, Tätowierungen, Faltenunterspritzungen, Fadenlifting, Injektionslipolyse“ | Teil III Ziffer 3.1.3, page 12 |
| Alternative medicine, novel methods and off-label use of medicines | not addressed | ||
| Remote treatment and telemedicine (video consultation) | not addressed | ||
| First aid, emergency help and treatment as a favour outside the practice | yes | „Erste-Hilfe-Leistungen bei Unglücksfällen im In- und Ausland“ | Teil II Ziffer 5.1 c), page 6 |
| On-call and emergency duty, emergency physician work | not addressed | ||
| Locum work (own work as a locum and liability for a locum in the own practice) | yes | „der Vertretung eines vorübergehend verhinderten Berufskollegen“ | Teil I Ziffer 1.2, page 3 |
| Work as an expert witness, teacher or lecturer | yes | „als Dozent im Inland und aus gelegentlicher Dozententätigkeit im Ausland“ | Teil II Ziffer 14.1, page 11 |
| Clinical trials and studies (work as an investigator) | no | „wegen Personenschäden, die auf klinische Prüfungen zurückzuführen sind, sofern hierfür …“ | Teil III Ziffer 3.1.6, page 12 |
| Activity outside the declared specialty | not addressed | ||
| Employed doctors: work for the employer, residual risk and recourse by the employer or hospital | not addressed |
Insured persons and forms of practice
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Cover for non-medical staff (medical assistants) including their personal liability | yes | „aus der Beschäftigung von nicht selbstständigem/nicht freiberuflichem Hilfspersonal …“ | Teil I Ziffer 2, page 3 |
| Cover for employed doctors, assistants and doctors in training | not addressed | ||
| Trainees, interns, students and clinical clerks | not addressed | ||
| Joint practice, shared premises, group practice and medical care centre | yes | „Diese Regelungen finden keine Anwendung, wenn alle Partner der Gemeinschaft über diesen …“ | Teil III Ziffer 1.1, page 12 |
| Joint and several liability for errors of practice partners | yes | „Die Ersatzpflicht des Versicherers bleibt auf die Quote beschränkt, welche der …“ | Teil III Ziffer 1.1, page 11 |
| Claims between insured persons | yes | „Haftpflichtansprüche dieser mitversicherten natürlichen Personen untereinander“ | Teil I Ziffer 2, page 3 |
Extensions and special risks
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Pure financial loss (for example wrong certificates and expert reports) | yes | „Mitversichert ist im Rahmen des Vertrags die gesetzliche Haftpflicht wegen …“ | Teil II Ziffer 4.1, page 5 |
| Breach of data protection, confidentiality and personal rights | yes | „Haftpflichtansprüche aus der Verarbeitung personenbezogener Daten im Sinne des BDSG zu …“ | Teil II Ziffer 4.2, page 6 |
| Loss of and damage to belongings of patients and visitors | yes, up to EUR 50,000 | „beträgt die Höchstersatzleistung je Versicherungsfall 50.000 Euro, die Gesamtleistung …“ | Teil II Ziffer 7, page 7 |
| Damage to rented practice premises and rented equipment | yes | „die gesetzliche Haftpflicht aus der Beschädigung von gemieteten Praxisräumen und alle …“ | Teil II Ziffer 3.2, page 5 |
| X-ray, radiation and laser (operating equipment, handling radioactive substances) | yes | „Schäden durch Röntgeneinrichtungen, Störstrahler sowie deckungsvorsorgefreien …“ | Teil II Ziffer 8.1 a), page 7 |
| Supply and use of medicines and medical devices, in-house production (product liability) | no | „wegen Personenschäden durch im Geltungsbereich des Arzneimittelgesetzes (AMG) an …“ | Teil III Ziffer 3.1.5, page 12 |
| Environmental liability and environmental damage (practice waste, waste water) | yes | „wegen Personen- und Sachschäden durch Umwelteinwirkung, wenn diese Umwelteinwirkung …“ | Teil IV Ziffer 1.1, page 13 |
| Extended criminal defence (defence costs in criminal proceedings after a treatment error) | yes | „übernimmt der Versicherer die Gerichtskosten sowie die gebührenordnungsmäßigen, ggf …“ | Teil II Ziffer 12.1, page 11 |
| Private liability of the policyholder and family included | yes | „Sofern vereinbart, ist für den/die Praxisinhaber die gesetzliche Haftpflicht als …“ | Teil V, page 18 |
| Cover abroad (treatment abroad, claims under foreign law) | yes | „die Ausübung der beruflichen Tätigkeit im Europäischen Ausland, sofern diese nur …“ | Teil II Ziffer 5.1 b), page 6 |
| Exclusion of claims before courts of the USA and Canada or under their law | none | „Die Selbstbeteiligung des Versicherungsnehmers an jedem Schaden beträgt 20.000 Euro …“ | Teil II Ziffer 5.2.3, page 6 |
| Vets: damage to treated animals, herd treatment and pre-purchase examination | not addressed | ||
| Naturopaths and allied health professions: invasive methods, injections, infusions and chiropractic | yes | „Dies gilt auch für Tätigkeiten und Behandlungen, die ohne ausdrückliche ärztliche …“ | Teil I Ziffer 1.2, page 3 |
| Direct claim of the injured party against the insurer | not addressed |
Exclusions
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Exclusion for intent and knowing breach of duty | yes | „aus bewusstem Abweichen von gesetzlichen und/oder behördlichen Vorschriften, von …“ | Teil II Ziffer 4.1 l), page 6 |
| Exclusion for activity without licence or outside professional rules | yes | „aus ärztlicher Tätigkeit und der Verschreibung von Medikamenten, es sei denn, der …“ | Teil III Ziffer 3.1.4, page 12 |
| Exclusion of promised results and contractual promises beyond statutory liability | not addressed | ||
| Exclusion of fee refunds and performance claims | not addressed | ||
| Exclusion of fines, penalties and punitive damages | yes | „auf Entschädigung mit Strafcharakter, insbesondere punitive oder exemplary damages“ | Teil III Ziffer 3.1.9, page 12 |
| Exclusion of losses from circumstances known at inception | not addressed | ||
| Exclusion for reproductive medicine, genetic engineering and germline interventions | yes | „wegen Schäden infolge der Veränderung des Erbguts (Genom), die ab der zweiten …“ | Teil II Ziffer 8.2 b), page 8 |
Deductible and duties
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Deductible per claim | yes | „Von jedem Versicherungsfall hat der Versicherungsnehmer 250 Euro selbst zu tragen.“ | Teil II Ziffer 11.1, page 10 |
| Duty to report changes in activity (new specialty, surgery, obstetrics, further doctors) | yes | „Wesentliche gefahrerhöhende Änderungen oder Erweiterungen des Risikos sind dem …“ | Teil I Ziffer 1.2, page 3 |
| Provisional cover for newly arising risks | yes | „Abweichend von Ziffer 4.2 AHB gelten die vereinbarten Deckungssummen auch für die …“ | Teil II Ziffer 1, page 5 |
| Deadline for reporting a loss or an impending claim | not addressed | ||
| Ban on admitting liability or settling without the insurer's consent | not addressed | ||
| Talking to the patient about the course of treatment and expressing regret allowed without losing cover | not addressed | ||
| No reduction of benefits for grossly negligent breach of duties | not addressed | ||
| Proceedings before expert commissions, arbitration boards or patient advocates recognised and costs covered | not addressed | ||
| Insurance certificate for the chamber or licensing body and notice of termination to the chamber | not addressed |
Term, cancellation and premium
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Policy term and tacit renewal | not addressed | ||
| Insurer's right to cancel after a claim | not addressed | ||
| Premium adjustment clause (increase during the term) | not addressed | ||
| Duty to declare rating factors (headcount, turnover, procedures) with retrospective charge | not addressed | ||
| Future improvements of the terms apply automatically to existing policies | not addressed | ||
| Guarantee not to fall below the association's model terms or a working group's recommendations | not addressed | ||
| Suspension or premium holiday when work is interrupted (parental leave, illness, stay abroad) | not addressed | ||
| Continuation of the practice after the policyholder's death (caretaker doctor, heirs) | not addressed |
Evaluated by NAMMERT from published policy wordings.
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Policy wordings and provider
- Legal entity
- Continentale Sachversicherung Aktiengesellschaft
- Distribution
- brokers and direct
- Besondere Bedingungen und Risikobeschreibungen Heilwesen (ContiBBR Heilwesen) Edition: Stand 01.07.2015, H.7e.4780.10/16 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 Continentale Heilwesen and available as plain text.
Volltext Continentale Heilwesen Arzthaftpflicht · As text (Markdown) Continentale Heilwesen Medical malpractice