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HUK-COBURG KT6 bis KT52: the policy wording in full
Krankentagegeld für Selbstständige, Freiberufler und Arbeitnehmer mit Leistungsbeginn ab dem 43. bis 365. Tag, Tagessatz in 5 Euro Stufen bis 300 Euro.
German market: tariffs for people living in Germany.
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Everything about this policy
What the policy covers: 62 points, each with its clause
Quotes are shortened.
The full German wording of each point is on the German page for HUK-COBURG KT6 bis KT52.
Basics
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Insurable daily sickness benefit per calendar day (maximum) | yes, up to EUR 300 | „Das Krankentagegeld kann in 5 Euro-Stufen, insgesamt für alle Krankentagegeldtarife bis …“ | Teil III I. Nr. 2, page 1 |
| Benefit capped at net earned income (no overinsurance) | not addressed | ||
| Income basis (reference period, self employed: profit as assessed for tax) | not addressed | ||
| Selectable deferment periods (benefit from day x of incapacity) | yes | „KT6 ab dem 43. Tag KT13 ab dem 92. Tag KT26 ab dem 183. Tag KT39 ab dem 274. Tag KT52 …“ | Teil III I. Nr. 1, page 1 |
| Earliest benefit start (shortest deferment) | yes | „Bei Arbeitnehmern ist entsprechend der Dauer der Entgeltfortzahlung durch den …“ | Teil III I. Nr. 3, page 1 |
| Benefit duration without time limit (as long as incapacity lasts) | yes | „Das versicherte Krankentagegeld wird für die Dauer einer Arbeitsunfähigkeit (§ 1 (3) …“ | Teil III I. Nr. 1, page 1 |
| Eligible persons (employees, self employed, freelancers, members of statutory insurance) | yes | „gegen Entgelt in einem festen Arbeitsverhältnis stehen (Arbeitnehmer)“ | Teil III Versicherungsfähigkeit b), page 1 |
| Tariff topping up statutory sickness pay (gap to net income) | not addressed | ||
| Offsetting of continued pay and social benefits against the benefit | not addressed |
Scope of benefits
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Benefit for partial incapacity | not addressed | ||
| Benefit during gradual return to work | not addressed | ||
| Benefit during inpatient treatment without or with shortened deferment | not addressed | ||
| Benefit during statutory maternity protection periods | yes, up to the sum insured | „Das versicherte Krankentagegeld wird für die Dauer einer Arbeitsunfähigkeit (§ 1 (3) …“ | Teil III I. Nr. 1, page 1 |
| Benefit when a child falls ill (care) | not addressed | ||
| Benefit for mental illness without special restriction | not addressed | ||
| Benefit during spa treatment, sanatorium stay or rehabilitation | not addressed | ||
| Benefit for incapacity abroad (Europe, worldwide) | not addressed | ||
| Benefit for incapacity due to organ or tissue donation | not addressed | ||
| Benefit for pregnancy complications outside protection periods | not addressed | ||
| Retroactive payment from the start despite late notice (no reduction) | not addressed |
Waiting periods
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| General waiting period | not addressed | ||
| Special waiting periods (childbirth, psychotherapy, dental treatment) | not addressed | ||
| No waiting period after an accident | not addressed | ||
| Credit for prior insurance periods against waiting periods | not addressed | ||
| No new deferment for recurring incapacity from the same cause | not addressed |
End of benefit and contract
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Benefit ends on occupational disability | not addressed | ||
| Definition of occupational disability (degree, prognosis period) | not addressed | ||
| Continued payment after occupational disability (months) | not addressed | ||
| Ends on receipt of old age or reduced earning capacity pension | yes | „noch keine Rente wegen einer Berufs- oder Erwerbsunfähigkeit beziehen oder beanspruchen …“ | Teil III Versicherungsfähigkeit, page 1 |
| Age at which cover ends | not addressed | ||
| Continuation or dormant cover during unemployment | not addressed | ||
| Continuation or dormant cover during parental leave | not addressed | ||
| Insurer may reduce the benefit when income falls | not addressed | ||
| Insurer waives ordinary right of termination | not addressed | ||
| Ends when residence or workplace moves abroad | not addressed |
Adjustments and options
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Increase on higher income without health check | not addressed | ||
| Shorter deferment without health check | not addressed | ||
| Conversion between employed and self employed without new health check | not addressed | ||
| Automatic indexation of the benefit | not addressed | ||
| Dormant cover for a reduced premium | not addressed | ||
| Premium waiver while receiving benefit | not addressed | ||
| Right to convert into disability income insurance | not addressed |
Obligations
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Deadline to report incapacity | not addressed | ||
| Interval for proof of incapacity (medical certificate) | not addressed | ||
| Examination by a doctor appointed by the insurer | not addressed | ||
| Duty to report a fall in income | not addressed | ||
| Benefit only while staying at home or in the country during incapacity | yes | „Versicherungsfähig sind Personen, die ihren ständigen Wohnsitz“ | Teil III Versicherungsfähigkeit, page 1 |
| Further sickness benefit cover only with the insurer's consent | not addressed |
Exclusions
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Exclusion for intent | not addressed | ||
| Exclusion for addiction (alcohol, drugs) and withdrawal treatment | not addressed | ||
| Exclusion for acts of war | not addressed | ||
| Exclusion for accidents under alcohol or drugs | not addressed | ||
| Exclusion for medically unnecessary procedures (e.g. cosmetic surgery) | not addressed | ||
| Exclusion of pre existing conditions | not addressed | ||
| Exclusion of certain sports or competitions | not addressed | ||
| Exclusion or restriction for back conditions | not addressed |
Spain specifics
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Benefit by diagnosis table (baremo) instead of actual days | not addressed | ||
| Maximum benefit duration per claim (days) | not addressed | ||
| Additional daily benefit for hospital stay | not addressed | ||
| Benefit only if incapacity is recognised by social security or the professional mutual | not addressed | ||
| Fixed benefit for childbirth or maternity | not addressed | ||
| Additional lump sum for death or permanent disability | 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.
Please report errors, we correct them the same day.
Policy wordings and provider
- Legal entity
- HUK-COBURG-Krankenversicherung AG
- Distribution
- brokers and direct
- Allgemeine Versicherungsbedingungen Krankentagegeld KT6 bis KT52 Edition: 01.2018 (AP00401U) 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 HUK-COBURG KT6 bis KT52 and available as plain text.
Volltext HUK-COBURG KT6 bis KT52 Krankentagegeld · As text (Markdown) HUK-COBURG KT6 bis KT52