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Hallesche langfristige: the policy wording in full
Langfristige Auslandskrankenversicherung mit Monatsbeitrag für Aufenthalte bis drei Jahre, Leistungshöhen nach gesondertem Tarif, mit Schutz bei vorübergehender Rückkehr nach Deutschland bis drei Monate und Verzicht auf das ordentliche Kündigungsrecht.
German market: tariffs for people living in Germany.
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Everything about this policy
What the policy covers: 66 points, each with its clause
Quotes are shortened. The full German wording of each point is on the German page for Hallesche langfristige.
Basics and territorial scope
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Benefit limit per claim (unlimited or fixed maximum) | as stated in the policy schedule | ||
| Worldwide cover (excluding country of residence) | yes | „Der Versicherungsschutz erstreckt sich auf Heilbehandlung im Ausland“ | § 1 (4), page 2 |
| USA and Canada included without surcharge or special rule | not addressed | ||
| Cover also within the home country away from the place of residence (common in Spain) | yes | „Ausdehnung des Versicherungsschutzes auf die Bundesrepublik Deutschland bis zur Dauer …“ | § 1 (4), page 2 |
| Maximum duration per trip (days or weeks) | yes | „spätestens drei Jahre nach dem Versicherungsbeginn“ | § 12 (7), page 8 |
| Annual contract for any number of trips in the insurance year | not addressed | ||
| Long stays over one year insurable (work and travel, study, emigration) | yes | „spätestens drei Jahre nach dem Versicherungsbeginn“ | § 12 (7), page 8 |
| Maximum entry age or age limit for cover | not addressed | ||
| Residence in the home country required (Germany, Austria, Spain) | not addressed | ||
| Purchase possible after departure | not addressed | ||
| Cover continues beyond the maximum duration if unfit to travel | yes | „so werden für den schwebenden Versicherungsfall ohne weitere Beitragszahlung bis zu …“ | § 6 (2), page 5 |
| Family tariff (partner and children in one contract) | not addressed |
Medical treatment and hospital
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Outpatient medical treatment | not addressed | ||
| Inpatient hospital treatment | not addressed | ||
| Free choice of hospital and doctor at destination | yes | „unter den öffentlichen und privaten Krankenhäusern, die unter ständiger ärztlicher …“ | § 3 (4), page 3 |
| Private doctor or senior physician, single room | not addressed | ||
| Prescribed medicines and dressings | not addressed | ||
| Medical aids after accident or illness (crutches, bandages, splints) | not addressed | ||
| Therapeutic remedies such as massage, physiotherapy, radiation | not addressed | ||
| Pain relieving dental treatment | not addressed | ||
| Simple dental fillings | not addressed | ||
| Repair of dentures and temporary dental work | not addressed | ||
| Treatment of pregnancy complications and premature birth | yes, up to the sum insured | „Untersuchung und medizinisch notwendige Behandlung wegen Schwangerschaft, Fehlgeburt …“ | § 1 (2), page 2 |
| Acute unexpected worsening of a pre-existing condition covered | not addressed | ||
| Acute mental illness (initial care, inpatient) | not addressed | ||
| Transport to the nearest doctor or hospital | not addressed | ||
| Accommodation of a parent when a child is hospitalised | not addressed | ||
| Daily hospital allowance in lieu of costs | not addressed |
Repatriation and assistance
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Repatriation as soon as medically sensible and justifiable | not addressed | ||
| Repatriation only if medically necessary | not addressed | ||
| Cost limit for repatriation | not addressed | ||
| Search, rescue and recovery costs | not addressed | ||
| Repatriation of mortal remains | not addressed | ||
| Burial at the place of death abroad | not addressed | ||
| 24 hour emergency hotline | not addressed | ||
| Cost guarantee to the hospital (direct billing) | not addressed | ||
| Visit of a close person during a longer hospital stay | not addressed | ||
| Return of accompanying minor children | not addressed | ||
| Additional return travel costs after illness (replacement ticket) | not addressed | ||
| Shipping of medicines to the destination | not addressed | ||
| Interpreter and translation costs | not addressed |
Exclusions and restrictions
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Exclusion: treatment as the purpose of the trip | not addressed | ||
| Exclusion: treatment known or foreseeable at departure | not addressed | ||
| Passive war risk and terrorism covered (sudden outbreak) | yes, up to the sum insured | „Die Leistungseinschränkung gemäß Satz 1 gilt nicht für Kriegsereignisse im Ausland, wenn“ | § 4 (1) a, page 3 |
| Illness during an epidemic or pandemic covered | not addressed | ||
| Exclusion or reduction if a government travel warning exists | yes | „für das Aufenthaltsland keine Reisewarnung durch das Auswärtige Amt besteht“ | § 4 (1) a, page 3 |
| Exclusion of dangerous or extreme sports | yes | „durch aktive Teilnahme an Sportarten, die nach der allgemeinen Lebenserfahrung …“ | § 4 (1) a, page 3 |
| Exclusion of motor sport and races | yes | „ferner durch berufsmäßige Teilnahme an Wettkämpfen“ | § 4 (1) a, page 3 |
| Exclusion under the influence of alcohol or drugs | yes | „für auf Vorsatz und Sucht beruhende Krankheiten und Unfälle“ | § 4 (1) b, page 4 |
| Exclusion of spa, sanatorium and rehabilitation | yes | „für Kur- und Sanatoriumsbehandlung sowie für Rehabilitationsmaßnahmen der gesetzlichen …“ | § 4 (1) d, page 4 |
| Exclusion for long term care or custodial care | yes | „für eine durch Pflegebedürftigkeit oder Verwahrung bedingte Unterbringung“ | § 4 (1) h, page 4 |
| Exclusion of intentionally caused illness and accidents | yes | „für auf Vorsatz und Sucht beruhende Krankheiten und Unfälle“ | § 4 (1) b, page 4 |
Deductible and benefit rules
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Deductible per claim or trip | not addressed | ||
| Subsidiary to statutory health insurance or other contracts | yes | „Besteht Anspruch auf Leistungen aus der gesetzlichen Unfallversicherung“ | § 4 (3), page 4 |
| Waiting period after purchase | not addressed | ||
| Obligation to notify before hospital admission, otherwise reduction | not addressed | ||
| Benefits only through the assistance company (no reimbursement of self paid costs) | none | „Die Rechnungen sind im Original einzureichen.“ | § 5 (3), page 4 |
| Deadline for submitting receipts | not addressed | ||
| Receipts in foreign languages accepted without certified translation | not addressed | ||
| Continued cover beyond contract end during a hospital stay | yes | „ohne weitere Beitragszahlung bis zu weiteren vier Wochen die tariflichen Leistungen …“ | § 6 (2), page 5 |
Contract and term
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Tacit renewal of the annual contract | no | „spätestens drei Jahre nach dem Versicherungsbeginn“ | § 12 (7), page 8 |
| Premium refund on early return (long stay) | yes | „mit Ablauf des Monats, in dem die Rückkehr erfolgt“ | § 12 (7), page 8 |
| Contract extension possible while abroad | not addressed | ||
| Premium changes with age bands | yes | „zahlen Kinder den Beitrag für die Altersgruppe 0-16 bis zum Ende des Jahres, in dem das …“ | § 7 (7), page 6 |
| Insurer may cancel after a claim | none | „Der Versicherer verzichtet auf das ordentliche Kündigungsrecht.“ | § 12 (2), page 7 |
| Meets Schengen visa requirements (at least 30,000 euros, no deductible) | not addressed |
Evaluated by NAMMERT from published policy wordings.
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legally only the wording of your own contract in the edition stated there applies.
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Policy wordings and provider
- Legal entity
- Hallesche Krankenversicherung auf Gegenseitigkeit
- Distribution
- brokers and direct
- Allgemeine Versicherungsbedingungen langfristige Auslandskrankenversicherung (PM 30u) Edition: PM 30u 08.23 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 Hallesche langfristige and available as plain text.
Volltext Hallesche langfristige · As text (Markdown) Hallesche langfristige