# Midwife liability insurance in Germany: what protects your work with mother and child > A self-employed midwife in Germany must hold professional liability insurance before she may practise. One mistake during a birth can harm a child for life, and the claims that follow can run into millions. What matters most is a high limit, cover that lasts long after the birth and a description of activities that matches the work you actually do. Quelle/Source: https://www.nammert.com/en/insurance-broker-midwife-liability.php Updated: 2026-11-14 ## Is liability insurance compulsory for midwives in Germany? Yes, for self-employed midwives. The duty is not set out in a federal law but in the professional codes for midwives of the individual German states, which differ in detail. The local health office asks for proof: in North Rhine-Westphalia a current insurance certificate is part of registering self-employed practice, in Lower Saxony it has to be renewed at regular intervals. Without cover you may not work on your own account. ## At a glance - **Compulsory?:** Yes, for self-employed midwives under the professional codes of the German states - **Limit in the DHV group contract:** 15 million euros in the new contract running to the end of 2031, previously 12.5 million - **Premium with birth attendance:** 13,292 euros for the 2025/26 insurance year in the DHV group contract - **Subsidy:** statutory health insurers refund most of it, not the share for privately insured clients - **How long claims can follow:** up to 30 years after a birth injury ## Group contract or an individual policy Most self-employed midwives in Germany are not insured individually but through the group contract of their professional association. The German Midwives Association (Deutscher Hebammenverband, DHV) has a contract with a consortium of insurers, and the Federation of Self-Employed Midwives (BfHD) has a framework contract of its own. The new DHV contract runs to the end of 2031 and raises the limit from 12.5 to 15 million euros. Midwives who do not attend births can also find individual policies in the healthcare liability ranges of some insurers. If you are starting out or switching, compare the wording side by side: limit, run off cover and the exact description of activities count more than the name on the contract. With a group contract, remember that cover depends on staying a member. ## With or without birth attendance The price of midwife liability depends almost entirely on whether you attend births. Antenatal care, postnatal visits, breastfeeding advice and classes are a manageable risk. Home births, birth centres and work as a self-employed hospital midwife carry the risk of a severe birth injury, which is why the DHV group cover with birth attendance cost 13,292 euros for 2025/26. Report every change in your work straight away. If you are insured without birth attendance and still assist at a birth, you may have no cover at all. Ask as well how the policy treats an unplanned emergency birth, for example when a baby arrives during a postnatal visit before the ambulance does. ## What the health insurers refund Because premiums for birth attendance are so high, the statutory health insurers pay back most of them. Midwives who attend births receive a liability refund and a supplement under the contract according to section 134a of Book V of the Social Code, applied for at the National Association of Statutory Health Insurance Funds. A minimum number of births is required, and an application can be refused if documents are missing after the deadline. The share that relates to care for privately insured clients is not refunded. For your own planning this matters: you pay the premium first, and the refund depends on deadlines and paperwork. ## Late claims and run off cover The effects of a mistake during a birth sometimes only show years later, when the child starts school. Claims arising from birth injuries can be brought up to 30 years after the event. That is why cover usually attaches to the event during the policy period, not to the date the claim arrives. For midwives who retire, give up birth attendance or change insurer, this is the key question. Get written confirmation that earlier births stay covered after the contract ends, keep your old certificates and keep careful birth records, because in a dispute decades later what was written down is what counts. ## What is covered - Bodily injury to mother and child caused by errors in care - Damage to property in the client's home, depending on the policy - Financial loss that follows from injury or property damage - Defence against unfounded claims, in court if necessary - Antenatal care, postnatal care, breastfeeding advice and classes - Birth attendance at home, in a birth centre or in hospital, if agreed - Claims brought many years after the event - Staff and stand ins, depending on the contract ## What is not covered - Damage caused intentionally - Birth attendance under a policy that excludes it - Work without a licence or outside the professional code - Fee repayments and billing disputes - Criminal and administrative fines - Damage caused with your own car, which needs motor liability ## Who needs it - Self-employed midwives who visit clients at home - Midwives attending home births or births in birth centres - Self-employed midwives attending births in hospital - Employed midwives with self-employed work on the side - Midwifery practices, partnerships and birth centres ## Who does not need it - Midwives employed only in a hospital and covered by its liability insurance, although a small residual cover can still make sense ## What it costs The premium depends above all on whether you attend births. With birth attendance the DHV group contract cost 13,292 euros for the 2025/26 insurance year, without it the cost is a fraction of that. The statutory health insurers refund most of the premium for birth attendance. **What drives the premium:** - Birth attendance or not, by far the biggest factor - Type of birth attendance: home birth, birth centre or hospital - Group contract through an association or individual policy - Limit of indemnity and deductible - Staff and form of practice - Claims history _We deliberately show no sample premiums for individual policies because prices depend heavily on the work you do. Your premium is fixed in the quote we obtain based on your details._ ## The policy levels on the market - **Without birth attendance:** Antenatal and postnatal care, breastfeeding advice and classes. Look for a clear rule on emergency births and a limit that can carry a serious injury claim. - **With birth attendance:** Home births, birth centres or hospital births. A high limit, long run off cover and an exact description of activities are essential, usually through the association group contract. - **Practice and birth centre:** Adds liability as operator, staff, damage to rented rooms and joint on call duty of several midwives. ## How to recognise a good policy | Criterion | Minimum standard | Strong policy | Why it matters | | --- | --- | --- | --- | | Limit for bodily injury | what the professional code of your state requires | a limit in line with the DHV group contract, 15 million euros there | A severe birth injury with lifelong care quickly exhausts small limits. | | Run off cover | events during the policy period stay covered | unlimited run off cover, also after retirement or death, free of charge | Claims from birth injuries can come up to 30 years later. | | Description of activities | the work you do today | everything the professional code allows, including classes, video advice and complementary methods | Anything not described is the first thing the insurer checks after a claim. | | Emergency birth | expressly regulated | included even in policies without birth attendance | Babies do not follow policy wordings, and the ambulance is not always first. | | Legal defence | included | included, costs not deducted from the limit | Expert reports and court cases about birth injuries take years. | | Insured persons | your own work | practice staff, students under supervision and stand ins | In a practice the same midwife does not always care for a client. | | Suspension during breaks | cancel and start again | premium free suspension during parental leave or illness | The contract stays in place without paying for months without work. | ## Insurers on the German market A large share of self-employed midwives in Germany are insured through the group and framework contracts of the DHV and the BfHD, whose wordings are not published. The list names insurers that write liability for health professions in Germany. It describes the market and says nothing about which insurers we work with. - **Versicherungskammer Bayern**: public insurer based in Munich, healthcare and hospitals - **Allianz**: liability for health professions through agents and brokers - **HDI**: part of the Talanx group, focus on the liberal professions and healthcare - **R+V**: insurer of the German cooperative banks, practices and hospitals - **Continentale**: healthcare liability that also covers allied health professions - **Alte Leipziger**: property and casualty arm of a mutual group, mainly sold through brokers 127 insurers supervised by BaFin, the German regulator, are licensed for this class of insurance. (Allgemeine Haftpflicht). Source: BaFin company database, 2026-09-18; EU insurers without a German office excluded. ## Typical claims and who pays - **Child left with a lasting birth injury** (often millions over many years): Lifelong care, lost earnings and damages for pain add up. A small limit will not carry this, strong contracts have limits in the tens of millions. - **Emergency birth on a postnatal visit** (up to millions, depending on the outcome): Insured without birth attendance and still present at a birth: good policies expressly cover the unplanned emergency birth, basic ones leave it open. - **Baby scales fall on a parquet floor** (a few hundred to a few thousand euros): Damage to property in the client's home is part of normal liability cover, as long as you are liable for it. - **Lawsuit 18 years after the birth** (often six or seven figures): Usually the policy from the year of the birth responds. What matters is that run off cover continues after a switch or retirement. - **Health insurer reclaims fees** (a few hundred to several thousand euros): A billing dispute is not a liability claim. Fee repayments are excluded from professional liability policies. - **Criminal proceedings after a birth** (legal fees often five figures): Liability insurance defends civil claims. Criminal defence costs are only covered if extended criminal legal protection is included. ## Myth or truth - „Self-employed midwives in Germany may work without liability insurance." ✘ False, the professional codes of the German states require it, and the health office asks for proof. - „The health insurers refund a large part of the premium for birth attendance." ✔ True, most of it comes back through the liability refund and supplement. The share for privately insured clients stays with the midwife. - „When the policy ends, liability for earlier births ends too." ✘ False, claims can come up to 30 years later. That is why run off cover of the policy in force at the birth matters. - „Cover without birth attendance costs only a fraction." ✔ True, antenatal care, postnatal care and classes carry much less risk than attending births. With birth attendance the DHV group premium for 2025/26 was 13,292 euros. - „As an employed hospital midwife I need no cover for work on the side." ✘ False, the hospital's liability insurance only covers work there. Self-employed postnatal care on the side needs its own policy. ## Common mistakes - Attending a birth while insured only without birth attendance - Not reporting that you have started home births or hospital work - Letting the proof of insurance at the health office lapse - Applying late for the health insurers refund or without the required documents - Giving up work without checking that earlier births stay covered ## FAQ ### Do I need my own policy as an employed midwife? For work in the hospital the employer is liable first, and its liability insurance protects you. If you also work on your own account, for example with postnatal visits, you need your own professional liability for that work. ### What limit should I choose? At least what the professional code of your German state requires, and preferably well above it. The new DHV group contract provides 15 million euros, which shows the size of claims a severe birth injury can reach. ### Do the health insurers pay my premium? If you attend births, mostly yes. Under the contract according to section 134a of Book V of the Social Code there is a liability refund and a supplement, applied for at the National Association of Statutory Health Insurance Funds. The share for privately insured clients is not refunded. ### Do I have to join an association? Not for the insurance itself, an individual policy is possible. In practice, however, most contracts with birth attendance run through the group contracts of the DHV or the BfHD, and without membership the choice becomes very small. ### What happens if a claim is made years later? Claims from birth injuries can come up to 30 years later. Usually the policy in force at the time of the birth responds. Keep your old certificates and settle run off cover when you change insurer or stop working. ### Am I covered if a baby arrives unexpectedly during a home visit? That depends on the wording. Good policies without birth attendance expressly cover an unplanned emergency birth. Ask before you sign, because this is one of the most common gaps. ### Why use a broker for midwife liability? Because the differences lie in the description of activities, run off cover and the emergency birth rule. We check the wording against the work you actually do, tell you when your association group contract is the better choice and stand by you after a claim. ## Legal basis and sources - [Insurance Contract Act (VVG, German)](https://www.gesetze-im-internet.de/vvg_2008/) - [BaFin company database (licensed insurers)](https://portal.mvp.bafin.de/database/InstInfo/) ## Request quotes We obtain quotes and come back with a comparison, free of charge. You can write in English. https://www.nammert.com/en/insurance-broker-midwife-liability.php#anfrage --- Your broker: Norman Nammert, trading as NAMMERT. Insurance broker licensed under section 34d(1) of the German Trade Regulation Act. Broker register no. D-C08Q-TOSD4-37. NAMMERT Assekuradeur GmbH is a separate company. It does not arrange your contract. NAMMERT Assekuradeur GmbH, Karl-Marx-Straße 4, 15711 Königs Wusterhausen, +49 3375 29 12 77, info@nammert.com. Wikidata: Q141141479.