# Critical illness insurance in Germany: a lump sum when the diagnosis arrives > Critical illness insurance, known in Germany as Schwere-Krankheiten-Versicherung or dread disease cover, pays an agreed sum in one go once a doctor diagnoses one of the conditions listed in the policy, such as cancer, heart attack or stroke. Whether you can keep working does not matter. The money buys breathing space for treatment, household and lost income, but it is not a monthly pension. Quelle/Source: https://www.nammert.com/en/insurance-broker-critical-illness.php Updated: 2026-11-03 ## Do I need critical illness cover if I already have BU? Usually it is an addition rather than a must. Occupational disability insurance (Berufsunfähigkeitsversicherung, BU) pays a monthly pension if you can no longer do at least half of your job, and the insurer often takes months to decide. Critical illness cover pays at diagnosis, even if you are back at work after treatment. It makes most sense for the self-employed, high earners with large fixed costs and anyone who cannot get BU. ## At a glance - **Mandatory?:** No - **Benefit:** one-off payment of the agreed sum on diagnosis of a covered condition - **Covered conditions:** roughly 40 to 75 depending on the policy, always cancer, heart attack and stroke - **Waiting period:** usually three months after the start, up to six with some insurers - **Survival period:** usually 14 or 28 days after diagnosis - **After payout:** the policy usually ends ## What the state system covers if you fall seriously ill Health insurance in Germany, statutory or private, pays for the treatment itself. Your income is a different matter. Employers continue full pay for six weeks, then the statutory health fund pays sickness benefit (Krankengeld) of 70 percent of gross pay, capped at 90 percent of net pay, for at most 78 weeks within three years for the same illness. Freelancers without daily sickness cover often receive nothing at all. On top of that come costs no insurer of the treatment pays: co-payments, travel to therapy, help at home, childcare, adapting your flat, perhaps unpaid leave for your partner. A lump sum you can spend as you see fit is designed for exactly that. ## How it differs from BU and basic abilities insurance The three products ask completely different questions. BU asks whether you are expected to be unable to do at least half of your last job for six months or more. Basic abilities insurance (Grundfähigkeitsversicherung) asks whether you have lost a defined ability such as walking or seeing. Critical illness insurance only asks whether a diagnosis on its list, meeting the stated criteria, has been made. That creates gaps in both directions. Mental illness and back problems are among the most common reasons people stop working, yet they almost never appear on a critical illness list. On the other hand, a treatable breast cancer triggers the full critical illness payout even if you are back at work within a year and BU would never pay. If you can afford only one policy, BU usually comes first because it protects your income until retirement. ## Where claims fail: definitions and time limits Not every cancer counts. German policies usually require a malignant, invasive tumour, while early stages such as carcinoma in situ and some skin cancers are excluded or covered only with a partial payment. A heart attack has to show typical findings such as ECG changes and lab values, and a stroke usually has to leave permanent neurological damage. A brief circulatory episode that clears without lasting effects normally does not qualify. Two time limits apply as well. The waiting period at the start stops people taking out cover when they already suspect something. The survival period means you must still be alive a set time after diagnosis, so the policy does not double as life cover. If your family needs money on your death, add term life insurance (Risikolebensversicherung). ## Tax and the health questionnaire For private individuals the lump sum is generally tax free in Germany, as it compensates for an illness rather than replacing taxable income. The premiums have little tax effect. The application includes detailed health questions, often also on smoking and family history. If you leave something out, the insurer may withdraw from the contract after a diagnosis. With a medical history, an anonymous pre-application through a broker is the safe route. ## What is covered - Lump sum on diagnosis of cancer, heart attack or stroke as defined in the policy - Further conditions on the list such as multiple sclerosis, Parkinson's disease, kidney failure or organ transplant - Depending on the policy, major surgery such as heart bypass or heart valve replacement - Depending on the policy, blindness, deafness, paralysis or loss of speech - Partial payments for early stages or milder forms, if agreed - Free use of the money, without proof of how it is spent - Payment regardless of occupation and ability to work ## What is not covered - Conditions not on the list, which almost always includes mental illness - Diagnoses during the waiting period after the start - Death within the survival period after diagnosis - Conditions not disclosed in the application - Milder forms that do not meet the definition, such as pre-cancerous stages without a partial benefit - A second serious illness if the policy ended with the first payout ## Who needs it - Self-employed people and freelancers whose business stops during treatment - Single earners and families with a mortgage or high fixed costs - People who cannot get affordable BU because of their job or medical history - Owners of small companies who need to bridge the absence of a partner - BU policyholders who want money in hand before the BU claim is decided ## Who does not need it - People with enough savings to cover one or two years without income - Anyone without BU who could still get it: that comes first ## What it costs The premium depends mainly on age, sum insured and whether you smoke, because the risk of cancer and heart disease rises markedly with every year of age. Your occupation matters much less than with BU. Starting young locks in a lower premium for the whole term. **What drives the premium:** - Age at entry and term - Sum insured - Smoker or non-smoker - Scope of the condition list and partial benefits - Health and family history - Guaranteed premium or net and gross premium with possible increases _We do not quote a premium range, because age and sum shift the price too much. Your premium is only fixed in the quote._ ## The policy levels on the market - **Basic:** A short list centred on cancer, heart attack and stroke, strict definitions, no partial benefits. Cheap, but it only pays for the most severe forms of the most common diagnoses. - **Standard:** A list of roughly 40 to 50 conditions, a short survival period and the option to increase cover on marriage, birth of a child or buying a home. The sensible choice for most adults. - **Premium:** A long list of 60 or more conditions, partial payments for early stages and smaller procedures, a premium guaranteed for the whole term and cover well into later life. ## How to recognise a good policy | Criterion | Minimum standard | Strong policy | Why it matters | | --- | --- | --- | --- | | Scope of the list | cancer, heart attack, stroke and a few others | 60 or more clearly defined conditions and procedures | The number alone says little, but every missing condition is a claim that will not be paid. | | Cancer definition | invasive malignant tumours only | partial payment for early stages and carcinoma in situ as well | Many tumours are found early today and then just miss a strict definition. | | Heart and blood vessels | heart attack only with all findings, bypass only after open surgery | payment for angioplasty of a coronary artery without major surgery | Narrowed arteries are now often treated by catheter, and older wordings then pay nothing. | | Waiting period | six months | three months | A diagnosis during the waiting period is not covered at all. | | Survival period | 28 days | 14 days or less | The shorter the period, the sooner the money arrives when you need it. | | Premium guarantee | net premium that may rise to the gross premium | premium guaranteed for the whole term | A low starting premium is little help if it may rise after a few years. | | Term | cover ends at 60 or 65 | term well beyond retirement age | The risk of the covered conditions rises sharply after 60. | | Increase option | none | higher cover without new health questions on marriage, birth, home purchase or going self-employed | When you need more cover later, you may no longer be healthy enough for a new application. | ## Insurers on the German market Only a handful of German life insurers offer critical illness cover. A large share of the market is also served by Irish companies such as Canada Life, which work in Germany through a branch and are therefore not on the German register. The list is a market overview and says nothing about whom we work with. - **Nürnberger**: standalone dread disease policy, tied agents and brokers - **Gothaer**: Perikon policy for serious illness, agents and brokers - **die Bayerische**: Premium Protect policy, agents and brokers - **Swiss Life**: serious illness option within its Vitalschutz policy, mainly through brokers - **Zurich**: distributes the Krankheits-Schutzbrief, underwritten by the Irish Zurich Life Assurance plc 77 insurers supervised by BaFin, the German regulator, are licensed for this class of insurance. (Lebensversicherer). Source: BaFin company database, 2026-09-18; EU insurers without a German office excluded. ## Typical claims and who pays - **Invasive breast cancer, treatable** (months off work, co-payments, help at home: easily five figures): An invasive malignant tumour is the core case of every policy. The full sum is paid even if you return to work after treatment. - **Pre-cancer found at screening** (procedure and follow-up, worry about the future): A carcinoma in situ usually does not meet the cancer definition. Strong policies pay a partial amount, basic ones nothing. - **Heart attack at 52** (hospital, rehab and months of lost income: five figures): The policy pays when the findings meet the definition, meaning typical symptoms, ECG and lab values. With a genuine heart attack that is almost always the case. - **Stent for a narrowed artery** (catheter procedure, a few weeks off): Without a heart attack or major surgery, basic wordings pay nothing. Newer strong policies also pay for angioplasty, often as a partial amount. - **Mini stroke with no lasting damage** (tests, medication, no permanent harm): A transient episode that clears within hours is not a stroke in the sense of almost any policy. Permanent deficits are required. - **Severe depression, a year off** (a year of lost income: five to six figures): Mental illness is not on the list. BU and daily sickness benefit are built for this common case. ## Myth or truth - „Critical illness cover pays even if I make a full recovery." ✔ True. The diagnosis triggers the payment, not a lasting impairment. What happens with the illness later does not change the payout. - „With this policy I no longer need BU." ✘ False. It pays once and only for diagnoses on its list. Back problems and mental illness, the most common reasons for occupational disability, are mostly excluded, and a lump sum does not replace income until retirement. - „Any cancer diagnosis leads to a payout." ✘ False. Policies usually require an invasive malignant tumour. Early stages and some skin cancers are often excluded or covered only with a partial amount. - „If you die shortly after diagnosis, the policy may pay nothing." ✔ True. Many policies require a survival period of 14 or 28 days. Term life insurance is there for the death case, and some policies combine both. - „Smokers pay the same premium as non-smokers." ✘ False. Smoking raises the risk of cancer, heart attack and stroke considerably, so insurers charge smokers noticeably more. Concealing it on the application puts the payout at risk. ## Common mistakes - Buying critical illness cover instead of BU when BU would be available - Looking only at the number of conditions, not at the definitions - Answering the health questions loosely and risking withdrawal after a diagnosis - Choosing a sum that barely bridges a year of income - Mistaking a net premium for a guaranteed one - Letting cover end at 60 or 65, just when the risk rises ## FAQ ### How much cover should I take out? Work out how long you might be off during treatment and rehabilitation and which fixed costs keep running in that time. Sums of around 50,000 to 100,000 euros are common, but your own calculation is what counts. ### Does the policy pay if I keep working despite cancer? Yes. Only the diagnosis as defined in the policy matters. Whether you work, are on sick leave or retired makes no difference. ### How is it different from basic abilities insurance? Basic abilities insurance pays a monthly benefit if you permanently lose an ability such as walking or seeing. Critical illness insurance pays a lump sum at diagnosis, even if you later recover fully. ### Is mental illness covered? As a rule, no. Depression, anxiety disorders and burnout are almost never on the list. BU is the cover designed for that common cause of long absence. ### What happens to the policy after a payout? With most policies, the contract ends once the full sum has been paid, so a second serious illness is no longer covered. After a partial payment the policy usually continues with a reduced sum. ### Is the payout taxable in Germany? For private individuals the lump sum is generally tax free. It can be different if a company takes out the policy for a partner and deducts the premiums as a business expense. ### Can I get cover with a medical history? That depends on the condition. People who have had cancer or a heart attack are often declined or offered an exclusion. With milder findings, an anonymous pre-application to several insurers is worth doing before any formal application is recorded. ### Am I covered if I move abroad? Cover usually applies worldwide, but the diagnosis must come from a recognised specialist and be documented according to the policy definitions. If you plan to leave Germany for good, check the conditions on change of residence beforehand. ### Can I take out a German policy as an expat? Yes, if you live in Germany and are registered here. Application forms and policy terms are usually in German, and the German version is binding, so we go through the health questions with you in English. ## 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-critical-illness.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.