Accident and initial injury
Document the event, primary injury, and continuous medical history as distinct elements.
Private accident insurance
Berlin and across Germany
Private Accident Insurance Claim Denied in Germany – Lawyer
Disability rating, deadlines, and pre-existing conditions
If an accident leaves permanent physical or mental impairment, the lump-sum benefit can be substantial. Disputes often concern the definition of an accident, timely medical confirmation, the disability percentage, and prior conditions.
The following points are particularly important for entitlement and valuation:
- ›Document the accident and the injury directly caused by it
- ›Protect policy deadlines for onset, medical confirmation, and notification of disability
- ›Assess the disability percentage under the limb schedule and functional evidence
- ›Review medical and legal deductions for illness or pre-existing damage
- ›Calculate progression, the insured sum, and any additional benefit components
You receive clear guidance on deadlines, disability valuation, and whether the insurer's medical and contractual reduction is supportable.
Check deadlines immediately: Policies often contain separate deadlines for the onset and medical confirmation of permanent disability. An ordinary accident notification may not satisfy them.
Full service in English language
What a private accident-insurance review covers
Disability percentage
Compare the limb schedule, functional impairment, and medical assessment with the policy.
Policy deadlines
Check onset, medical confirmation, and notification against the actual policy deadlines.
Prior conditions and progression
Review deductions for prior conditions and recalculate the benefit with progression.
From the accident to the amount payable
The insurer does not only ask whether an accident occurred. Entitlement and amount result from the chain of event, initial injury, permanent impairment, and contractual calculation.
Causal chain
The accident, primary injury, and lasting functional impairment must be connected by coherent medical evidence.
Valuation rather than diagnosis
The amount depends on permanent loss of function, not merely the name of the injury.
Check the benefit formula
The disability percentage, insured sum, progression, and permissible deductions together determine payment.
Frequently asked questions: Private accident insurance
What deadline applies to a private accident disability claim?
It depends on the policy. There are often separate deadlines for onset of permanent disability, medical confirmation, and notification to the insurer.
How is the disability percentage determined?
For listed body parts, the limb schedule and loss of function usually apply. Other impairments are medically assessed by their effect on overall physical or mental capacity.
Can the insurer deduct for a pre-existing condition?
Only under the policy and where a contributing effect is established. The percentage should not be assumed without evidence.
Is private accident insurance the same as occupational disability insurance?
No. Accident insurance covers lasting impairment caused by an accident; occupational disability insurance focuses on the ability to perform the insured occupation.
Mandant
3 months ago
Mr. Lerch provided me with highly professional, calm, and dedicated support throughout my legal proceedings. I particularly appreciated his honest assessment of my case and the clear communication he maintained throughout the entire process. Thanks to his strategy and preparation, we achieved a significantly better outcome than originally anticipated in the penalty order. I felt well-advised and taken seriously at all times. I can therefore wholeheartedly recommend Mr. Lerch and thank him again for his support. B. Paal
Mandant
5 months ago
Complete satisfaction! I needed an expert opinion for the recognition of professional experience towards my studies and received very professional support and advice from Mr. Lerch throughout the entire process. The fact that the application for recognition was accepted was simply the icing on the cake!
Mandant
5 months ago
Thank you so much for your prompt assistance in my rather complex case. I can highly recommend you – reliable, friendly, and straightforward!
How your insurance dispute is handled
Step 1
Send the claim and decision
You describe what happened and provide the policy, terms, and the insurer's decision.
Step 2
Assess cover and evidence
The policy, objections, deadlines, and evidence are assessed together.
Step 3
Receive clear guidance
You receive clear guidance on the claim, the risks, and commercially sensible options.
Step 4
Pursue the claim
We agree on negotiations and, where needed, proceedings before the German courts.
About Dr. Lerch
Dr Philipp Lerch represents policyholders in denied or reduced private accident disability claims in Germany. The focus is on policy deadlines, reliable medical assessment, and correct benefit calculation.
Related insurance-law services
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Overview of denied and reduced insurance claims in Germany.
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If an insurer refuses the agreed benefit following a death.