📄 Private occupational disability insurance: contract basics
In brief
§ 172 Abs. 1 VVG describes the statutory minimum content of occupational disability insurance: the insurer must pay if the insured person, as a result of illness, bodily injury or loss of strength, which must be proven by a doctor, is expected to be permanently unable, or at least unable for six months, to practise the occupation last worked in, as it was structured without health impairment. The specific benefit requirements – such as from what percentage of occupational disability benefits are paid – are not governed by the law, however, but by the insurer's policy terms and conditions in each case.
When the contract is concluded, the pre-contractual duty of disclosure under § 19 VVG applies: health questions must be answered truthfully and completely. Incorrect or incomplete information can lead years later to contestation or withdrawal by the insurer.
Step by step
- Read the policy terms and conditions, not just the application formOnly the specific policy terms and conditions show from what degree of occupational disability benefits are paid and what proof is required.
- Answer the health questions in the application carefully and completelyEven seemingly unimportant previous illnesses belong there.
- Submit the benefit claim in good timeAs soon as you are expected to be unable to practise the occupation to the agreed extent for at least six months.
- Plan for the insurer's review datesOngoing BU pensions are reviewed periodically by the insurer – see the separate topic page on this.
Deadlines
- The most common point of dispute is the pre-contractual duty of disclosure (§ 19 VVG): incomplete or false information about previous illnesses when the contract is concluded can lead years later to retroactive contestation or withdrawal – even if the current illness has nothing to do with the one concealed, although counter-proof of no causality under § 21 VVG remains possible.
- The statutory minimum standard of § 172 VVG is almost always made more specific or extended in the insurance terms and conditions and provided with additional exclusions – so always read the specific policy terms and conditions, not just the text of the law.
In depth · legal basis, figures and practice – for advisers and professionals
§ 172 VVG: statutory minimum content
The law defines only the minimum framework; details such as the relevant degree of occupational disability (in practice usually 50 percent), waiting periods or duties to provide proof arise from the individual contract.
Pre-contractual duty of disclosure
§§ 19–22 VVG govern the consequences that incorrect or incomplete information at the conclusion of the contract can have: withdrawal, contestation for fraudulent misrepresentation or retroactive adjustment of the contract, depending on the degree of fault.
Retroactive recognition after six months
§ 172 Abs. 3 VVG provides that an impairment lasting uninterrupted for at least six months is retroactively deemed occupational disability, even if no permanent prognosis could yet be made at the start.
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