BGI/GUV-I 506 E - In good hands. Your Statutory Accident Insurance Functions, services and organization

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Abschnitt 5.3 BGI/GUV-I 506 E - Financial benefits

Should they not be receiving earnings, employees receive injury benefit for the duration of their incapacity for work. This constitutes 80 % of their former regular gross earnings, and must not exceed their net earnings. Schoolchildren and students likewise receive injury benefit if they were also in paid employment at the time of their incapacity for work. A temporary allowance is paid during a measure for occupational rehabilitation. Insured persons suffering an accident whilst performing a task in the public interest may receive additional benefits. These are generally paid for the duration of medical treatment and occupational rehabilitation, in addition to the insured person's or surviving dependants' pensions.

Pension payments

Insured persons receive a pension when their earning capacity has been reduced for over 26 weeks and the reduction in their earning capacity is at least 20 %. The pension entitlement generally begins at the point at which injury benefit ceases to be paid. In the event of complete loss of earning capacity, the full pension comprises two-thirds of the annual earnings prior to the accident or occupational disease. Where the earning capacity is partly reduced, the pension corresponds to the level of reduction, for example one-third of the previous gross earnings in the case of a 50 % reduction in earning capacity. Where children are concerned, the earning capacity is extrapolated from the potential for employment which would have existed after the accident had the child already been available for employment. Should the earning capacity be reduced by at least 20 % overall as a result of several insured events, an insured person's pension is paid for each accident. In this case however, the consequences of a discrete insured event are considered only if they reduce the earning capacity by at least 10 %. The accident insurance institutions continue to pay this pension as long as the earning capacity remains reduced, i.e. under certain circumstances for life, irrespective of whether an occupation is pursued.

In the event of death, the accident insurance institutions pay the following benefits in particular:

  • Death benefit

  • Transportation costs

  • Surviving dependants' pensions (to which the deceased's widow, widower, orphaned children, and under certain circumstances former spouse, relatives in the ascending line, step-parents and foster-parents are entitled).

Info

Background: reduction in earning capacity

The reduction in earning capacity is based upon the extent to which the reduction in an insured person's physical and mental performance caused by the insured event reduces their capacity for work. Should the capacity for work be reduced by several insured events, the reduction in earning capacity is determined separately for each event, and several pensions are paid accordingly. The reduction in earning capacity is stated as a percentage.

Full and part pensions

Should the earning capacity be lost completely (100 %), a full pension is paid. This is equal to two-thirds of annual earnings prior to the occupational accident or disease. Where the reduction in earning capacity is partial, a proportion of the full pension corresponding to the reduction is paid (part pension). Entitlement to a part pension exists where the earning capacity is reduced by 20 % or more.

Example:

The pension of an insured individual with annual earnings of € 36,000 and a reduction in earning capacity of

  1. a

    100 % and

  2. b

    20 % is calculated as follows:

  3. c

    full pension = 2/3 of 36,000 = € 24,000, of which 100 % reduction in earning

    capacity = a pension of € 24,000 per year = a pension of € 2,000 per month

  4. d

    part pension = 2/3 of 36,000 = € 24,000, of which 20 % reduction in earning

    capacity = a pension of € 4,800 per year = a pension of € 400 per month