What is the expanded term of ALM

accident

Table of Contents

  1. Statutory accident insurance (GUV)
    1. term
    2. Scope of insurance
  2. Private accident insurance
    1. term
    2. Extended definition of an accident

Statutory accident insurance (GUV)

term

Temporary events that have an external effect on the body and lead to damage to health or death (§ 8 I S. 2 SGB VII).

Scope of insurance

In the GUV, however, only accidents at work and also occupational diseases are insured (Section 7 I SGB VII). Accidents at work are accidents suffered by insured persons as a result of an activity on which insurance cover is based (insured activity) (Section 8 I S. 1 SGB VII).

Private accident insurance

term

An accident occurs when the insured person involuntarily suffers damage to his health as a result of an external event that suddenly affects his or her body (Section 178 II sentence 1 VVG). The term accident thus includes five characteristics: event, damage to health, sudden, external, involuntary. If even one of these prerequisites is missing, there is no accident in the sense of private accident insurance.

Extended definition of an accident

In addition to the classic definition of an accident, there is also the so-called “extended definition of an accident”. This includes events equivalent to an accident, such as increased physical exertion. If as a result a joint is dislocated in a limb or spine or muscles, tendons, ligaments or capsules are pulled or torn, the definition of an accident is considered to have been met. The characteristic of the classic accident term “from outside” is missing here. Because of this, it is referred to as a fictional accident. In addition, it is now customary in the market to apply the fiction of an accident to other facts. The expanded definition of an accident therefore often includes “involuntary freezing to death, suffocation or drowning”, “damage to health from suddenly acting gases, vapors” and “sudden damage to health as a result of rescuing people, animals or things”. Each insurer can individually decide which accident fictions to list under the extended accident term in its general insurance conditions for accident insurance.