Statutory accident insurance is an arm of the social insurance system. As a mandatory insurance scheme, it provides compensation for damage to health suffered by insured persons in the course of their insured work activities. The legal basis is the Seventh Book of the Social Code (SGB VII).
The mandate of the statutory accident insurance system
The mandate of the statutory accident insurance system is to use all available resources to:
- Prevent covered incidents (occupational accidents and work-related illnesses) and health hazards in the workplace.
- Restore an insured employee's health and ability to work following an occupational accident or work-related illness.
- Provide financial compensation to insured persons and their surviving dependants.
Who is insured by the statutory accident insurance?
Employees and trainees in particular are covered. The following groups of individuals are also covered :
- People who work in the public interest, e.g. aid workers, emergency rescue workers, blood donors, court witnesses, jurors.
- Children cared for in childcare centres or by suitable childminders, school children and students in schools and universities, and people in vocational education and further training.
- People who are self-employed farmers, work on a family farm or who work as paid employees in agriculture.
- Home carers.
- Unemployed persons who visit the employment agency or another body at the agency's instruction.
- Certain volunteers (e.g. in volunteer fire brigades)
- People undergoing rehabilitation treatment (e.g. during a stay in hospital).
Business people can take out insurance on a voluntary basis if they are not already subject to compulsory insurance by law or by statute, as is the case in some sectors. Insurance coverage is provided irrespective of age, religion, nationality and income.
Cases for statutory accident insurance coverage
The occurrence of an insured incident is the prerequisite for the provision of services and compensation under the statutory accident insurance scheme. Insured incidents include accidents in the workplace and work-related illnesses. Accidents in the workplace include not only those which actually occur while working, but also those that happen on the way to and from work. Accidents in this category are accidents suffered by employees on their way to or from work. Occupational illnesses are illnesses that insured persons contract at work, which are either listed in the ordinance on occupational diseases or caused by the occupation according to new medical findings.
There must also be a causal relationship between the work performed by the insured person and the accident, and also between the accident and the injury or illness. This means that insurance cover is only provided when the illness or injury can be traced to a work-related insured activity in the individual case.
Benefits of the statutory accident insurance system
Services include therapeutic treatments, medical rehabilitation, occupational participation assistance (e.g. retraining), cash benefits for insured persons (e.g. income replacement and pension payments) and, if an insured person dies, surviving dependants' benefits (widows/widowers and orphans pensions).
Statutory accident insurance funds
The accident insurance funds are the sectoral occupational accident insurance funds, the agricultural accident insurance fund and the public sector insurance funds (e.g. accident insurance funds, Land accident insurance funds, municipal accident insurance associations). The postal, e-mail and internet addresses of the accident insurance funds can be found on the following website:
German Social Accident Insurance (DGUV) - umbrella organisation of the sectoral German social accident insurance funds and the public-sector accident insurance funds: www.dguv.de
Financing of statutory accident insurance
In the commercial sector, accident insurance is financed by contributions borne solely by employers, meaning insured persons do not make contributions for the insurance cover. The amount of the employer's contributions is based on insured employees' pay and the respective hazard level. In the accident insurance for the agricultural sector, separate contribution rates apply, which are largely based on the land area farmed and the yield achieved by the agricultural companies. Public-sector occupational accident insurance funds generally pay for their costs from their budgets (tax revenue).