Accident benefits

Even if other people were involved in the accident, it is very important for us to have precise details of all those involved and their liability insurance policies. This is because even in the case of accidents for which you are responsible, we can in some cases assert claims for compensation with many liability insurers without you or another person involved in the accident suffering any disadvantages as a result.

The reason: We have so-called sharing agreements with many liability insurers, which, for reasons of simplification, do not involve an examination of the question of fault. This represents an enormous administrative simplification, as not every claim has to be negotiated at length according to the factual and legal situation.

If you receive an accident questionnaire and there is no accident, you do not have to complete the form in full. This is the case, for example, if you are taken to hospital by ambulance due to circulatory problems.

Important: Even if you can only answer a few questions in this case, please return the form in any case or send us a short written description of the reasons in your own words. This is the only way to avoid us having to remind you to submit the questionnaire at regular intervals.

Results in an injury

• from an accident at work and leads
• an inability to work or duration of treatment of more than one week

a so-called transit doctor must be consulted. You can find these via the search portal of the National Association of the German Social Accident Insurance.

Please send the corresponding certificate of incapacity for work to us as usual.

In the event of an accident caused by a third party, the insured person’s claim for compensation is transferred to the respective health insurance fund.

This means that the BKK W&F initially covers the costs of the legally regulated treatments and then reclaims these from the party responsible or their liability insurance. This does not create any disadvantage for you as the injured party. This also applies, of course, if the accident is self-inflicted.

In order to assert claims for compensation, health insurance companies are legally obliged to investigate any evidence of an accident. As service providers such as doctors, emergency services or hospitals generally only provide diagnoses, we are reliant on the assistance of our policyholders. This is because not every injury diagnosis is based on damage caused by a third party.

We therefore use an accident questionnaire to find out whether an accident actually occurred.

An accident at work is when the accident is directly related to a professional activity. This also includes accidents on the direct route between home and work.

The special feature: The costs for the treatment of the consequences of occupational accidents are not borne by the BKK W&F, but by the employer-funded statutory accident insurance. Another advantage for the injured party: No co-payments are required for the treatment, as the underlying seventh Book of the Social Code does not provide for these.

However, not only employees are insured against the consequences of accidents at work. Other groups of people are also covered by statutory accident insurance. These are, for example

• Pupils and students during lessons/lectures
• First aiders at the scene of an accident
• Volunteers
• Blood donor
• Hospital patients

If it is an accident at school or kindergarten, please also let us know the name and address of the kindergarten.