After a work accident or occupational disease, statutory accident insurance covers significantly more than the health insurance fund – following the principle "rehab before pension" and without co-payments. Which benefits exist, how high they are and what private accident insurance additionally provides – read on.
The core benefit is complete medical care: under Section 26 SGB VII, insured persons are "entitled to medical treatment including medical rehabilitation benefits" (source: gesetze-im-internet.de, translated) – by all suitable means. This includes the accident insurance doctor (Durchgangsarzt), hospital treatment, the Berufsgenossenschaften's specialist clinics, physiotherapy, aids and care – without prescription fees or co-payments.
If you are unable to work after the accident, you receive injury benefit (Verletztengeld) once your employer's continued salary payments end: 80 percent of your regular pay, capped at your net salary – and thus more than the health insurer's sickness benefit. During vocational rehabilitation measures, a transitional allowance is paid.
If you can no longer practise your old profession, accident insurance finances retraining, workplace adaptations or further education – the goal is a lasting return to working life.
If your earning capacity remains permanently reduced, accident insurance pays a pension – specifically, if earning capacity is "reduced by at least 20 percent" (source: Section 56 SGB VII, gesetze-im-internet.de, translated). The full pension amounts to two thirds of the annual earnings; partial reductions are paid proportionately. Surviving dependants receive pensions and a death grant.
Private accident insurance pays regardless of where and when the accident happens – including leisure, household and holidays. Typical benefits: a one-off disability lump sum based on the benefit scale (Gliedertaxe, with progression), an optional accident pension, hospital daily allowance, rescue costs and cosmetic surgery. It does not replace occupational disability insurance, but it closes the big leisure gap in statutory coverage – we clarify individually which components make sense for you.
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As a rule, until working capacity is restored, at most until the 78th week after incapacity began; thereafter transitional allowance or pension benefits may follow.
The employer reports the work accident; the Berufsgenossenschaft initiates much of the process ex officio. However, your own applications and appeals are worthwhile if benefits are denied or classified too low.
No, statutory accident insurance pays no compensation for pain and suffering and does not reimburse property damage. Private coverage or claims against the responsible party come into play here – see our guide Car Accident: Who Pays Compensation?.
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Sources: Section 26 SGB VII – Principle (treatment and rehab), gesetze-im-internet.de · Section 56 SGB VII – Conditions and amount of the pension entitlement, gesetze-im-internet.de · Updated: 2026
