What is the scope of the insurer

Start and scope of insurance coverage

I.


1. Insurance cover begins at the time specified in the insurance policy, when the policyholder pays the first or one-off premium in good time.


2. The premium invoiced contains the insurance tax that the policyholder has to pay in the amount determined by law.


II.


1. Unless otherwise agreed, the first or one-off fee is due immediately upon conclusion of the contract. Payment is deemed to be on time if it is made immediately after receipt of the insurance policy and the request for payment (and after the 14-day objection period specified in the insurance policy). If payment of the annual fee has been agreed in installments, only the first installment of the first annual fee counts as the first fee.


2. If the policyholder does not pay the first or one-off amount on time, but at a later point in time, the insurance cover does not begin until this point in time.


3. If the policyholder does not pay the first or one-off premium on time, the insurer can withdraw from the contract as long as the premium has not been paid. It is considered a withdrawal if the insurer does not claim the first or one-off premium within three months of the conclusion of the contract.


4. If the collection of the premium from an account has been agreed, the payment is deemed to be on time if the premium can be collected on the due date specified in the insurance policy and the policyholder does not object to an authorized collection. If the due premium could not be collected by the insurer through no fault of the policyholder, the payment is still on time even if it is made immediately after a written request for payment by the insurer. If the policyholder is responsible for repeatedly failing to collect the premium, the insurer is entitled to demand payment outside of the direct debit procedure in the future.


III.


1. The insurer's obligation to provide benefits includes examining the liability issue, defending against unjustified claims and reimbursing the compensation that the policyholder has to pay based on an acknowledgment given or approved by the insurer, a settlement concluded or approved by the insurer, or a judicial decision. Once the insurer's obligation to pay has been established, the compensation must be paid within two weeks.


If the insurer requests or approves the appointment of a defense counsel for the policyholder in criminal proceedings due to a damaging event that may result in a liability claim falling under the insurance cover, the insurer shall bear the fee-based, possibly the higher costs of the Defense attorney.


If the policyholder has to provide security for a pension owed from an insured event by virtue of the law or if he has slackened the avoidance of the enforcement of a court decision by providing security or deposit, the insurer is obliged to provide security or deposit in his place.


2. For the scope of the insurer's benefits, the insured sums stated in the insurance policy form the maximum limit for each damaging event. This also applies if the insurance cover extends to several persons liable for compensation. Several temporally related damages from the same cause or several damages from deliveries of the same defective goods are deemed to be one damaging event. It can be agreed that the policyholder will participate in compensation for each damage event with an amount specified in the insurance policy. It can also be agreed that the insurer limits its total benefit for all loss events in an insurance year to a multiple of the agreed sum insured.


3. If, in an insured event, there is a legal dispute about the claim between the policyholder and the injured party or his legal successor, the insurer will conduct the legal dispute on behalf of the policyholder at his own expense.


4. The insurer's expenses for costs are not offset against the sum insured as benefits.


IV.


1. If the liability claims exceed the sum insured, the insurer only has to bear the legal costs in the ratio of the sum insured to the total amount of the claims, even if there are several lawsuits arising from one damaging event. In such cases, the insurer is entitled to exempt itself from further benefits by paying the sum insured and its share of the costs incurred up to that point corresponding to the sum insured.


2. If the policyholder has to make pension payments to the injured party and if the capital value of the pension exceeds the sum insured or the remaining amount of the sum insured after deduction of any other benefits from the insured event, the pension to be paid shall only be in proportion to the sum insured or its remaining amount reimbursed by the insurer at the capital value of the pension. The pension value is calculated on the basis of the general mortality tables for Germany with survival character 1987 R men and women and on the basis of the actuarial interest rate, which takes into account the actual capital market interest rates in Germany. This is based on the arithmetic mean over the last 10 years of the current returns in the public sector, as published by the Deutsche Bundesbank. Subsequent increases or reductions in the pension are calculated at the time of the original commencement of the pension with the present value of a deferred pension according to the stated calculation basis.


For the calculation of orphan's pensions, age 18 is agreed as the earliest final age. For the calculation of the victim's pensions, the final age of 65 is agreed as the final age for employees, unless otherwise determined by judgment, settlement or other determination or the circumstances on which the determination is based change. When calculating the amount with which the policyholder has to participate in ongoing pension payments if the capital value of the pension exceeds the sum insured or the remaining insured sum after deduction of other benefits, the full amount of the other benefits will be deducted from the sum insured.


3. If the settlement of a liability claim demanded by the insurer fails through acknowledgment, satisfaction or settlement due to the resistance of the insured person, the insurer does not have to pay for the additional expenditure on the main thing, interest and costs arising from the refusal.



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