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Benefits in the event of long-term care for persons covered by statutory accident insurance


Your employers' liability insurance association or accident insurance fund as the provider of accident insurance pay care allowance.

On the one hand, the amount of the care allowance depends on the type or severity of your health damage. On the other hand, the extent of the assistance required plays a role. Both together result in the so-called need for long-term care, which is measured as a percentage. There is no determination of the degree of care as in the statutory long-term care insurance.

Your percentage of long-term care needs determines the amount of your care allowance. There is a minimum and a maximum amount set by law.

Home care, if desired, takes precedence over placement in an inpatient care facility. Both private caregivers, such as relatives, and professional outpatient services can provide you with home care.

The benefits of the statutory accident insurance due to the need for long-term care take precedence over the benefits of the social long-term care insurance and the associated long-term care funds. If you receive corresponding benefits from the statutory accident insurance, your entitlement to care benefits from the social long-term care insurance is suspended.

Process flow

Your employers' liability insurance association or accident insurance fund will check on its own initiative ("ex officio") whether you are entitled to care benefits.

  • The examination begins as soon as there are indications that you are in need of care.
  • Your employers' liability insurance association or accident insurance fund determines the percentage of the need for long-term care
  • You will receive a corresponding notification.

You don't need to apply. Nevertheless, you are free to apply for care benefits from your employers' liability insurance association or accident insurance fund online or by post.

Online Service:

  • Go to the online service.
  • You will be guided through the procedure on the accident insurance service portal.
    • If you would like to receive the answer from your employers' liability insurance association or accident insurance fund in the mailbox of your BundID account or My company account, you must have an account and authenticate yourself.
    • If you would like to receive the answer by post, you can continue without registering.
  • Select your responsible employers' liability insurance association or accident insurance fund or find out more using the industry search.
  • Upload the required documents.
  • Fill out and submit the online form.
  • Your report will be automatically forwarded to your accident insurance institution.
  • You will receive feedback in the desired way.

Online service of your employers' liability insurance association or accident insurance fund:

  • If you have access to the portal of your employers' liability insurance association or accident insurance fund, you may also be able to submit the report there electronically.

Notification by post:

  • Please send an informal letter to your employers' liability insurance association or accident insurance fund.
  • Pay attention to the required information and enclose the necessary documents.

Requirements

You are entitled to care benefits from the statutory accident insurance from the day you become helpless or in need of care. That is, you

  • require the help of other people to a considerable extent
    • for the ordinary and regularly recurring tasks in the course of daily life
    • because of the consequences of an insured event
      • Accident at work, commuting accident or occupational disease

Which documents are required?

  • You don't need to submit any documents.

What are the fees?

There are no costs.

What deadlines do I have to pay attention to?

There is no deadline.

Applications / forms

Forms available: No

Written form required: No

Informal application possible: Yes

Personal appearance required: No

Online services available: Yes

Appeal

  • Contradiction
  • Detailed information on how to file an objection can be found in the notice issued by your employers' liability insurance association or accident insurance fund.

What else should I know?

There are no hints or specifics.

Technically approved by

Federal Ministry of Labour and Social Affairs (BMAS)

Professionally released on

06.01.2023

Author

The text was automatically translated based on the German content.

Source: Serviceportal Niedersachsen (Portalverbund des Bundes und der Länder)