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How long is daily allowance paid after an accident? The BGH has now taken on this question and decided a case in Bavaria. The judgment is relevant for customers, intermediaries and insurers.
After an accident, an accident insured person is entitled to a daily allowance until the end of the treatment and not just until the last visit to the doctor. The Federal Court of Justice (BGH) made this clear, like the Donaukurier reports.
The plaintiff had been prescribed physiotherapy ten times during his last visit to the doctor. His insurance did not want to pay a daily allowance for this period, which the BGH criticized in a judgment. (Az. IV ZR 19/19)
The case
The plaintiff had injured his finger in April 2016, and in June he went to the doctor who prescribed physiotherapy again because of problems. The insurance conditions stated that the patient had to be “impaired in their ability to work and undergo medical treatment” in order to be entitled to daily allowance. The Nuremberg Higher Regional Court was of the opinion that physiotherapy was not medical treatment.
The BGH sees it differently. In the understanding of the average insured person, gymnastics would be “regularly regarded as part of medical treatment”. It does not matter whether a follow-up appointment is made with the doctor afterwards.
The BGH declares that medical treatment “regularly includes the duration of the treatment measures ordered by the doctor”. So the plaintiff gets money, the Higher Regional Court Nuremberg must now clarify whether the man actually took part in the physiotherapy.
Author: VW editorial team
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