A disability claim decides whether an occupational disability insurance (Berufsunfähigkeitsversicherung, BU) actually pays out when it matters. Whoever files it must inform the insurer about health, course of illness and professional consequences, and provide evidence. This guide explains which documents are typically requested, which statutory rules govern deadlines and where the policy terms make the difference.
Short answer: You file the occupational disability claim with your insurer as soon as you have become unable to work in your occupation. The insurer then examines cause, occupation, duration and extent of the limitation and may request information and evidence under § 31 of the German Insurance Contract Act (VVG). If the review is not finished after one month, § 14 VVG allows partial payments. Last updated: November 2026.
Key points
- The insurer pays under § 172 VVG if the agreed occupational disability (Berufsunfähigkeit) occurs after the policy has started.
- The decisive reference is the occupation you last practised, as it was designed without the health impairment.
- Under § 31 VVG the insurer may request information and evidence, as far as this is necessary and reasonable.
- If the investigation is not finished within one month of your notification, § 14 VVG allows you to request partial payments on account.
- Gaps in the application delay the review. The one-month period pauses if you are responsible for the delay.
What the insurer checks
Before paying, the insurer answers three questions. First, whether occupational disability in the sense of your contract actually exists. Second, which occupation is the relevant reference. Third, whether the limitation is expected to last. The statute measures against the occupation you last practised, as it was shaped without the health impairment. A temporary limitation does not meet the test, because the rule explicitly refers to a lasting condition.
| What is checked | Typical documents |
|---|---|
| Cause of the limitation | Medical reports, certificates, discharge letters |
| Last occupation practised | Employment contract, job description, employer confirmation |
| Duration of the impairment | Progress reports from treating physicians, sick notes |
| Extent of the limitation | Information on working hours, tasks and income |
Which documents can the insurer request?
Under § 31 subsection 1 VVG, the insurer may demand any information needed to establish the insured event or the extent of its obligation to pay. It may also request evidence, but only where obtaining it can reasonably be expected of you. A complete folder with the key documents speeds up the process. The provision does not, however, entitle the insurer to every document it would like to see.
- Complete the application form in full and answer questions on your medical history truthfully.
- Sort medical reports, discharge letters and certificates from the last years in date order and keep copies.
- Obtain an employer confirmation and a description of your tasks, so that your last occupation is clearly documented.
- Sign declarations releasing doctors from confidentiality only for the bodies the insurer names specifically.
- File every request with its deadline and ask for written confirmation of each document received.
How long does the review take, and what applies to partial payments?
Under § 14 subsection 1 VVG, a monetary benefit becomes due once the necessary investigations into the insured event and the extent of the benefit are complete. The provision does not set a fixed period for the whole review. Partial payments work differently: if the investigations are not completed within one month of notification, you may request partial payments of at least the amount the insurer is likely to owe. This is a useful lever when a file drags on.
The one-month period is not rigid, however. Under § 14 subsection 2 sentence 2 VVG, it is suspended for as long as the investigations cannot be completed because of a fault on the policyholder side. Late documents therefore do not forfeit your claim, but they postpone the point from which partial payments can be requested.
| Stage | What happens | Basis |
|---|---|---|
| Notification of the claim | The one-month period starts with the notification | § 14 subsection 2 VVG |
| Investigations | The insurer examines cause, occupation and duration | § 31 VVG, § 172 VVG |
| Partial payment | Possible if investigations are not completed within one month | § 14 subsection 2 VVG |
| Benefit | Due once the investigations are complete | § 14 subsection 1 VVG |
What role do medical assessments play?
Whether and how the insurer commissions its own medical assessment depends on the policy terms (Tarifbedingungen). Some terms describe the procedure precisely, others leave the insurer more room. It is therefore worth reading the terms before you apply, not only once an assessment has been announced. It also makes sense to have the questions and the procedure confirmed in writing. Your own statements with supporting medical evidence can become part of the file.
An assessment is not a verdict on you as a person. It is a professional view of your capacity to work. Treating doctors can summarise their findings so that the assessor grasps the course of the condition quickly, which creates clarity for everyone involved.
What happens if the application has gaps?
Gaps in an application often lead to follow-up questions. Each question extends the process, even if the benefit is ultimately payable. A list with date, recipient and content of every letter helps you keep track. If a document is missing, it is better to flag it early than late. This keeps the one-month period under § 14 VVG traceable and avoids the impression that you caused the delay yourself. For what follows a rejection, see BU abgelehnt: Was du jetzt tun kannst (in German).
Frequently asked questions
Is there a fixed deadline for filing an occupational disability claim?
The statutory provisions reviewed here do not set a general deadline for the claim itself. What matters is when you notify the insurer and how quickly you supply documents. Check your policy, because notification duties and time limits may be set out there more precisely.
Can I request partial payments on account?
Yes, if the investigations are not completed within one month of your notification. The partial payment corresponds to the amount the insurer is likely to owe at minimum. The exact amount can be disputed in individual cases, so a written justification is important.
May the insurer request all of my health data?
No. The duty to provide information under § 31 VVG covers what is needed to establish the insured event and the extent of the benefit. If the insurer asks beyond that, a written query asking why a particular detail is needed for the review is worthwhile.
What changes if I submit the claim late?
The partial payment rule is tied to your notification. Whoever notifies later starts the one-month period later. Whoever delays investigations through their own fault sees the period suspended. The precise consequences depend on the contract and should be clarified in advance, for example with the insurer or, in a dispute, with the Versicherungsombudsmann bei BU-Streit (in German).
Do I need a lawyer to file the claim?
In most cases you can file the claim yourself. Once the insurer rejects or limits the benefit, the matter becomes legally more demanding, and specialist advice can then make sense. Whether the cost is worthwhile depends on the individual case.
How to proceed now
- Read the policy terms and mark the notification deadlines, the rules on assessments and the course of the benefit review.
- Create a folder with medical findings, work evidence and a chronology of the limitation.
- File the application in full and have receipt confirmed in writing.
- After one month without a decision, ask in writing for the status and, if appropriate, request partial payments.
- If the claim is rejected, review the reasons and plan the next steps, for example with a conciliation body.
Related guides
- How do I protect my working capacity? The overview for career starters (in German)
- Insurance ombudsman for disability disputes: when conciliation helps (in German)
- Disability claim rejected: what you can do now, before giving up (in German)
- Disability re-examination: what happens when you feel better again (in German)
- Premium waiver in a disability claim: what happens to the premium (in German)
Sources: § 172 VVG, Benefits of the insurer (occupational disability), last updated November 2026; § 14 VVG, Maturity of the monetary benefit, last updated November 2026; § 31 VVG, Duty of the policyholder to provide information, last updated November 2026.
Last updated: November 2026. This guide is general information, not individual advice.
