Hospital Cash Benefit (Krankenhaustagegeld)
The hospital cash benefit (Krankenhaustagegeld) is a fixed cash amount that accident or supplementary health insurance pays to the insured person for each calendar day of medically necessary inpatient treatment, irrespective of the actual costs incurred.
Concept
The hospital cash benefit is a fixed-sum benefit: the agreed daily rate is paid for every calendar day on which the insured person is undergoing medically necessary inpatient treatment, without any need to evidence costs. In accident insurance the benefit requires an accident as its cause (AUB 2020 section 2.5, AUVB 2022 “Spitalgeld”); as a module of supplementary health insurance it also responds to illness-related hospital stays. In Switzerland the term Spitaltaggeld is customary. The benefit period is limited, in the German model wording to a maximum of several years from the date of the accident; the AUB 2020 treat an outpatient operation that avoids inpatient treatment as equivalent for a limited number of days.
Design and Limits
Stays in sanatoria, convalescent homes and spa facilities do not count as medical treatment, nor do stays where medical rehabilitation rather than acute treatment is the main purpose. Common extensions are the convalescence benefit following the hospital stay, rooming-in benefits for children and increased daily rates for intensive care. Examples from practice: German AUB tariffs limit the benefit to three to five years from the date of the accident, pay a flat number of days for outpatient surgery and double the daily rate for stays abroad, for children or from the fourth day of treatment; Austrian wordings provide hospital cash for up to 365 days within four years, and group PA wordings include a hospitalisation benefit extension with a fixed daily amount for up to 365 days. Internationally, the benefit corresponds to hospital cash or hospital indemnity coverage, which the NAIC defines as a pre-determined fixed daily indemnity based on a hospital stay.
Practical Relevance
The hospital cash benefit serves to cover unreimbursed ancillary costs of a hospital stay – co-payments, relatives’ travel, domestic help, loss of income for the self-employed – and, thanks to simple proof (hospital confirmation of stay), generates little dispute at claims stage. From the insurer’s perspective it is inexpensive to price but carries accumulation risk in group contracts and potential for abuse through unnecessary prolongation of stays, which is why wordings emphasise medical necessity.