Claims

You will only see what your insurance is worth when you need it. Our experts in the claims department will be there for you prior, during and after the claim. We will always provide you with help and assistance.

On this page, we have collected the most important issues when it comes to a claim. We will provide you with advice what to do in the event of a claim and with detailed information about the settlement of your claim. Our overview Procedure in the event of a claim also provides orientation. Should you still have questions, please feel free to Contact us.

Wünschen Sie Beratung?
Alle Fragen beantworten wir Ihnen gerne:

T +49 2247 9194-983

E

Mo - Fr: 08:00 bis 18:00 Uhr

Telegram Messenger


au-pair24.de Reviews with ekomi.co.uk

What to do in an emergency?

What can I do to find the correct contact partner and get help immediately? Besides medical emergencies there are also situations which require personal support. We offer information for both cases.


Medical emergency

One generally speaks of a medical emergency if a life-threatening situation occurs unexpectedly.
Without immediate medical care, severe health impairment or the death of the person is to be expected. Help is needed immediately.

Medical care is provided by the family doctor, the family doctor's locum, the medical helpline service, the nearest available hospital or by the pan-European emergency number 112.

Emergency number 112

Telephone helpline

In an emergency, you as host family are the first and nearest available contact person for your au pair. An open conversation can often work wonders. If this does not help, you or your au pair can contact the au pair agency.

If your au pair does not want to talk to you or the agency in a difficult situation, both you and your au pair can also contact the "TelefonSeelsorge" (telephone helpline). Trained volunteers provide support by phone, chat or webmail. This phone number is only available in Germany:

TelefonSeelsorge (telephone helpline) 0800 1110111 or 0800 1110222

Deutsche Telekom is a partner of the "TelefonSeelsorge" (telephone helpline). Your call is toll-free.

What to do in the event of illness?

Do you suffer from abdominal pain, a toothache or psychological problems? Go see a doctor! As au pair you are covered by a private international health insurance.

Please consider the following three rules of conduct for outpatient treatments:

  1. Please consult a general practitioner before seeing a specialist or going to hospital.
  2. Please provide the physician with our Ärzte-Info-Ticket (medical info card) prior to the treatment.
  3. Please tell your doctor that some treatments require approval and that you need a medical costs projection for these treatments.

1. Primary care physician

Primary care physicians are responsible for diagnosis and therapy and coordinate the need for further treatment. This includes assessing if they are able to carry out the treatment themselves or if it is necessary to consult a specialist.
This makes it easier to coordinate therapies and to avoid that examinations are carried out twice. It furthermore helps to avoid incompatible therapies, interlink medical benefits and reduce costs. This recommendation does, of course, not apply to necessary visits of gynecologists, eye specialists, emergency physicians or doctors on call.

2. Medical info card "Ärzte-Info-Ticket"

You will receive a medical info card (Ärzte-Info-Ticket) together with your insurance certificate. This card shall help you in case of illness and necessary treatment. Please provide the physician with this vital information prior to any treatment. The card contains information about the type of billing as well as important details regarding your insurance coverage.
Here you can print out your "Ärzte-Info-Ticket":

Ärzte-Info-Ticket (medical info card) (German)

3. Medical costs projection

In some cases, it is necessary for you to have our written guarantee of performance as a precondition for full reimbursement. This requires that we are provided with the medical costs projection of the respective physician or dentist.

Click here to find out for which treatments you need a medical costs projection.

Your medical costs projection will be processed in one working day. In case of an emergency, please label your medical costs projection as “urgent”. We will then check these documents within two hours.
We recommend a medical costs projection prior to any extensive treatment. This will help you and your doctor to plan reliably and to avoid financial disadvantages.

You are not sure whether the treatment of an illness is covered?

If you are not sure whether the treatment of your illness is covered, you can call us prior to the treatment. We will inform you about the scope of your insurance and we will tell you what you should consider during treatment.

Contact us.

Upcoming hospital stay

If you are admitted to a hospital, you will be asked about your insurance cover. You are covered by your international health insurance. The policy covers treatment within compulsory health insurance without optional services. The easiest way for you is to present your "Ärzte-Info-Ticket" (medical info card) during the admission.
Here you can print out your "Ärzte-Info-Ticket":

Ärzte-Info-Ticket (medical info card) (German)

After your admission, the hospital will contact us and, under normal circumstances, we will then settle the billing directly with the hospital.

Inpatient treatment without emergency situation

If an inpatient treatment is not an emergency treatment, we recommend arranging the details of the planned therapy beforehand with our claims department. This way, we can help you to minimize any financial risk.

Contact us.

What to do in the event of toothache?

You have a toothache? Please consider the following three rules of conduct for the event of illness:

  1. Go to the dentist of your choice.
  2. Please provide the dentist with our Ärzte-Info-Ticket (medical info card) prior to the treatment.
  3. Please tell your doctor that some treatments require approval and that you need a medical costs projection for these treatments.

1. Consulting the dentist of your choice

You are free to choose your dentist. We recommend dentists in private practice who are authorized for all statutory health insurance funds. You can also go to a private dental clinic. However, the fees charged by these clinics often exceed the scope of insurance coverage.

2. Medical info card "Ärzte-Info-Ticket"

You will receive a medical info card (Ärzte-Info-Ticket) together with your insurance certificate. This card shall help you in case of illness and necessary treatment. Please provide the physician with this vital information prior to any treatment. The "Ärzte-Info-Ticket" contains detailed information on invoicing modalities and your policy's scope of benefits.

Here you can print out your "Ärzte-Info-Ticket":

Ärzte-Info-Ticket (medical info card) (German)

3. Medical costs projection

Not all dental treatments are covered. In some cases, a medical costs projection is a necessary precondition for a 100% reimbursement of the reimbursable treatment expenses. We differentiate between emergency treatments and pre-existing medical conditions.

Emergency treatments are covered

In case of toothache, you usually receive immediate dental treatment. Such treatment aims to reduce pain and to treat the respective tooth. As with any other travel health insurance, the policy covers dental treatment for the relief of new and acute pain (emergency treatment).

No pre-existing medical conditions will be covered

The aim of this insurance is to protect the au pair against unforeseen events and against pain. No treatments of undersupplied and root-fractured teeth are covered, since they are regarded as pre-existing medical conditions. Extensive dental restorations which are often medically necessary and reasonable are not covered by this insurance policy.

We insist on a medical costs projection prior to the planned treatment in the following cases:

  • treatment of more than two teeth during the insurance period,
  • periodontal treatment,
  • treatments with an estimated cost range of more than € 250.

Without our written approval of the medical costs projection, the reimbursement of the above named benefits is limited to 50% of the reimbursable costs.

Your dentist can send us the medical costs projection by fax prior to starting the treatment. It will be processed in one working day. In case of an emergency, please label your medical costs projection as “urgent”. We will then check these documents within two hours.

You are not sure whether the treatment of an illness is covered?

If you are not sure whether the treatment of your illness is covered, you can call us prior to the treatment. We will inform you about the scope of your insurance and we will tell you what you should consider during treatment.

Contact us.

What to do in the event of damages as a result of an accident?

An accident is a sudden, unexpected, involuntary and external event taking place at a certain time and place and causing damage to a person's health.

Medical treatments that become necessary as a result of an accident are covered by health insurance.

Permanent impairment or death as a result of an accident is covered by accident insurance. Accident insurance also provides financial assistance in case of plastic surgery, rescue costs or long-term hospital stays as a result of an accident.

Please notify us immediately in case of an accident.

Notification of damages as a result of an accident is handled by:
DR-WALTER GmbH
Abteilung Leistung (Claims Department)
Eisenerzstr. 34
53819 Neunkirchen-Seelscheid
Email leistung@dr-walter.com

Tel: +49 2247 9194-31
Fax: +49 2247 9194-20

Click here for the right claim forms.

What to do in the event of liability losses?

Liability insurance deals with financial claims caused by the au pair's misconduct. Under statutory regulation, the policy covers the risks of everyday life as well as any activities as an au pair. The policy includes any third-party claims as well as any personal damage to you, your children and other persons living in your household caused by an au pair up to the maximum sum insured; in addition, the policy also covers damage to immovable property of the host family.

Please notify us immediately in case of liability losses.

Notification of liability losses is handled by:
DR-WALTER GmbH
Abteilung Leistung (Claims Department)
Eisenerzstr. 34
53819 Neunkirchen-Seelscheid
Email: leistung@dr-walter.com

Tel: +49 2247 9194-31
Fax: +49 2247 9194-20

Click here for the right claim forms.

How are your invoices refunded?

Direct billing with doctors or hospitals

After the admission of a patient, hospitals usually contact our claims department. Billing then takes place directly with the hospital.

Doctors and dentists can settle their bills directly with us, too. You just need to submit your "Ärzte-Info-Ticket" (medical info card) to the physician prior to the treatment. If the doctor sends the invoice to DR-WALTER GmbH, we will transfer the invoice amount directly to the doctor’s account.

Advantage of direct billing: if the treatment costs are within the sums insured under the policy, you do not need to bother with the billing at all.

If you receive an invoice

If your doctor does not want to settle the bill directly with DR-WALTER GmbH, you will receive an invoice after the treatment. Please send the original invoice along with your insurance number to DR-WALTER GmbH and name the account you want the reimbursement transferred to.

Please note: laboratory bills as well as prescriptions can only be reimbursed when we receive the doctor’s original invoice (along with the diagnosis). Processing of bills/invoices usually takes 7 to 14 days.

Please send your invoice to:
DR-WALTER GmbH
Abteilung Leistung (Claims Department)
Eisenerzst. 34
53819 Neunkirchen-Seelscheid

Claim forms

Here you will find all claim forms as PDF files that you can fill in and print out at home.

Claim documents overview:

If you don’t have the “Acrobat Reader” to open the file, you can download it for free at www.adobe.com.