INSURANCE COVER · BENEFITS · LIABILITY
Understanding protection.
Clarifying claims.
Insurance should provide support when it matters. We review the agreed cover and support private insured persons, businesses and institutions with coverage issues, claim assessments and disputes.
Discuss your matterContracts. Cover. Representation.
YOUR MATTER
Policyholders, insured persons and beneficiaries are not always the same. We clarify who has which rights and from whose perspective the contract, loss and correspondence must be assessed.
We assist with personal protection and losses in private life. For benefit applications and refusals, we consider policy terms and evidence. The insured person, policyholder and beneficiaries are distinguished in legal terms.
We review your organisation's contractual insurance cover and the legal handling of a loss. Property damage, interruptions and liability issues are assessed against the relevant policy. Responsibilities and cooperation remain clear.
We assist with personal protection and coverage issues connected with professional responsibility. For D&O and other liability policies, we distinguish the liability claim made from the question of insurance cover. The interests of the company and the insured person may diverge.
OUR SERVICES
We assess the agreed cover against the specific event. Entitlement to benefits, requested cooperation and potential defences are evaluated individually.
Understanding the scope of cover and obligations.
We advise private and business policyholders on insured risks, exclusions and contractual duties. We help insured persons and beneficiaries clarify their own rights. We consider the application, policy, terms and endorsements together. Where the contract is changed or terminated, existing claims and possible consequences are assessed separately.
Comparing the decision with the contractual basis.
We support policyholders and other entitled persons in submitting and legally substantiating claims. Following a refusal, we examine the reason given, the insured event and available evidence. Recovery demands or alleged breaches of duty are assessed from your particular position. We prepare further submissions, negotiations or representation in court.
Connecting occupational activity with the policy standard.
We support insured persons and policyholders with the legal preparation of a benefit application and disputes over the decision. The specific occupation, policy terms and medical records are particularly relevant. We distinguish legal assessment from medical evaluation. In reassessments, we also consider the previous course of events and the information requested.
Distinguishing treatment, contract and reimbursement.
We support insured persons in disputes over reimbursement, the contractual scope of benefits and recovery demands. We advise policyholders on contractual issues that may also affect other insured persons. We review terms, billing and the reasons for the decision. Statutory health or long-term care insurance issues are addressed within social security law; medical necessity may require additional specialist assessment.
Establishing claims and entitled persons.
We support policyholders with contractual matters, termination and the legal assessment of statements. We advise beneficiaries and heirs on their respective positions when benefits become payable. We examine agreements, declarations and changes to beneficiary rights. Where claims compete, their bases are assessed separately; the different roles may require separate engagements.
Establishing the loss event and insured interest.
We support private owners and businesses with damage to buildings, fixtures, goods or other insured property. We examine the event, agreed risks and amount of loss claimed. For business policies, additional cover components and insured interests are considered separately. Technical causes and valuations may require expert assistance.
Handling liability claims and coverage separately.
We help businesses and insured persons coordinate the legal aspects of liability cases and insurance cover. We advise corporate officers on their own coverage position and companies on their contractual rights and duties. We examine notification, the insured activity and exclusions. A liability dispute is distinguished from a potential coverage dispute with the insurer.
Assessing duties and alleged consequences individually.
We advise policyholders on information, evidence and cooperation requested before and after a loss. Those facing a reduction or recovery demand receive an assessment of the specific basis and reasons. We consider the contractual provision, actual conduct and its significance for the case. A breach of duty does not produce every alleged legal consequence without further examination.
WORKING TOGETHER
The assessment begins with the complete contract and the specific event. Only then can we determine what information is missing and how a decision may be challenged or a claim substantiated.
We establish the policy, affected persons, course of the loss and previous notifications. Current deadlines and outstanding information requests are recorded first.
We compare the terms with the facts and the insurer's reasons. Additional evidence, specialist assessments and costs are agreed with you.
We assist with further correspondence and negotiations. If necessary, we prepare court representation on the agreed issues in dispute.
QUESTIONS & ANSWERS
An initial guide to common questions. Your legal position, the documents and the facts determine the assessment of your individual case.
Legal information: 1 November 2026
Monetary benefits generally become due once the necessary enquiries into the insured event and extent of benefits have been completed. The law provides for interim payments under certain conditions. We assess which investigations are still necessary and whether payment or further reasons can be demanded.
No. For contractual policyholder duties, relevant factors include the agreement, degree of fault, connection with the case and statutory requirements. Different consequences may follow depending on the facts. A blanket refusal is therefore assessed against the specific reasons given.
Under the statutory model, liability insurance covers both indemnification against valid claims and defence against unfounded claims. Whether a particular matter falls within the agreed cover must be assessed against the policy and the case.
Statutory health and long-term care insurance are generally governed by social security law. Private health insurance is based on the insurance contract. We clarify the classification of your matter so that the procedure and relevant documents can be assessed appropriately.
Yes. The person who entered into the contract, the person insured and the person intended to receive benefits may differ. We assess their respective positions and authority to act. This is relevant, for example, to family policies, life insurance and D&O.
Yes. We can assess the legal scope and individual terms of a specific contract. This does not include a market comparison or the brokering of insurance products. We agree the desired scope of review in advance.
The complete decision, policy, terms, endorsements and documents submitted so far are helpful. Please also tell us about known deadlines and outstanding questions. We then clarify the further review needed and remuneration for more detailed work.
