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Hospitalization insurance or personal accident insurance: here is the difference

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Guide-savings.beHospitalization insurance and personal accident insurance are 2 different types of insurance. Those who absolutely wish to have them both, will always have to accept a certain overlap in terms of coverage of hospital costs. It is impossible to avoid being ‘overinsured’ because by taking out these 2 insurances, you cannot separate the overlapping elements from the whole. Below, Guide-epargne.be provides you with explanations on this subject.


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Undoubtedly, hospitalization insurance is the best known of the 2. It will reimburse your medical expenses in the event of hospitalization, both for illness and for an accident. The personal accident insurance will intervene in case you have medical expenses following an accident. Hospitalization is not required for this.

Hospitalization insurance

You can take out hospitalization insurance with a health insurance fund or an insurer. Sometimes it is also part of the fringe benefits granted by your employer. It completes the intervention of your health insurance fund.

Pipe: How to choose the mutuality that suits you best?

Since the costs associated with hospitalization can be considerable, this insurance is not an unnecessary luxury. Indeed, the compulsory health insurance only covers part of the hospital costs. In this case, the non-reimbursed part will be borne by this insurance. So you don’t have to worry about the bill you will receive later.

The main condition to be met in order to be able to use your hospitalization insurance: you must have been hospitalized. If this is the case, you will also be reimbursed for outpatient costs relating to previous care and subsequent treatment. In some cases, this is limited to a few months before and a few months after. Good to know also: hospitalization insurance intervenes in the event of illness as well as in the event of an accident.

Personal accident insurance

Personal accident insurance offers more extensive cover than hospitalization insurance. It is not limited to hospital costs. On the other hand, it only intervenes for accidents, not for illnesses.

According to the rule, it must be a question of personal injury in private life, although some personal accident insurance policies also cover personal injury in the workplace. Your physical injury must have been caused unexpectedly and suddenly.

Personal accident insurance covers accidents that occur in private life (at home, on the street, in your free time, etc.), but not in the workplace, in general. This insurance also covers accidents that occur during the practice of a sport/leisure. Some insurance excludes dangerous sports; others charge a higher premium for accidents occurring while practicing these sports. In addition, there are still other exclusions which may differ from one insurance to another.

Also read: A bungee jumping accident? Most insurances do not intervene.

The overlap

Personal accident insurance insures you against the financial consequences of an accident. In the event of death, the insurance will pay an agreed sum. In case of permanent disability, she will pay a certain sum or a percentage of this sum. If it is a temporary disability, the insurance may also pay a daily allowance.

Personal accident insurance also provides reimbursement for medical expenses. This will be done after deduction of the intervention of the mutuality or the hospitalization insurance. This latter intervention partially overlaps with accident insurance.

An example

Personal accident insurance will give you and your household financial compensation in the event that you have long-term expenses as a result of an accident; this is to prevent your household from encountering financial difficulties following your death or permanent disability. A few examples: an airplane pilot who has suffered a permanent eye injury, following which he can no longer practice his profession. Or a model who suffered severe facial burns in her kitchen, which abruptly ended her career. These 2 people lost their source of income following their accident. If they have personal accident insurance, they will be entitled to financial assistance. This insurance will also grant you financial assistance in the event that you need to adapt your home/vehicle following your accident/disability.

The percentage of invalidity

Since personal accident insurance is generally based on a calculation of physiological invalidity, you will be entitled to a certain percentage of the sum agreed in the policy. This percentage corresponds to the percentage of your disability. In this case, a person declared 25% disabled will receive 25% of the contractually agreed amount.

For the self-employed, this method of calculation is not so interesting. A freelance pianist who has lost a little finger may be declared 5% physiologically disabled for personal accident insurance, while he may be 100% economically disabled for another type of insurance. This is why it is in your interest to check which type of disability is mentioned in the personal accident insurance.

Driver insurance

Without knowing it, you may have a variant of personal accident insurance. By taking out car insurance, some people also opt for driver’s insurance. In this case, drivers will still be covered, regardless of whether or not they are at fault with respect to the accident.

Which auto insurance is right for you? Compare the prices and conditions of several insurers here.

Read more on Guide-epargne.be:

Where is the difference between advantageous travel insurance and expensive travel insurance?

Does fire insurance cover your heat pump?

What risks do you run if you do not have family insurance?

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Source: Guide-savings.be