The principle of insurance in France is that the insurer and the insured party sign a contract through which:
- the insured party commits to paying the insurer a certain amount in the form of one-off or regular payments
- the insurer commits to paying an indemnity to the insured party in the event of a justified claim, with the aim of compensating for material damage or personal injury.
The insurance contract must clearly state the name of the property and the insured person or persons, as well as any exclusions from the guarantees and the terms and conditions. The contract may be adapted by the addition of specific conditions for each insured party.
What obligations result from the contract?
Insurance can be used to cover the most significant and frequent risks:
- Civil risks: if you injure someone
- Social risks: maternity, illness, invalidity, death or unemployment
- Automobile risks: to provide an indemnity for damages caused to others in the event of an accident
- Tenancy risks: in rented accommodation, this type of insurance pays an indemnity to the landlord in case of damage (fire, water damage etc.)
- Employer’s liability risks: pays out indemnities to employees in high-risk sectors such as construction or medical services.
If an incident causing material damage or personal injury occurs and there is no insurance contract, the person responsible must pay damages to the victim out of their own pocket.
It is important to remember that the law requires French people to be insured.
Medical insurance is at the heart of the French system of medical cover. Created over 70 years ago, medical insurance aims to improve the health of the population, while ensuring good risk management and improving the efficiency of the health system. There are 3 régimes or schemes: the general scheme, the agricultural scheme and the special social security scheme for self-employed persons.
The general scheme covers for employees in the private sector, civil servants working for a local or regional authority, hospitals, and students. In 2009, it covered 57 million beneficiaries, or 89% of the French population. The scheme provides cover for maternity, sickness, work accidents, invalidity and death.
The general scheme is managed by the Assurance Maladie (or health insurance) organisation. It is a network of several structures with a head office, the CNAMTS and it pays out reimbursements via the CPAM (or local health insurance fund) offices in mainland France and via the CGSS (Caisses générales de sécurité sociale or general social security fund) offices in the DOM or French Overseas Departments.
If you work in the agricultural sector, you are covered by the agricultural scheme and your point of contact is the mutualité sociale agricole (MSA) or agricultural social insurance mutual fund.
Lastly, the régime social des indépendants (RSI) or special social security scheme for self-employed persons covers the following business activities:
- Storekeepers and traders
If you are covered by this scheme, your point of contact is the agricultural social insurance mutual benefit fund (MSA)
If you change professional status, please contact your social security organisation to find out what steps you need to take.
Click here to find out which social security organisation provides you with health insurance cover.
There are also special schemes for specific cases. These schemes cover, for example the employees of the French national rail organisation, the SNCF the French electricity company, EDF, and the Paris local public transport network, the RATP.
Mutual insurance funds only reimburse part of health care costs. However, complementary health insurance is available through private insurance, called mutuelles. In general, French people take out this type of health insurance to make up the difference.
In France, the principle of reimbursement is applied to costs: patients pay the doctor for a service and show their carte vitale or social security card, giving their insurance information. The appropriate health insurance scheme and the complementary scheme (mutuelle) then automatically repay the costs.
The rates used to calculate reimbursements vary from service to service. In the general scheme, reimbursements cover 70% of medical and dentistry services. For hospital stays, the figure rises to 80% and coverage rates for medicines are 100%, 65%, 30% or 15%.
For more information on the health insurance system in France, visit the Ministry of Health and Solidarity’s website by clicking here.