House Insurance in France
- Finding an Insurer
- Types of Insurance Cover
- Holiday Home Insurance
- Insurance of Valuable Objects
- Terminating Your Insurance Policy
- Making an Insurance Claim
- Disputes with Your Insurance Company
5. Insurance Disputes
We can distinguish two kinds of disputes, covering those relating to property and to person.
There are separate procedures that exist for disputes relating to refusal of cover, and disputes concerning claims etc.
Where you are unable to settle the dispute using the procedures set out below you would need to take legal action in the courts.
5.1. Refusal of Insurance Cover
Insurers are not obliged to offer insurance to any applicant, so they can refuse to insure if they consider it appropriate to do so.
More often than not, rather than outright refusal, an insurance company may offer to insure but on the basis of a premium which may be excessive, and/or other conditions which may be too restrictive.
In the event of either refusal of cover or over-pricing then you have recourse to an official independent body established by the government and the insurance industry called the Bureau central de tarification (BCT).
The BCT was set up in 1993 to regulate rates where an insurance company refuses cover to an applicant or does so on terms that may be exorbitant.
However, their role is limited to determining a rate for third party (public liability) cover for car insurance, building works insurance (responsabilité décennale/dommage ouvrage), natural disasters (catastrophes naturelles), and third party medical insurance.
Accordingly, if you are in dispute with your insurance company about the extent of cover for your home the BCT are unable to intervene.
In other cases, in order to invoke the assistance of the BCT you need to have made an application for insurance using the normal declaration requested by the insurance company (proposition d’assurance). You should ensure you send the application by recorded delivery and that you keep a copy of the application.
The insurance company are obliged to reply within 15 days (45 days for medical insurance). If they do not do so then it is assumed that they are not willing to offer cover.
If they do reply but on the basis of an unreasonable premium then you should send all the paperwork by recorded delivery to the BCT for their adjudication.
Further details of the process can be found at BCTC - Comment nous saisir?
The BCT have two months to consider the case and their decision is binding on the insurance company, although not on the complainant.
If cover is arranged, via the BCT, the insurer is only obliged to do so for a year.
5.2. Other Disputes
In relation to other disputes a process of mediation exists.
The procedures are supported by advisory legislation at a European level through the EEA, although the procedures themselves are non-statutory.
In order to invoke the mediation procedure, in the first instance you are required to have tried to resolve the matter using the internal complaint procedures of the insurance company. Indeed, as always, it clearly makes sense to try and resolve any problem amicably.
So your first step must be to find out information on the internal dispute resolution procedure and follow it. Normally it will require that you write a letter to your insurer setting out your complaint, including any supporting documentation. It is important the letter is sent by recorded delivery (lettre recommandée, avec accusé de réception).
If appropriate, get an expert opinion. Some insurance policies allow clients to obtain a second opinion paid by insurance company. Even if they do not, you are well advised to get some professional advice as your complaint carry far more weight.
If you are unable to resolve the matter to your satisfaction the French insurance industry has put in place a system of mediation to resolve disputes.
Notable amongst the disputes that have been referred for mediation in the past have been those relating to termination of insurance policies, although with the change in law such disputes have receded in recent years.
Other frequent grounds of dispute concern the unwillingness of the insurance company to renew a policy following a claim by the insured, although there are limits on the ability of mediation to resolve such disputes.
The system of mediation is independent of the insurance companies and operates through the professional federation, called Féderation Française des Sociétés d’Assurances (FFSA).
The French Insurance Code requires that your insurance contract provides you with details of the complaints procedure and the contact details of the mediator (médiateur) to whom you can make your complaint.
You can make your complaint on-line at Saisir le Médiateur.
You can also do so by post at:
La Médiation de l'Assurance,
TSA 50110,
75441 Paris, Cedex 09
You need to make your complaint to the mediator within two years of the dispute being raised with your insurance company.
Only disputes involving private individuals can be considered by the mediator.
The insurance companies are required to respond to requests for information by the mediator within a matter of weeks although the whole process of mediation can take a lot longer.
Under the terms of the dispute protocols the FFSA mediators are given two months to respond, although cases do sometimes run over the stipulated period.
The opinion of the mediator is non-binding on the insurance company. Nevertheless, there is a strong moral obligation to accept the opinion (formal advice) of the mediator.
The insured is not obliged to accept decision.
Where you are not satisfied by the opinion of the mediator then the only other recourse is to a court of law. No complaint can be referred to a mediator where litigation is under way.
You have two years from the date of the dispute to bring the case before a court of law, although this increases to ten years for those who are beneficiaries to a life insurance contract, other than the insured and assignees of accident insurance of a deceased person.
Next: Index - House Insurance in France
