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Insurance Claim Denied in France? Here's How to Fight Back

Whether it's a CPAM denial, a mutuelle dispute, or a private insurer, France's Médiateur de l'Assurance and Code des assurances protect you.

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Key Regulators in France

These bodies regulate insurance and protect your rights as a policyholder in France.

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ACPR — Autorité de Contrôle Prudentiel et de Résolution

France's financial and insurance regulatory authority (under Banque de France). ACPR licenses and supervises all insurers operating in France, enforces conduct standards, and protects policyholders through market conduct oversight.

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Médiateur de l'Assurance

France's free, independent insurance ombudsman. Handles disputes between individual policyholders and member insurers. Processes approximately 30,000 cases per year. Recommendations followed in ~95% of cases.

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CPAM — Caisse Primaire d'Assurance Maladie

France's social health insurance body. Manages Sécurité Sociale reimbursements. CPAM denials are appealed to the Commission de Recours Amiable (CRA) within 2 months, then to the Tribunal de Judiciaire.

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DGCCRF

France's consumer protection agency. Handles unfair commercial practices by insurers, including deceptive policy terms and misleading claims handling.

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Your Rights in France

France's Code des assurances and Sécurité Sociale framework provide strong policyholder protections.

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You have 2 months to file a recours amiable (internal appeal) with CPAM's Commission de Recours Amiable (CRA) for Sécurité Sociale denials.

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The Médiateur de l'Assurance is free and requires no lawyer. You must have filed an internal complaint with the insurer first. Apply at mediation-assurance.org.

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Under the Code des assurances, ambiguous policy terms are interpreted against the insurer (contra proferentem). This is a powerful argument for disputed exclusions.

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Insurance claims have a 2-year prescription period (prescription biennale) under Article L.114-1 of the Code des assurances — shorter than general contract law. Act promptly.

Related Guides for France

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Learn what to do if AXA France has denied your insurance claim. Understand your rights under French law, common denial reasons, and the step-by-step appeal process including ACPR and Médiateur de l'Assurance.

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AXA France Insurance Claim Denied? How to Appeal

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