Institut national de la consommation (INC)

According to the results of the “Health Barometer 2010”, 11 million people who were victims of accidents in everyday life (ACVC) sought care, 4.5 million injured people had recourse to emergency services and 500,000 were hospitalised. About 20,000 people die each year from strokes, a third of whom are elderly. By way of comparison, traffic accidents kill about 3,500 people a year.

In view of the frequency of this risk, it may be worth taking out an insurance policy.

Presentation of “Accidents of Life” insurance contracts

Article L. 1171-2 of the Public Health Code defines accidents in everyday life (ACVC) as “all unintentional injuries, with the exception of traffic accidents and accidents at work”.

They correspond to accidents occurring in the home, in sports or leisure areas, at school and may take the form of defenestration, choking, drowning, falls, burns or electrocution, poisoning, cuts, etc.

Prevention is essential to avoid these accidents, the consequences of which can be very serious.

To protect yourself from the financial consequences that may arise as a result of an accident in everyday life, it is possible to take out a specific insurance policy, generally called “life accident insurance”. These contracts cover your financial losses but can also protect your loved ones in the event of death.

Insurers, through the FFSA (Fédération Française des Sociétés d’Assurance, now FFA – Fédération Française des Assurances), have created a “Garantie des Accidents de la Vie” (GAV – Life Accident Guarantee) label for contracts covering this type of accident.

The purpose of these contracts is to cover “the prejudice resulting from accidental events that occur in the private life of the insured, under the age of sixty-five, provided that the accident results in the death of the insured or that the permanent disability directly attributable to the accident is at least equal to 30%”.

It allows rapid compensation to be paid to the insured, even in the absence of a person at fault. This is the main advantage of the contract: even if the person is injured alone, he or she will be able to receive compensation for the injury, which would not have been the case without insurance.

Moreover, compensation is made according to the principles of ordinary law, i.e. according to the scales set by case law, and not according to contractually fixed scales which may not be well adapted. Indeed, compensation under ordinary law has the advantage of taking account of changes over time in the social perception of losses.

To qualify for the GAV label, insurance companies must comply with a minimum base of guarantees, which they can enhance by lowering, for example, the threshold for triggering guarantees or by offering ancillary services, such as assistance or legal protection cover to assist you in any recourse.

In practice, many insurers comply with the minimum guarantee base and add to it, without being labelled “GAV”. In this practical information sheet, you will find the basic guarantees that must, at the very least, make up your contract.

All contracts are based on three essential elements, which determine the amount of the premium:

the number of people covered by the contract (single / couple / family),

– the compensation ceiling: it is at least €1 million per victim, but the insurer may decide to increase this ceiling,

– the insurer’s intervention threshold, from which the guarantees come into play (AIPP rate – Physical and Psychic Integrity Damage – following the accident and determined after an expertise). This rate is 30% in the basic contract, but insurers often provide a trigger rate of between 5 and 15%.

The “basic” content of the GAV contract

What accidental events are covered?

The following events must be covered by the GAV contract:

accidents in private life (e.g. a fall at home, an injury while doing sport, a serious burn),

– natural and technological disasters (e.g. a flood, earthquake, tidal wave, explosion in a factory near your home),

– medical accidents (these are accidents caused during surgery, prevention, diagnosis, exploration, treatment by doctors and medical auxiliaries. The consequences must be abnormal and independent of the evolution of the condition in question for which the act was performed and of the previous state),

– accidents due to attacks or offences (e.g. injuries related to a terrorist attack or attempted murder, assault and battery).

75441 Paris Cedex 09

https://www.mediation-assurance.org/Saisir+le+mediateur