Top-up health insurance 'mutuelle' in France

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cartevitale
mutuelle
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(James Higginson) #1

When we arrived in France I was stunned to discover that my kids needed to be insured before they could be released into polite society. I was pretty clueless in those days (still am in many ways!) but fourteen years later, I have got to grips with French insurance requirements.

Insurers are the same the world over. They will do anything possible to avoid paying out. We all know this and we all know that we should, in theory, read every small detail of the policy, but which of us can honestly say we do it?

Last year we had two unfortunate (and expensive) incidents caused by my failure to do just that. In the summer we borrowed a car from a friend and upon breaking down in Italy, discovered that we would have to foot the recovery costs, despite having been (verbally) assured by the agent that we would be covered. Ouch! Then we went to the dentist for what was supposed to be a routine clean. Our dentist is very good and always checks the “mutuelle” policy details before starting anything expensive but on this occasion the insurers had changed the T&C and we were left 400€ out of pocket. Double ouch!

So when it came to renewal time, I was determined to be more careful.

These days there are a number of comparison sites and some of them are very good. So one morning I sat down with a huge mug of coffee and started painstakingly filling in my details and requirements. Some time later I got a phone call. I don’t generally have much time for people cold calling me. I figure I can work out what I require and where to get it myself. But this guy was different; professional, intelligent and clearly knew his stuff. And, he emailed me straight away, offering to explain the policies in English!

So, drum roll, enter Fabien!

To cut a long and boring story short, whilst I’d found a good top-up health insurance policy at a reasonable price, Fabien found us a better one at a cheaper price.

I was so impressed with his professionalism and approach that we got him to look at our household insurance which was also up for renewal. He has done a fabulous job in finding us a policy that really suits our needs. He’s enabled us to include all kinds of extras such as cover for the horse and the dogs, and made sure that we have the exact levels of cover that we need for valuables and equipment. He explained everything clearly and simply and in English and is our point of contact should the worst happen and we need to make a claim. Best of all, he saved me a load of time, energy and hassle. And this was all free of charge!

Insurance is a minefield. Everyone’s needs and budgets are different so taking expert advice is the most sensible option. The problem is finding someone you can trust. James and I can’t recommend Fabien highly enough. In fact, we’re so impressed that he is currently sorting out life insurance cover for us. We’ve passed his details onto all our friends and would now like to do the same for you. If you would like to get the best possible insurance cover, whether it’s “assurance habitation” or “assurance vie” for the best possible price.


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(David Silcox) #2

The system is flawed. Your situation is exactly what I think about at 04:00. Older people getting f...ed due to greed, naivety, lack of support and health concerns. In my opinion governments have a few primary responsibilities, health care, reliable services (hydro, water (in and out) and defence. Unfortunately governments have been coerced and cajoled, lobbied and probably bribed to give into corporate greed. I am all for Capitalism and I know the true nature of greed and it is not all on Wall St. Here is an example that you may relate to. Insurance companies expect to pay out no more than 60% of their revenue in claims. That leaves 40% in the company to run the corporation. OK for auto insurance but health care??? No way.


(Shirley Mitchell) #3

Sorry, David. I wrote fully about my problem on one of these forums but received no response.

I took my paperwork to the Mairie last week - to the monthy Juridique Gratuite ( equivalent to Citizens Advice Bureau) - and the lawyer advised me to keep sending the same reply to the Mutuelle's letter of REFUSAL of my résiliation. Unlike my broker who has arranged my cantract with another Mutuelle, the Law man said it may come to court but he can't see a judge givng a verdict against a woman of 80 of unblemished character.The broker said "They do this but then they get tired and give up."

The devil of it is - I cannot use my new Carte de Tierce until the old lot withdraw.

I do sympathise - apparently Mutuelles are well known for this "trick" and in my case, they SWEAR they sent a letter in good time for me to cancel - but I NHEVER received their letter (which was not sent byregistered post) - the avocat told me this is yet another "trick"

The sum involved in my case is well over a thousand Euros - IN ADVANCE - for a service I no longer need and have three times cancelled ( by registered post.)


(David Silcox) #4

What I find quite startling about these type of forums is that reasonable and extremely intelligent well intentioned people like yourself would say something like that and not be specific. Here is what I know. I have a Mutuelle, the renewal date is February and I cannot cancel it with out sending a registered letter to Allianz, the insurance company 2 months in advance of the renewal date. What else should I "BEWARE" of. What I do not know is whether I can change the policy in any way in the interim. PS: I just reviewed the past 6 months: PAID 1500 euros to the Assurance Maladie and Allianz combined, not including the taxes paid to the government. Received in reimbursements 360 Euros. What is unclear and my fault is the actual amount that I paid out as some providers want cash as in the 90 Euros surgery that I had on Friday at the Laurier Clinic in Frejus.


(Shirley Mitchell) #5

But BEWARE if you need to cancel the contract!!!


(David Silcox) #6

I am interested in what you consider a lot of money. I have never in my entire life been so broke.


(Catharine Higginson) #7

Oh well - you must be earning lots of money then! x


(David Silcox) #8

Sorry that is just health care for Carte Vitale, Assurance Maladie the taxes or "Social Charges" are much more.


(Catharine Higginson) #9

522 is pretty reasonable for a 1/4!! Depending on your turnover of course!!

Don't forget that your URSSAF payments are basically tax that helps society to function, CAF payments to families and for holidays for kids, help for parents employing nannies etc. etc. - not all to do with your health care as such, just how society works!


(David Silcox) #10

Got got URSSAF invoice today, 522.00 euros per quarter that plus 140 euros per month for the mutuelle. Something has to give


(David Silcox) #11

I have been in touch with Fabien. He is thorough and knowledgeable. I am hypercritical because I know the insurance business (20 years selling in Canada). I just had a very minor surgery yesterday at a clinic in Frejus. I will be watching the reimbursement process carefully but that said I have never seen anything so ridiculous and complex, convoluted and confusing as this French health care system.


(Angella Turner) #12

hi

after reading this i did indeed contact Fabiene can not praise him enough not only did he help with the insurance but he wrote all the necessary letters

great find guys


(Catharine Higginson) #13

Thanks mush xxx


(Valerie Skinner) #14

Blimey, enough to worry about without the threat of hefty bills on top. But apart from that, big hug to my buddy xxx


(Catharine Higginson) #15

They are now very bad at reimbursing things like the arm thing. James had some insoles a couple of years ago that were 480€ and the secu paid around 80€. As it said on the prescription 'achat' I doubt any of it would have been reimbursed. I'm sure you can easily check the refund rate for 4 boxes of paracetamol and two boxes of ibuprofen. And I'm sure you will :)


(Steve Hayes) #16

surely the secu would reimburse most of it


(Catharine Higginson) #17

Update!!!

On Wednesday the stupid son got hit by a football and by today he was in a sufficient amount of pain for me to do an emergency run to A&E. Now I have no idea what I would have been charged by the hospital if I hadn't had a mutuelle but I left with a prescription for 12€ of painkilllers and 56, 64 € worth of splint for his arm - all of which was reimbursed by our new mutuelle. I have also got a prescription in my handbag for James all of which is non-reimbursable by the secu but our new mutuelle gives us 150€ per person of non-refundable medicines every year, so that one will be ok too.

None of this would have been refunded on our previous mutuelle so thank you very much Fabien!


(Chris Kite) #18

There’s no denying your logic Steve, but for many it is illogical and so for various reasons more people subscribe to a Mutuelle than don’t I think.


(Kate and John Fagalde) #19

Thanks for sharing this valuable information Catharine and James. We have always felt that our premium was quite high, but we are great believers that you only know if an insurance is good or bad when something happens, luckily, nothing happened yet to verify that. We are definitely going to ask Fabien for advice after checking our policies exp dates, and when his telephone cools down a bit after this discussion. Thanks - Kate and John


(Valerie Skinner) #20

That's what I wanted to say but you managed it in half the number of words and far more eloquently, Chris, lol.