Question 13859 — supplementary insurance

Summary

Mr. Julien Guibert draws the attention of the Minister of Labor and Solidarity to the legal and practical difficulties encountered by many policyholders in the context of the implementation of collective welfare guarantees, in particular during the succession of collective contracts subscribed to by an employer, particularly a public one. Indeed, it appears that certain insured persons, placed on prolonged work stoppage or on long-term leave, are refused the benefit of welfare benefits (additional daily allowances, continued salary, disability pension), on the grounds of a disagreement between successive insurers. In these situations, the insurer currently in charge of the collective contract refuses to intervene, invoking the prior nature of the event causing the loss, while the previous organization considers, for its part, that it is no longer required to guaranteed due to the termination of the collective contract. This results in a blocking situation that is particularly detrimental to policyholders, who find themselves deprived of any compensation, despite continued affiliation with compulsory insurance schemes. However, the principle of continuity of guarantees in terms of complementary social protection constitutes an essential element of securing the rights of policyholders. In this regard, if Article 4 of Law No. 89-1009 of December 31, 1989 known as the “Evin Law” organizes the maintenance of guarantees in certain cases of termination of the employment contract, it does not explicitly deal with situations of succession of collective contracts at the initiative of the employer, particularly in the public service. Furthermore, case law and general principles of insurance law, particularly in terms of determining the fact generator of the risk and obligation of guarantee, appear insufficiently readable for the insured and give rise to divergent interpretations on the part of the insurers. In addition, the amicable remedies provided, in particular referral to the insurance mediator, do not always lead to an effective resolution of the dispute, in particular when one of the organizations concerned does not participate in the procedure. Under these conditions, policyholders are forced to initiate litigation before the competent courts, involving long delays and significant costs, incompatible with their fragile situation. In this context, it appears essential to clarify the applicable legal framework and strengthen the guarantees offered to policyholders. Consequently, he asks him to clarify, with regard to the law in force, the rules for determining the insurer responsible for the provident benefits in the event of a succession of collective contracts, in particular when the event giving rise to the claim falls within a transition period between two contracts; to indicate the respective obligations of successive insurers, in particular in terms of continuity of rights and absence of breach of guarantee for affiliated policyholders of uninterrupted manner; to specify the measures likely to be implemented in order to more strictly regulate the practices of insurers and to avoid situations of transfer of liability detrimental to policyholders and, finally, if it plans to enact a clear doctrine or normative provisions (regulatory or legislative) making it possible to legally secure these situations and prevent policyholders from being forced to initiate lengthy and costly litigation procedures to assert their rights.

Machine translation from French. The official text remains authoritative.

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1. 31 March 2026

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• Julien Guibert · auteur

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