Question 5934 — elderly people

Summary

The loss of autonomy constitutes a gradual risk that is difficult to objectify, which explains the existence of different standards depending on the actors. Insurance contracts most often favor the daily life actions (ADL) grid, which has the advantage of being understandable by consumers because it refers to everyday actions. In order to overcome criticism of insufficient consideration of cognitive difficulties, some insurers use specific cognitive tests, such as the Folstein test. The use of the Autonomy Gerontology Groups Iso Resources (AGGIR) grid by insurance contracts would effectively allow better consistency between the criteria for granting the personalized autonomy allowance (APA) and those of the insurers' services. To impose it would, however, raise an issue of insurability because the AGGIR grid is likely to evolve over time, independently of the actuarial assumptions made by insurers to price their contracts. If contractual freedom is for these reasons privileged, market practices aimed at standardizing criteria must nevertheless be encouraged, in particular within the framework of the label for the guarantee of long-term care insurance (GAD).

Machine translation from French. The official text remains authoritative.

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• Annaïg Le Meur · auteur

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