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Great novelty on the Health Insurance website. In the event of an accident caused by a responsible third party, the organization can now recover the sums incurred for the care of the victim from the person responsible for the incident.
Until now, the recourse against third parties – which makes it possible to recover from the person responsible for an accident the health expenses incurred – could not be done online on Améli.fr. Good news: it is now possible, and this novelty will greatly facilitate the daily life of users.
A quick and easy online process
The steps to take are very simple. If a doctor has prescribed you “a work stoppage in the last two months”you should declare it to the health insurance fund by connecting to your Améli.fr account.
To do this, simply go to your personal space, in the “My steps” section, then click on the “declare an accident caused by a third party”.
Another option: directly access the online accident declaration on the site Ameli.fr.
As a reminder, an accident caused by a third party is an incident of which you are the victim and which is caused, voluntarily or not, by a natural or legal person, whose responsibility is engaged.
This responsible third party may:
- A particular ;
- A company (store, etc.) or an administration (local authority, etc.);
The types of accidents concerned are multiple: domestic or school accidents, intentional blows or injuries, traffic accidents, accidents caused by an animal (bite, scratches, etc.), sports accidents, falls due to poor road maintenance. , medical accidents, accidents caused by a defective product…
The victim must also declare the circumstances of the accident, the nature of his injuries, the person responsible, etc.
Reimbursement of per diems does not change
Once the declaration has been received, the Health Insurance is authorized to claim from the third party responsible or from its insurance.reimbursement of daily allowances as well as all other benefits resulting from the accident”.
The organization would also like to reassure users on this point: in the event of an accident caused by a third party, “nothing changes for your care”. The conditions of rights and calculations of daily allowances remain the same, regardless of the responsibility of the victim during the accident.