- How does Life Accident Guarantee Insurance work?
- Better understand your GAV insurance in practice
Bad cuts, drowning, suffocation, poisoning… The figures regularly published by the public authorities make you dizzy! On average, there are no less than 11,500 deaths per year, including 230 of children, as a result of domestic and everyday accidents. That is almost four times more than fatal road accidents, yet much more publicized!
How to explain, under these conditions, this incredible paradox according to which goods are often better insured than their owners ? To respond to the lack of protection in the event of a domestic accident without a responsible third party, insurers have developed a new label entitled “Life Accident Guarantee”.
How does Life Accident Guarantee Insurance work?
Definition and principle of the label GAV
A Life Accident Guarantee insurance contract aims to protect the insured and compensate him for the damage suffered in the event of an accident in private and daily life. The specificity of this formula lies in the fact that the identification of the person at the origin of the damage is, most of the time, immaterial. The insured can perfectly be covered and reimbursed if he has contributed himself, through carelessness or negligence, to the accident of which he was the victim. The same will apply if the expertise concludes that there is no identifiable cause, and all the more so if a responsible third party is involved (in which case the third party's civil liability insurance could possibly take over or supplement the compensation. ).
As in other areas of insurance (auto, home, civil liability, etc.), the concept of life guarantee has been the subject of a harmonization effort among all insurers through the FFSA. This resulted in the creation of ’a GAV label, granted to all contracts that offer a certain number of minimum guarantees, including the definition of a compensation ceiling which cannot be less than one million euros.
What are the risks covered?
To prevent the blur of the concept of accident of daily life from settling in, GAV-labeled insurance formulas automatically cover several categories of accidents.
Accidents in domestic life – IVS
4.5 million injured in France each year
Domestic accidents proper are obviously the first and most important cover. Without claiming to be exhaustive, they include in particular burns, falls, drowning, suffocation and poisoning as well as mutilation and cuts. A hand scalded while preparing a meal, for example, comes within the scope of GAV protection, as does a finger that is accidentally severed during gardening or DIY work.
Accidents occurring in the context of leisure or travel are covered, but under variable conditions depending on the contracts which may provide for certain exclusion clauses. The fall of your child during a country bike ride, for example, or an injury received during a game of the local football club fall into this category. Regarding travel, the insurer is only required to compensate you if the accident occurred in France or in one of the member countries of theEEA, that is to say the twenty-eight countries of the European Union and a few other states including Switzerland, Norway and Iceland. Unless, of course, if the contract goes beyond the label's requirements and is more generous on this point.
The guaranteed life label also requires coverage of natural disasters, attacks and attacks. A very useful precaution since it would be difficult to understand if your car and your home were protected against damage resulting from a flood or a landslide, while the bodily injuries caused by these various events would not be!
The last traditional category is that of medical accidents. Poorly performed surgery or inappropriate drug treatment can have devastating consequences for a patient's physical and mental well-being. The damages set by a court are quite random and uncertain, while a GAV protection formula is more responsive and relies on the findings of an independent expert to trigger compensation within a short time frame.
Better understand your GAV insurance in practice
Who can be covered by GAV insurance?
Although each contract can be quite widely personalized, insurers often offer two different types of formulas depending on the number of people to be covered. The formula individual, as its name suggests, only covers the signatory of the contract against the risks mentioned above. The formula familyconversely, aims to cover the entire household, especially children. The contributions will of course be more substantial in this second hypothesis.
For what prejudice?
In the context of a guaranteed life contract, the condition for triggering compensation is linked to a physical harm. The medical expertise must indeed demonstrate that the accident caused, for the victim, a permanent disability greater than or equal to 30%. Note, however, that this is the minimum threshold set by the label, and that more protective contracts may provide for a lower threshold, for example at 10% or 5% and even from the first percent.
From the moment this precondition is fulfilled, the insurer is required to respect a very broad assessment of the damage : it must in particular take into account the aesthetic damage (for example, a victim disfigured by a burn) and prejudice of approval (in the event that the injury, for example, prevents the practice of an activity or leads to sexual impotence).
If the accident results in the death of the insured, the other beneficiaries of the contract will also be compensated for their economic damage (loss of income of the deceased) and moral (grief-related distress).
What are the excluded risks?
The GAV insurance contract aims to protect the individual in the context of his private life. This explains why the work accident, also covered by other socio-professional measures, do not fall within its scope. Road accidents, likewise, are subject to their own legal regime and do not fall within this framework.
The GAV label does not, moreover, prevent the insurer sets out a number of exclusions in the contract, including the practice of certain sports activities deemed to be risky.
Legal deadline for compensation
It is up to the victim or his family, first of all, to report the accident or death to the insurance as soon as possible. The insurer then has a legal deadline of five months to hire an expert to determine the degree of damage suffered and offer compensation. The latter, if it is accepted by the victim or his beneficiaries, will finally be paid during the following month.
Remember that the compensation ceiling fixed by the contract cannot be less than one million euros.
Still largely unknown, GAV insurance is nevertheless likely to offer a valuable support to your household in a very large number of emergency situations. Many policyholders wrongly feel that they are well covered – outside their place of work or during their road trip – by their complementary health insurance.
However, a supplement is limited to covering your health expenses in the event of hospitalization or medical care. What about the “after-accident”? Likewise, remember that your liability insurance, contrary to a widely held belief, only compensates for damage you may cause to others, and not to yourself. It is therefore better to have the reflex to ensure your own safety and that of your children too!
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