Complaint to a supplementary health insurer about a reimbursement (France)
Published byDocMuse
This document is in French
The PDF you download is in French — that is the language it has to be filed in, so it is not translated. Everything on this page is here to tell you what it says.
For a member of a French mutual, insurer or provident institution who has not received the expected reimbursement from their complémentaire santé. Check your online member area first, often the quickest. In French, the letter identifies the contract, the care and the amount expected, records the steps already taken and names the mediator in the contract, free, to be approached within a year of the written complaint. Sold blank, to complete by hand, as it holds health data. Sent by registered post to keep proof.
- Made for use in France
- Last updated October 13, 2026
When to use this document
- Your top-up health insurer in France has not paid the reimbursement you expected for your care.
- Your mutuelle reimbursed far less than expected for glasses or dental work.
- You have already asked through your online member area and the problem is still not solved.
- You want to make a written complaint to your mutuelle before turning to its mediator.
What you fill in
The details the document asks for.
- Sender
- Sender's address
- Supplementary health insurer (mutual, insurer or provident institution)
- Supplementary health insurer's postal address
- City
- Date
- Member or contract number
- Date of the care
- Refund expected (amount in euros)
- What the complaint is about
- Complaint history
- Requested outcome
- Attachments
Preview
This document is produced for you. Your answers are typed into it and the finished PDF is yours to keep.
Common questions
- Why has the French supplementary health insurer not paid, and what should I check before writing?
- Often it has not received the Assurance Maladie statement: the automatic link between the fund and the insurer is not always active, or the care was paid without the carte Vitale. Check your member area, then send the statement and the invoice if needed. Check the contract's cover too: fees above the agreed rate or equipment may be capped. The letter is for when these steps were not enough.
- Which mediator do I approach after a complaint to a French supplementary health insurer?
- The one your contract or the insurer's website names: the mediator of a federation of mutuals, the insurance mediation service, or that of the provident institutions. It is free, and possible only after a written complaint that got no satisfactory answer; it must be made within a year of that complaint (article L. 612-2 of the French Consumer Code). So keep proof of the date your letter was sent.
- What goes with a reimbursement complaint in France, and why is the template blank?
- Enclose the Assurance Maladie statement, the invoice or fee note, the accepted quote for equipment, and copies of earlier exchanges. The letter describes care: that is health data, which DocMuse does not collect, so the template is sold blank, to complete by hand. Send it by registered post with proof of receipt, or through the member area if it gives a dated acknowledgement.
How you can sign this document
- Print it and sign by hand. The signature lines in the document are left blank on purpose — sign on them in ink.
- Sign it yourself with a qualified electronic signature. If you already hold a QES — Evrotrust, B-Trust, StampIT, ZealiD or any qualified provider on the EU Trusted List, on a card, a USB token, in a mobile app or in the cloud — our signing guide explains step by step how to sign this exact file without invalidating it. Step-by-step help, and a way to check it worked
DocMuse sells documents, not legal advice. Acceptance always depends on the recipient's rules and your local law.
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