Complaint to the CPAM about a reimbursement of care (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 an insured person whose care was not reimbursed, or wrongly, by the French local health insurance fund (CPAM) in mainland France, or by the general social security fund (CGSS) in the overseas departments other than Mayotte. The free route comes first: the messaging service of the ameli account. In French, the letter is for when a posted complaint is better: it identifies the care, the dispute and the request, and names the fund's mediator and then the amicable appeals committee. The social security number is written by hand. Sold blank, as it holds health data.
- Made for use in France
- Last updated October 13, 2026
When to use this document
- The Assurance Maladie in France has not reimbursed a doctor's visit or treatment you paid for.
- Your local health insurance fund reimbursed the wrong amount for your care.
- You have written through your ameli account and the problem is still not solved.
- You want to send a complaint about a reimbursement to your CPAM by post.
What you fill in
The details the document asks for.
- Sender
- Sender's address
- Health insurance fund (e.g. CPAM de Paris, CGSS de La Réunion)
- The fund's postal address (CPAM or CGSS)
- City
- Date
- 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
- Should I write to the CPAM or use my ameli account in France?
- Start with the ameli account: its messaging is free, leaves a written record and lets you attach documents. The official forms stay free and are not sold here: the paper feuille de soins, when the practitioner did not use the carte Vitale, and form S3125 for care received abroad, also available online. The letter is for when you prefer a posted complaint, for instance on an old file or after an unsatisfactory online reply.
- What is the difference between the CPAM's mediator and the amicable appeals committee in France?
- The fund's mediator handles difficulties in your dealings with the fund, free and informally (article L. 217-7-1 of the French Social Security Code). To challenge a notified decision, such as a refusal to reimburse, the compulsory route before any court is the amicable appeals committee, within two months of notification. A time limit also runs for the reimbursement claim itself: two years from the first day of the quarter after the care (article L. 332-1).
- Why is the social security number written by hand on the complaint to the CPAM?
- The fund needs the number to find your file, but DocMuse never collects it: the letter leaves a line to complete by hand. For the same reason the template is sold blank, as a complaint about care holds health data. It applies in mainland France and the overseas departments, where the fund is the CGSS, except Mayotte. In Alsace-Moselle, the local health insurance scheme tops up reimbursements, and the complaint can mention it. Send the letter by registered post if proof matters.
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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