Lexique assurance expatrié

ACTUAL COSTS or REAL EXPENSES: Expression used in insurers' coverage tables to designate the health costs incurred by the insured. Here at international-sante.com, we prefer to simply use the term "expenses," since we don’t know what "Unreal Expenses" would be ;-). Coverage of 100% of the actual cost or real expenses means that the insured will be reimbursed in full, while coverage of 90% of the actual cost or real expenses means that the insured must pay 10%.

BENEFICIARY: The person benefiting from the coverage. The exact definition may vary from one policy to another, so read the terms and conditions of your policy carefully.

BODILY DAMAGE: This refers to physical damage to a natural person, for example, permanent disability following an accident.

CAISSE DES FRANÇAIS DE L'ETRANGER: Social Security for French citizens living abroad. See our CFE page.

CFE: Caisse des Français de l'Etranger. See our CFE page.

CFE COMPLEMENTARY INSURANCE: Any global health insurance that supplements the Caisse des Français de l'Etranger. Compare to first euro insurance. Generally, the coverage amounts listed in the coverage tables include the CFE reimbursement. For more details, see the CFE page.

CIVIL LIABILITY: Legal obligation to compensate damage caused to a third party. By extension, the term refers to the insurance covering this obligation.

CLAIM EVENT: An event that is covered by insurance: accident, illness, etc.

DAILY ALLOWANCES: Compensation paid for each day the insured is unable to work due to illness or accident. Also called IJ in French.

DEDUCTIBLE: The amount that remains after reimbursement, to be paid by the insured. It can be expressed as a percentage, an annual fee or a fee per procedure.

DISABILITY: Permanent physical incapacity to perform certain actions that may partially or completely limit the insured’s ability to practice their profession or any profession. Each insurer uses its own definition of disability, often combining the concepts of physical and professional incapacity, and referring either to the insured's profession or to all professions. The exact definition is specified in the policy’s terms and conditions.

EFFECTIVE DATE: Date on which the policy becomes effective. You are not covered before this date.

EXCLUSIONS: Whatever is not covered by the policy. All expat health insurance policies contain exclusions. They can be found in the Terms and Conditions in a different font from the rest of the text, and are more visible (in bold or on a colored background, for example). Read them carefully before subscribing. They are available online at the bottom of the coverage tables.

EXPATRIATE or EXPAT: A person who leaves their country of origin to live abroad. This change will affect their social security and health care coverage. See “Expatriate or seconded employee: What’s your status?”

FIRST EURO: see “first euro health insurance”

FIRST EURO HEALTH INSURANCE: Refers to a health insurance that covers the entire amount spent. This is different from complementary health insurances that only provide reimbursement after a 1st level social protection plan, such as social security or the Caisse des Français de l'Etranger for expats, has provided reimbursement.

HOSPITALIZATION: Admission to a hospital, generally including an overnight stay (inpatient care), or surgery performed in an operating room. Daytime care provided in a hospital setting for routine medical procedures isn't generally considered routine outpatient medical care, not hospitalization. For further clarification, read the definition of hospitalization in each policy carefully. Health care or examinations performed in a hospital emergency room aren't considered routine medical care, not hospitalization. They are not included in hospitalization coverage.

IMPATRIATE: A person who enters the country to take up residence.

INSURANCE YEAR: A period of one year used to calculate lump-sum coverage limits. Depending on the insurer, the insurance year runs either from January 1 to December 31 or from the date of subscription to the anniversary date of that subscription.

LEGAL PROTECTION: Coverage providing for the payment of legal fees (a lawyer, experts, mediators, translators, etc.) in a dispute between the insured and a third party. Policies generally also cover legal assistance services to provide first level answers or help the insured find a local professional.

MATERIAL DAMAGE: Refers to damage to property. For example, a car hitting a bus stop causes material damage to the bus stop.

NSURED: The person benefiting from the coverage. The exact definition may vary from one policy to another, so read the terms and conditions of your policy carefully.

POLICYHOLDER: Person who subscribes to the policy. This may be a natural person for individual policies, or a legal entity for collective policies.

PRE-AUTHORIZATION: Prior agreement from the insurer to grant coverage. In expat health insurance policies, this generally concerns recurring expenses, such as physical therapy sessions or non-urgent hospitalizations.

PRESCRIPTION: A document issued by a physician to prescribe medication, care, examinations or tests.

REPATRIATION ASSISTANCE: Repatriation assistance is a service that allows you, in case of illness or accident, to be immediately repatriated to a medical service capable of providing you with the best possible care. This service may be included or offered as an optional add-on. It is essential in areas where the local health care system may be inadequate. It is optional in regions where the health care system is satisfactory. In such cases, it can provides repatriation services or the presence of a relative for your own comfort. Repatriation is organized by a medical team using the transportation method best suited to your medical condition: light medical vehicle, ambulance, train or passenger plane with medical assistance, or an air ambulance.

RESPONSIBILITY RATE: Reference rate on which social security bases its reimbursements.

SECONDMENT: Situation in which an expatriate maintains a strong connection with the social security organizations of their home country. See “Expatriate or seconded employee: What’s your status?”

SPECIAL CONDITIONS: Document supplementing the terms and conditions that includes the insured's personal information, the persons insured, the coverage included and the premium.

SUBSCRIPTION CERTIFICATE: Document issued by the insurer confirming subscription to the insurance policy.

SUBSCRIPTION FORM: Document formalizing the application for insurance. The information contained in this document has contractual value. It must be completed with complete honesty and without omission, or the coverage may be cancelled.

STUDENT: Status of a person pursuing their studies, enrolled in an official training institution (a university, college or school) recognized as such in the host country. Depending on the policy, this status may be subject to age limits, or extended to include apprentices, nannies, interns, etc.

TERMINATION: Definitive termination of the insurance policy. Coverage generally stops after the date of termination. This termination must be handled in accordance with the conditions stipulated in the policy (period of notice, termination date, etc.).

TERMS AND CONDITIONS: The general rules of an insurance policy. They provide an exhaustive explanation of how the coverage works, the amounts insured, the limits of coverage and the exclusions. They are valid for all policies of the same type, and may therefore include text explaining coverage not subscribed to by the insured. To find out what coverage is included in your policy, please refer to the special conditions.

TRAVEL: A stay in a location other than the main place of residence. The maximum duration of covered trips is specified in every policy. Check the precise definition in each policy.

WAITING PERIOD OR DELAYED COVERAGE: Period during which coverage is not provided. The insured will not be reimbursed for expenses incurred during the waiting period. Waiting periods vary from one policy to another, so it’s important to read the conditions of your policy carefully.