Refer to the Commission (CCI) in case of medical accident, nosocomial infection ...
Verified 17 February 2022 - Directorate for Legal and Administrative Information (Prime Minister)
If you are the victim of a medical accident, a iatrogenic disease or a hospital-acquired infection, you may refer the matter to the Medical Accident Compensation and Conciliation Commission (CCI). Depending on the seriousness of the damage, the conciliation procedure or the amicable settlement procedure will be used.
You can go to the Medical Accident Compensation and Conciliation Commission (CCI) if you are a victim
- of a medical accident
- or a iatrogenic disease
- or a hospital-acquired infection.
For a major
You can act yourself or be represented by a lawyer.
for a protected major, the curator or guardian may also refer the matter to the ICC.
For a minor
It's the legal representative who must refer the matter to the commission.
In the event of death, the rights-holders may refer the matter to the ICC.
Action must be taken within 10 years from consolidation of the damage.
You must inform:
- the ICC of judicial proceedings (pending, future or completed) relating to the same facts,
- the judge you referred to the ICC if legal action is taken.
Referral to the ICC suspends the prescription and contentious appeals until the end of the procedure.
if the person's state of health has not been consolidated before his death, action must be taken within 10 years of the death of the person concerned.
How do I apply?
The case shall be referred to the committee by means of the cerfa form No 12245 together with the supporting documents listed in the package leaflet.
The file must be sent to the CCI of the place where the medical act in question was carried out
- either by registered letter with acknowledgement of receipt,
- or by a deposit against receipt with the secretariat of that KIC.
This is free of charge.
Who shall I contact
A medical accident shall be considered serious if it has resulted in damage exceeding one of the following thresholds:
- Rate of permanent physical or mental injury (PIA) greater than 24%
- Temporary cessation of professional activities (ATAP) for at least 6 consecutive months (or 6 non-consecutive months in a 12-month period)
- Temporary discomfort constituting temporary functional deficit (TFD) greater than or equal to a rate of 50% for at least 6 consecutive months (or 6 non-consecutive months in a 12-month period)
Exceptionally, the nature of gravity may be recognized where the victim is declared definitively unfit to pursue his professional activity or where his conditions of existence are seriously affected thereby.
Depending on the value of the gravity threshold, the KIC:
- prompts you to enter it for reconciliation, when the severity threshold is less than 24%
- or linked to the settlement procedure, where the gravity threshold is higher than 24%.
It applies if you are in one of the following situations:
- You're not satisfied with the care you received
- You disagree with a health care practitioner or facility
- You have been the victim of a serious damage lower at the severity threshold (24%).
The President of the ICC shall inform the persons concerned of the procedure and may request further information.
With your agreement, the ICC will:
- forward your request to the user relations committee of the establishment
- or delegate the task of conciliation to one of its members or to an independent mediator
- or study the facts herself.
Following this examination, the ICC shall draw up a document setting out the outcome of the conciliation. It shall be signed by the parties and a copy shall be given to each of them.
the members of the ICC shall be bound by professional secrecy.
For this procedure to apply, your prejudice must be superior at the severity threshold (24%).
The ICC is verifying that this is the case.
The threshold is exceeded if you are declared permanently unfit to practice your profession or if your living conditions are seriously affected.
More specifically, a medical accident, an iatrogenic disease or a nosocomial infection is of serious importance if it has led to a temporary cessation of professional activities during
- a duration of at least 6 consecutive months
- or 6 non-consecutive months in a 12-month period.
Once the file is complete, the ICC has a period of 6 months to give its opinion.
The ICC may obtain communication of any document, including medical documents, using means to ensure confidentiality vis-à-vis third parties. Its members shall be bound by professional secrecy.
Each party concerned shall receive copies of the requests for documents made by the ICC and of all documents communicated to it.
In the event of inadmissibility, you can submit a request for conciliation to the CCI.
If there is any doubt as to the admissibility of the file, the President shall appoint an expert. The parties shall be informed of its decision.
If the file is deemed admissible, the President shall appoint an expert or a panel of experts and fix a time limit for the submission of the expert report.
In the course of the expert opinion procedure, the expert may take the parties' comments into consideration and attach, at their request, any relevant documents in his report.
A copy of this report shall be transmitted to each Party at least 10 days before the date of the ICC meeting.
The parties shall be summoned before the ICC and may be assisted or represented by a person of their choice. They may be heard there at their request or at the request of the ICC.
At the end of the meeting, the ICC issues an opinion which is addressed to the parties. It shall be accompanied by the documents necessary to draw up an offer of compensation.
if you wish to challenge the medical expertise, you have the right to request a friendly counter-expertise or additional expertise. In court, with the assistance of your lawyer, you can demand a forensic expertise.
The ICC has 6 months from the receipt of the complete dossier to give its opinion.
According to the ICC's decision of liability, it is the insurance of the professional who compensates the victim or Oniam.
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Responsibility of the healthcare professional
If a liability is established by the ICC, the insurer of the healthcare professional must make a compensation proposal, within a period of 4 months upon receipt of the notice.
This offer is provisional (i.e. an advance on compensation) if the insurer has not been informed of the consolidation of the victim's condition.
Once informed of the consolidation, the insurer has 2 months to make a final compensation proposal.
The tender must indicate for each point on which the damage relates:
- Rating selected
- Provisional or definitive nature of the tender
- Amount of compensation to be paid to the victim or his dependants
If the insurer has not made an offer within 4 months (he refuses to make it or remains silent) or if the professional is not insured, the victim or his successors in title can contact theOniam: titleContent by registered letter with acknowledgement of receipt.
Oniam replaces the insurer to make an offer and compensate the claimant within the same time frame.
Lack of responsibility
If the harm is not related to any act involving the responsibility of a health professional, we are talking of therapeutic hazard.
The compensation of the victim is then paid by Oniam, only if the damage exceeds the threshold of gravity.
The procedure and the time limits for compensation are the same as for the insurer.
You agree to compensation
Acceptance of the offer by the victim eliminates the possibility of appealing to an administrative or civil court or receiving compensation from another body.
In case of aggravation of the damage or death related to a nosocomial disease, Oniam takes responsibility for the compensation of the victim or his beneficiaries.
The insurer of the trader has one month after receipt of acceptance of his offer to pay the amount.
If the time limit is exceeded, he must pay interest on the amounts to be paid corresponding to 2 times the statutory rate per day late.
You refuse it
If you contest the offer of the insurer or the absence of an offer from Oniam, you can bring the matter before the competent court depending on the nature of the fact that generated the damage.