ONIAM (French national office for medical accident compensation)

ONIAM is the French public administrative body, overseen by the health ministry, that pays what liability law does not. The Kouchner law of March 4, 2002, created it for therapeutic hazard: a no-fault medical accident, abnormal given the patient's condition, above a severity threshold (permanent impairment above 24%, or criteria on time off work and serious disruption). The About law of December 30, 2002, handed it hospital-acquired infections above 25% permanent impairment, and deaths. Lawmakers later added mandatory vaccinations, transfusion contaminations, benfluorex in 2011, sodium valproate in 2017 and emergency public health measures. The victim files with a regional conciliation and compensation commission (CCI), which issues an opinion; the office or the insurer then makes the offer. For 2023, ONIAM reported 188 million euros paid out, and an average award of roughly 140,000 euros per medical accident file. For a medical malpractice underwriter, the sore point is Article L. 1142-15 of the Public Health Code. If the insurer makes no offer, or a plainly inadequate one, the office pays in its place, then recovers from the insurer by subrogation, with a penalty of up to 15% of the award. The fund therefore also works as a prod against slow carriers. Not to be confused with FAPDS, which picks up losses above the limits carried by private practitioners.