Compulsory medical liability insurance (France, Kouchner law)
A liability insurance obligation imposed in 2002 on self-employed health professionals and facilities, in a regime distinguishing fault, paid by the insurer, from therapeutic hazard, paid by national solidarity.
The law of 4 March 2002 on patients' rights and the quality of the health system, known as the Kouchner law, overhauled compensation for medical accidents in France. It sets a principle: the health professional or facility is liable for harmful consequences of its acts where there is fault. It therefore requires self-employed professionals and facilities to buy liability insurance, subject to penalties. Where the harm results from a therapeutic hazard, without fault, and reaches a severity threshold, the victim is compensated under national solidarity by a public body. Regional commissions offer a free amicable route. The regime triggered an insurability crisis in the early 2000s for some high-risk specialties, obstetrics, surgery, anesthesia: insurers withdrew, premiums soared, and the Central Pricing Bureau was approached by practitioners without an insurer. The authorities responded by setting minimum cover limits, helping high-risk specialties pay premiums, and creating in 2012 a fund covering the share of awards exceeding self-employed practitioners' insurance limits. The scheme illustrates the French combination of compulsory insurance, public solidarity and price intervention to make a very long-tail risk insurable.
A newborn suffers severe after-effects following an error during delivery at a private clinic. The self-employed obstetrician's fault is established, with an award of 9 million euros. The obstetrician's insurer pays up to the policy limit, and the fund created in 2012 covers the excess.
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