The Insurance Disputes Law Review: France
New legal developments have not resulted in major changes this year. Most of the changes provide clarifications about well-established rules of insurance disputes in substantive and procedural terms that are helpful for practitioners. Nonetheless, the evolution of the insurance market and recent trends within insurance litigation raise many thorny issues that remain unresolved. At the moment, however, the most pressing issue is undoubtedly the insurance disputes that have arisen as a result of the covid-19 pandemic and the insurability of health crises.
The legal framework
i Sources of insurance law and regulation
France has a specific code dedicated to insurance law. This code provides very precise rules that derogate from the law usually applicable in contractual matters. For instance, the limitation period is two years for insurance claims, whereas it is five years for contractual claims. In addition to the specific law applicable to the insurance contracts, different regimes are set out according to the nature of the insurance policy (car insurance, life insurance, liability insurance, etc.). As a result, numerous solutions under French law are specific to a particular kind of insurance and cannot be generalised to all insurance policies.
The French Civil Code may also come into play in insurance disputes. It applies in all matters related to the insurance policy that are not governed by a specific provision under the Insurance Code. Other specific provisions may also come into play, such as the Consumer Code when the dispute is between a professional and a consumer.
Finally, European directives on insurance hold considerable sway over insurance law. As noted below, the European influence was again recently demonstrated as it resulted in rendering ineffective some provisions of the Insurance Code related to car insurance.
ii Insurable risk
Under French law, the subscriber does not have to show any interest to conclude an insurance policy. As a result, the subscriber can issue an insurance policy not only on his or her own behalf but also on behalf of a third-party beneficiary.
Under French law, insurability of the risk is determined with regard to the nature of the insurance contract. Insurance is considered as a 'contingent contract' under the French classification of contracts. It implies the risk must exist to be insurable. Thus, an event that already occurred cannot be covered. Moreover, if the event occurred as a result of the policyholder's intentional conduct, the insurer can reject the claim.
In addition, a risk cannot be underwritten by an insurer if it contradicts public policy. Notably, criminal offences are not insurable. Therefore, a company cannot ask its insurer to pay a fine for which the company is liable.
Finally, some risks are excluded by law, such as the risk of riots or civil war.
iii Fora and dispute resolution mechanisms
French law does not provide for a specific court to deal with insurance-related claims. Depending on the nature of the parties, the claim can be brought before the civil courts, the commercial courts and even the administrative courts when it involves public entities.
i Significant cases in procedural terms
Bringing an action in insurance litigation
The special limitation period must be mentioned in some insurance policies pursuant to Article R112-1 of the French Insurance Code.
In addition, in a recent decision, the Court of Cassation held that an insurer who fails to fulfil this obligation cannot rely on either the special limitation period or the general limitation period (five years). Also, the burden of proof regarding the communication of the limitation period lies with the insurer.
Practitioners must also be aware that certain actions arising from the insurance relationship are not subject to the two-year limitation period.
Conducting insurance litigation
Under French law, the insurer can conduct proceedings on behalf of the policyholder against a third party. By doing so, the insurer waives raising certain defences accruing from the insurance relationship in any concurrent or subsequent claims against the policyholder (except when specifically otherwise provided by the insurer). It is, however, well established under case law that the waived defences are only related to the 'guarantee' and do not concern the 'nature of the risk covered, nor the amount of compensation'.
This distinction can be very hard to make in practice and requires frequent clarifications from courts. For instance, in Perron company and others v. Allianz IARD, it was ruled that the clause that limited the guarantee to certain circumstances in which a risk occurred did not concern 'the nature of the risk covered'.
Settlements in insurance proceedings
In National Military Security Found and Benoit X v. Crédit Mutuel and Guillaume Y, the Court of Cassation held that the waiver of future claims contained in a settlement agreement prevents the victim from claiming further damages even if they were not covered by the settlement.
In this case, the victim suffered various losses then signed a settlement agreement with the insurer of the wrongdoer. Afterwards, the victim sued the wrongdoer and his insurer for further damages that were not covered by the settlement. Under French law, there are two contradictory theories to resolve this issue. First, the 'theory of the scope of settlements' states that the settler may claim for some losses that are not pointed out in the settlement. In contrast, the 'theory of abandonment' states that the settler waives all his or her rights to claim for damages related to the dispute regardless of the fact that the settlement does not deal with them. In the matter at hand, the Court decided that the abandonment theory should prevail because the settlement agreement stated that 'the victim declares himself to be satisfied of all of his rights'. However, this does not mean that the same rule will apply in every case. It mainly depends on the way the settlement agreement is drafted.
In CRAMA v. Mr X, it was found that the insurer cannot raise a settlement agreement concluded with the victim of the wrongdoing against the co-perpetrator of the damage.
In this case, the damage was caused by two wrongdoers. The insurer of the first wrongdoer concluded a settlement with the victim and compensated her. Then, the insurer of the first wrongdoer sought to reclaim half of the settlement sum from the second wrongdoer. However, the Court of Cassation found that the second wrongdoer was not bound by the settlement agreement concluded by the first wrongdoer. The fact that the second wrongdoer was aware of the settlement did not mean that it could be enforced against him.
ii Significant cases in substantive terms
Insurers usually require policyholders to issue a risk of statement before the conclusion of the insurance policy. In practice, it means the policyholder has to fill out an application form before entering the insurance policy. When the policyholder issued a false statement, it is usually raised by the insurer as a defence to deny the insurance claim.
However, the insurer can invoke a false statement made by the policyholder in the insurance form only if the questions asked by the insurer were sufficiently precise. The insurer has to prove it had asked clear questions to raise any defence based on the policyholder's false statement. Consequently, if the question is slightly unclear or stated in overly general terms, the insurer loses any defence based on the imprecise answer given. Accuracy is particularly important as an insurer cannot invoke an omission or a false statement from the policyholder if the questions asked within the application form did not involve the disclosure of the relevant information. In Mrs H and Mr V v. Macif, the insurer could not blame the policyholder for not disclosing that her son was a secondary or occasional driver of the insured vehicle because the insurer had not asked questions about secondary or occasional drivers.
Defences of the insurer against the policyholder
Legal exclusion of intentional breaches
A risk brought about by an intentional breach by the policyholder is not insurable. On this basis, the Court of Cassation recently denied the insurability of a barn destroyed as a result of the owner's failure to repair it. The Court held that the owner could not be unaware of the risk of collapse. Thus, by making the risk certain, the insuree had committed a wilful misconduct, thereby excluding the insurer's liability.
Moreover, in Axa France IARD v. Generali IARD it has been reaffirmed that damage resulting from intentional fault is excluded from the insurance coverage only for its part sought by the policyholder. In this case, the policyholder's son had committed arson by setting fire to furniture outside an establishment, but the fire had spread to the inside of the establishment as well. The Court of Cassation ruled that the policyholder's son's arson sentence did not imply that he sought for the damage to occur as it did.
In Family'Immo v. Lloyd's, the Court of Cassation ruled that the serious negligence of the policyholder who knowingly put its clients at risk did not amount to the intentional breach required to exclude the risk's coverage by the insurer.
In this case, an estate agency, Family'Immo, knew that the property bought by its clients had several construction defects but made the sale anyway. Family'Immo was found liable for contractual breach and asked its insurer, Lloyd's, to compensate its client. The Court ruled that even if the negligence of Family'Immo was unacceptable for a professional since it acted in bad faith, it did not amount to an intentional breach within the meaning of the Insurance Code.
Contractual exclusion: recent application
In addition to the legal exclusions, insurers can exclude some risks from the insurance policy. Pursuant to Article L113-1 of the Insurance Code, those contractual exclusions have to be 'formal and limited'. A significant part of the insurance litigation in France is related to this issue.
In construction insurance, the activity declared to the insurer excludes risks from other undisclosed activities. In the important case M C v. Mutuelle du Mans IARD the insured builder had contracted an insurance policy hedging the risk concerning only its structure work. The builder, Euroconstruction, entered into a contract for the entire construction of a single-family house. The Court of Cassation ruled that the damage caused on this site was not covered by the insurance as the activity of building a single-family house was not expressly included in the contract.
Upon the occurrence of the damage, the insured must put in a claim accurately and faithfully. The insurer may exclude coverage because of a false statement of claim. To benefit from this exclusion, it was held that it must be provided for in the insurance policy by the insurance company, which must demonstrate the insured's bad faith.
Conditions of guarantee: the hard hurdle of policyholders
To limit the coverage, an insurer may also protect itself by setting out conditions precedent in the insurance policy. Usually, the policy imposes certain duties on the policyholder, especially the obligation to take preventive measures. If the policyholder does not comply, the risk is not covered. Contrary to exclusions of guarantee that are easier to defeat, recent insurance litigation has shown that the conditions are very difficult to override, as illustrated in La Riviera v. Alpha Insurance.
In this case, a nightclub owned and operated by La Riviera was ravaged by a fire. It appeared that La Riviera, which had entered into a property and casualty insurance contract with Alpha Insurance, did not comply with precautionary measures listed in the contract. La Riviera raised plenty of defences to override the conditions precedent of the insurance policy. All of them failed.
First, La Riviera argued that the conditions were so numerous that they contradicted each other. According to La Riviera, the guarantee was therefore illusory. This head of claim referred to Chronopost, in which the Court of Cassation decided that a contractor cannot limit his or her essential obligation to the point that the obligation is no longer effective. Nevertheless, the Court rejected the claim by stating merely that the guarantee was not illusory.
La Riviera also questioned the appropriateness of the conditions. According to La Riviera, the breached preventive measures would not have enabled it to avoid the fire even if they had been taken. The Court rejected the argument, standing by a strict application of the clause.
Finally, La Riviera discussed the nature of the conditions. It argued that the condition precedent in fact amounted to an indirect exclusion of guarantee that was to be treated under the aforesaid Article L113-1 of the Insurance Code. The claim was rejected on procedural grounds. Meanwhile, the substantive issue of qualification is left unresolved. As observed by some authors, it could be a valuable defence in future cases.
Defences of the insurer against a third party: major change for car insurance
This may be the most discussed topic recently. In Fidelidade-Companhia de Seguros Ltd, the Court of Justice of the European Union (ECJ) stated that European Directive 72/166/CEE, which deals with car insurance, prohibited domestic law from providing that certain defences, such as the invalidity of the car insurance policy, can be raised by the insurer against the victim of a car accident.
The recent Growth and Development Act brought French law into conformity with European law. The newly adopted Article L211-7-1 of the French Insurance Code provides that the invalidity of a car insurance policy cannot be raised against the victims.
Scope of the insurance policy: the PIP case
Another ongoing legal saga, the Poly Implant Prostheses (PIP) breast prostheses scandal, has lasted over nine years in France. In 2010, PIP placed breast prostheses on the market that were produced without regard to certain public health regulations. The hazardous prostheses were implanted in thousands of patients, leading to disputes in several countries. In Electromedics Ltd and others v. Allianz IARD, the Court of Cassation made a ruling in an action brought by the foreign distributors of the defective prostheses against the insurer of PIP.
In the case at hand, distributors from Brazil, Italy and Bulgaria asked for compensation from Allianz IARD on the basis of a liability insurance policy that Allianz had entered into with PIP. The distributors raised multiple losses that were covered under the policy (e.g., losses of turnover, stocks, margins and provision made for the compensation of customers). However, the insurance policy defined its territorial scope as limited to the 'harmful events' that occurred in France. Thus, the issue was whether the damage had occurred in France. According to the foreign distributors, the harmful event occurred during the manufacturing of the prostheses by PIP (i.e., the harmful event would allegedly have occurred in PIP factories in France). The Court of Cassation rejected the argument and held that the harmful event was the breaking of the prostheses, which occurred outside France. Thus, the losses suffered did not fall within the material coverage of the insurance policy.
The ECJ recently stated that Article 18 of the Treaty on the Functioning of the European Union providing for the prohibition of discrimination on grounds of nationality was not applicable to the insurance policy clause limiting the territorial scope of the coverage to one Member State.
Remedies: the situation of the insurer during natural disasters
Natural disasters have become a growing cause for concern in the insurance sector, especially because case law tends to deprive insurance companies of any recourse against third parties that could have contributed to the damage on the grounds of force majeure. This trend was recently illustrated in Swisslife Insurance v. SNCF and the State.
In 2003, major abnormal rainfalls occurred in the south east of France. This resulted in floods that particularly hit the town of Arles. Swisslife Insurance compensated a large number of inhabitants who suffered damage to their properties. The final bill amounted to more than €5 million, yet the town was surrounded by flood barriers connected to the railway line used by SNCF, the French national rail operator. These protections having been ineffective, Swisslife Insurance exercised recourse against SNCF and the French state. However, the Council of State, which heard the claim, found no breaches by the defendants. The Court pointed out that the floods were provoked by one of strongest rainfalls on record. The Court concluded that the state and SNCF could not be held liable since their alleged breaches would be excused on the grounds of force majeure.
The international arena
i International jurisdiction: the measures of inquiry in futurum
In Ergo Versicherung AG v. EPMD, it was ruled that French courts could order measures of inquiry in futurum in France within an insurance dispute even if foreign courts had substantive jurisdiction to handle the case.
French law refers to European standards provided under Regulation Brussels I bis to establish international jurisdiction of French courts. Article 35 of Regulation Brussels I bis provides that a party may apply for 'protective measures as may be available under the law of that Member State, even if the courts of another Member State have jurisdiction as to the substance of the matter'.
In this case, the policyholder applied for measures of inquiry in futurum. Under French law, measures of inquiry in futurum can be granted by the president of the court to allow a party to collect evidence before any legal proceedings. Therefore, the issue was whether those measures of inquiry in futurum are protective measures within the meaning of Regulation Brussels I bis. The Court of Cassation found measures of inquiry in futurum consisted in protective measures and fell within the scope of Article 35 of Regulation Brussels I bis.
ii Applicable law: recent developments within transport insurance
The Court of Cassation recently had to interpret an exclusion clause raised by an insurer against a transporter under an insurance policy that covered the international carriage of goods in AIG Europe the Netherlands v. Miedzynarowy Transport Drogowy.
The dispute was about an exclusion of guarantee provided by a transport insurance policy. In this case, two conflicting sets of rules were potentially applicable: the UN Convention on the Contract for the International Carriage of Goods by Road (CMR) and the conflict rules applicable for insurance matters. The Court stated that the CMR is a special convention applicable to transport that could not govern the law applicable to the insurance contract but only determine the insurable risk. Thus, the Court applied the rules of conflict applicable to insurance matters.
Trends and outlook
i Prospective outcomes of recent legal developments
French law has recently developed to allow class actions in limited circumstances. Consumer class action may only be brought by an association of consumers. The action must also be related to sales contracts or provision of services contracts concluded by consumers placed under the same or similar situations.
The case National Confederation of Housing v. 3F Real estate company does not concern an insurance dispute but may have an impact on class actions that could be brought against an insurer.
In this case, the Court of Appeal of Paris declared inadmissible the action of an association of consumers seeking remedies for a breach committed by a professional lessor under several similar rent contracts. According to the ruling, the rent contracts were not 'provision of services' contracts within the meaning of the Consumer Code. We can imagine that this reasoning could be transposed to class actions against an insurer, which could be declared inadmissible since those actions are found in the Insurance Code and not the Consumer Code.
Insurers may also intervene in class actions as the guarantor of the victims or the wrongdoer. The Healthcare System Modernisation Act extended class actions to damages arising from healthcare products, which is a growing concern for insurers.
On 22 June 2020, the EU institutions reached an agreement on a draft directive on representative actions to empower representative entities in all Member States to obtain collective redress on behalf of groups of EU consumers in respect of infringements of EU law.
Information due to the policyholder
The Insurance Distribution Act has significantly developed the insurer's duty of information. The text provides some vague standards. For instance, it requires that 'distributors of insurance products act in an honest, impartial and professional way'. The insurer is also required to provide 'objective information about the offered insurance product in an understandable form'. Ever growing litigation may arise from this text, which offers great leverage to policyholders to obtain remedies for breach of pre-contractual information.
ii Evolving sectors of insurance litigation
The ECJ clarified its directive concerning the requirement for Member States to ensure that drivers are insured. In Fundo de Garantia Automovel v. Alina Antonia Destapado the ECJ ruled that a vehicle whose owner has stopped driving must still be insured until the vehicle is officially decommissioned. The immobilised car must be insured, albeit kept in a private location without any intention of it being used again. The ECJ has also confirmed that the obligation to provide liability insurance to all running vehicles includes damages arising from any vehicle component, irrespective of whether the component is used in the movement of the vehicle or not.
In France, damages arising from terrorism are submitted to two different regimes with regard to the nature of the damage. Corporal damages are covered by the Compensation Fund for Terrorist Acts (CFTA), which is financed by a contribution on insurance premiums. Material damages are left to the insurance sector. Certain insurance policies must mandatorily cover material damages arising from terrorism. Thus, insurance disputes related to terrorism mainly concern material damages. However, indemnification disputes with the CFTA in relation to corporal damages tend to develop in France as recently illustrated by Mrs Y v. CFTA, in which the CFTA successfully challenged the status of victim of the claimant and denied indemnification.
According to Europol, ransomware is now the predominant threat in relation to cybercriminality. This consists of hacking into an IT system, disabling it and then demanding a ransom to restore the system to its normal state. To tackle this and other cyberattack-related issues, insurers have issued customised insurance policies covering this kind of risk. However, the high complexity of cyberattacks makes it difficult to know what kinds of risk fall under the insurance coverage. This may lead to some highly technical debates about the scope of coverage in the future. Moreover, the insurability of the cyberattack risk is also under discussion. Notably, it remains unclear whether the ransom paid to restore a system is insurable.
The same goes for political risk. Mirroring global trends, employees of French multinational companies face an increasing risk of kidnapping around the world. Specific insurance policies cover all the losses incurred by the company in the event of an attack against its employees on foreign territory: care of the victims, medical care, loss of profits, ransom paid and even the fees of a professional negotiator. The same issues may arise as those discussed above in relation to cyberattack risks regarding the validity of these guarantees: the insurability of the risk and the scope of the coverage.
iii Insurance coverage amid Covid-19
In reaction to the covid-19 pandemic, the French government imposed a national lockdown in mid March. Many business were forced to close to the public and as a result have incurred significant operating losses, which many hope to recover under their insurance policy.
Some affected businesses have already brought cases before the French commercial courts, claiming provisional payments on operating losses. In those cases, insurers argued that coverage was to be denied because the lockdown was out of the scope of the insurance contract, which provided coverage for operating losses for the period when the business were closed as a result of a local authority's administrative decision.
However, the Paris Commercial Court, for example, found that there was no serious dispute as to the terms of an insurance contract providing such coverage and thus awarded a provisional payment to the claimant.
Moreover, the government is currently working on a risk insurance scheme to cover operating losses in the event of a catastrophe, including health crises, and is likely to take legislative measures to that effect before the end of the year.