{"id":2824,"date":"2009-03-31T13:08:41","date_gmt":"2009-03-31T11:08:41","guid":{"rendered":"https:\/\/www.toutsurmesfinances.com\/assurance\/les-garanties-et-les-remboursements-en-cas-d-accident-corporel.html"},"modified":"2025-09-08T13:02:25","modified_gmt":"2025-09-08T11:02:25","slug":"les-garanties-et-les-remboursements-en-cas-d-accident-corporel","status":"publish","type":"post","link":"https:\/\/www.toutsurmesfinances.com\/assurance\/les-garanties-et-les-remboursements-en-cas-d-accident-corporel.html","title":{"rendered":"Les garanties et les remboursements en cas d’accident corporel"},"content":{"rendered":"

Il s’agit des \u00e9v\u00e9nements suivants :<\/p>\n

\u2022 les accidents de la vie courante
\n\u2022 les accidents survenus au cours de la pratique, en qualit\u00e9 d’amateur, d’une activit\u00e9 sportive,
\n\u2022 les accidents du travail ou de service
\n\u2022 les accidents de la vie scolaire de votre enfant<\/p>\n

Selon les contrats, les garanties peuvent \u00eatre limit\u00e9es \u00e0 une seule ou quelques unes de ces cat\u00e9gories d’accidents.<\/p>\n

Ces garanties permettent de couvrir les cons\u00e9quences des accidents en question quelle que soit leur gravit\u00e9 :<\/p>\n

<\/span>Les frais de soins<\/strong><\/span><\/h2>\n

Les frais de soins et m\u00e9dicaux cons\u00e9cutifs \u00e0 un accident (consultations, hospitalisation, mais aussi ambulance et r\u00e9\u00e9ducation) sont pris en charge par votre assureur en compl\u00e9ment de la S\u00e9cu, dans les limites stipul\u00e9es par le contrat.<\/p>\n

<\/span>L’incapacit\u00e9 temporaire<\/strong><\/span><\/h2>\n

Quand l’accident dont vous avez \u00e9t\u00e9 victime vous oblige \u00e0 interrompre votre travail pour une dur\u00e9e temporaire, votre assureur vous verse une indemnit\u00e9 journali\u00e8re forfaitaire pr\u00e9vue dans le contrat. Elle est g\u00e9n\u00e9ralement payable d\u00e8s le premier jour de l’accident, mais un d\u00e9lai de carence est parfois pr\u00e9vu dans certains contrats. Dans la plupart des cas, le contrat pr\u00e9voit une dur\u00e9e maximale d’indemnisation fix\u00e9e \u00e0 6 mois, 1 an, voire 3 ans, selon les contrats.<\/p>\n

<\/span>L’invalidit\u00e9\/l’incapacit\u00e9 permanente<\/strong><\/span><\/h2>\n

Cette garantie pr\u00e9voit, selon les dispositions du contrat, le versement d’un capital ou d’une rente en cas d’invalidit\u00e9 permanente, totale (IPT) ou partielle (IPP), caus\u00e9e par un accident.<\/p>\n

Le taux d’invalidit\u00e9 est fix\u00e9 par le m\u00e9decin expert d\u00e9sign\u00e9 par la soci\u00e9t\u00e9 d’assurances, selon un bar\u00e8me de r\u00e9f\u00e9rence qui varie en fonction des contrats. En effet chaque contrat d\u00e9termine \u00e0 partir de quel taux d’incapacit\u00e9 permanente partielle l’assur\u00e9 per\u00e7oit une indemnisation. Le taux d’incapacit\u00e9 est fix\u00e9 par un m\u00e9decin sp\u00e9cialiste en indemnisation des dommages corporels. Ce taux est d\u00e9termin\u00e9 \u00e0 partir du bar\u00e8me indicatif d’\u00e9valuation du taux d’incapacit\u00e9 en droit commun :<\/p>\n

<\/span>La garantie d\u00e9c\u00e8s<\/strong><\/span><\/h2>\n

En cas de d\u00e9c\u00e8s de l’assur\u00e9 li\u00e9 \u00e0 un accident, l’assureur verse la prestation pr\u00e9vue, sous forme de capital ou de rente au(x) b\u00e9n\u00e9ficiaire(s) d\u00e9sign\u00e9(s) ou, \u00e0 d\u00e9faut, \u00e0 ses ayants droit.<\/p>\n

<\/span>Prestations forfaitaires ou indemnitaires ?<\/strong><\/span><\/h2>\n

La F\u00e9d\u00e9ration Fran\u00e7aise des Soci\u00e9t\u00e9s d’Assurance (FFSA) distingue deux types de prestations qui sont pay\u00e9es par les assureurs en fonction de leur caract\u00e8re forfaitaire ou indemnitaire.<\/p>\n

Les prestations \u00e0 caract\u00e8re forfaitaire<\/span> \u00ab sont fix\u00e9es \u00e0 l’avance dans le contrat en fonction d’\u00e9l\u00e9ments pr\u00e9d\u00e9termin\u00e9s (bar\u00e8mes conventionnels, garanties en capitaux…) par l’assureur et l’assur\u00e9, ind\u00e9pendamment du pr\u00e9judice subi \u00bb, explique la FFSA. Les cons\u00e9quences directes de ce principe forfaitaire sont de deux ordres : 1) L’absence de recours de l’assureur contre l’\u00e9ventuel tiers responsable de l’accident : 2) pour l’assur\u00e9, le cumul possible de ces prestations avec celles dont il peut b\u00e9n\u00e9ficier par ailleurs. Les prestations forfaitaires les plus courantes vers\u00e9es par les assureurs concernent les garanties d\u00e9c\u00e8s, incapacit\u00e9 temporaire et invalidit\u00e9. Elles peuvent se cumuler avec les prestations vers\u00e9es par les r\u00e9gimes obligatoires.<\/p>\n

Les prestations \u00e0 caract\u00e8re indemnitaire<\/span> sont \u00e9valu\u00e9es en fonction du pr\u00e9judice effectivement subi et visent \u00e0 replacer l’assur\u00e9 dans la situation qui aurait \u00e9t\u00e9 la sienne si l’accident n’avait pas eu lieu.<\/p>\n

L’indemnisation vers\u00e9e dans ce cadre rend ainsi en compte les pr\u00e9judices \u00e9conomiques, physiologiques et personnels de la victime et des ayants droit, ce qui n’exclut pas la possibilit\u00e9 pour l’assureur d’inclure des clauses de limitation (plafonds de garantie, franchises…).<\/p>\n

<\/span>S’il n’y a pas de tiers responsable ?<\/strong><\/span><\/h2>\n

Aucun recours n’est possible. Mais dans le cas contraire et \u00e0 la diff\u00e9rence des prestations \u00e0 caract\u00e8re forfaitaire, l’assureur peut, apr\u00e8s d\u00e9dommagement de l’assur\u00e9, exercer un recours contre l’\u00e9ventuel tiers responsable de l’accident pour obtenir le remboursement des indemnit\u00e9s pr\u00e9vues dans le contrat. Ces formules peuvent donc \u00eatre assimil\u00e9es \u00e0 des contrats d’avances sur recours. Dans le jargon des assureurs, cela s’appelle le \u00ab recours subrogatoire \u00bb.<\/p>\n","protected":false},"excerpt":{"rendered":"

L’assurance contre les accidents couvrent, en fonction des contrats, des accidents survenus dans la vie priv\u00e9e ou de la vie professionnelle.<\/p>\n","protected":false},"author":13718,"featured_media":22463,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[5],"tags":[],"class_list":["post-2824","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-autres-assurances"],"acf":[],"yoast_head":"\nAccident corporel : remboursements soins, indemnit\u00e9s et capitaux d\u00e9c\u00e8s<\/title>\n<meta name=\"description\" content=\"Garanties en cas d\u2019accident corporel : prise en charge des soins, incapacit\u00e9 temporaire, invalidit\u00e9, indemnit\u00e9s d\u00e9c\u00e8s selon votre contrat...\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" 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