In parallel with an independent subscription to provident death insurance, Social Security, through Health insurance, can allow the payment of a death benefit. Who can only ask if the deceased was contributing to the Social Security Health Insurance? The award conditions are relatively strict and must be known to be able to claim payment. What is the amount of the death benefit of the CPAM? How do I get it? Answers and advice!
Does Social Security provide a death benefit?
It is necessary to understand the different terms of organizations related to health insurance in France to understand how death insurance in question works:
- Social Security: a compulsory body created in 1945 intended to guarantee employees' protection in the public and private sectors. Each member contributes according to his income and receives compensation according to his needs.
- Health insurance: it represents one of the five branches of Social Security, the other four being: Work accidents and occupational diseases (AT / MP); Family: handicap and accommodation included; Retirement: old age and widowhood in particular; Contributions and collection: this is the branch responsible for collecting contributions and redistributing them to the four other branches mentioned above.
Therefore, health insurance is affiliated with the general social security scheme and notably covers maternity, pathologies, invalidity, and death. Therefore, Health Insurance manages the payment of the death benefit of Social Security through various funds.
Membership in one of the two compulsory social security schemes is done either through the general scheme or through the agricultural scheme. Other additional special regimes exist, such as funds for military personnel (CNMSS) or railway employees (CPRSNCF).
How does Social Security death benefit work?
Affiliation to the general social security scheme gives the possibility of claiming sickness insurance benefits, including a death benefit for any person who contributes typically. The amount in question will be paid to a beneficiary, usually a relative, with an order of transmission, in the manner of inheritance tax.
As a public interest body pays the death benefit, it can be considered a social benefit relating to health insurance. Social Security operates like any mutual, according to a principle of solidarity (here national), materialized by collective contributions from beneficiaries, which can subsequently claim compensation.
In this sense, the French State should provide for the needs of people, who must in exchange comply with the duty to contribute to mutualize the health risks that may affect any citizen.
What are the conditions for granting the death benefit by Social Security?
The Social Security death benefit can only be paid to the beneficiaries of the deceased if one of the following conditions is met:
- he was employed in the past three months;
- he received an indemnity from Pôle Emploi for the three months preceding his death or had received one during the last 12 months;
- he received an invalidity pension;
- At least 66.66% (2/3) received an annuity regarding a work accident or occupational disease (AT / MP).
How much does Social Security pay for death insurance?
The death benefit paid by Social Security is now calculated based on the law of 22 December 2014 on financing for Social Security. This text provides that for all deaths occurring after 1 st January 2015, the death benefit provided to the deceased's beneficiaries is equal to a fixed amount determined by decree and upgraded each year. On 1 st April 2020, the amount paid under the insurance death by Social Security equals € 3472.
Regarding the PAMC (Conventional Practitioner and Medical Auxiliary), they can claim the death benefit from Social Security. However, the amount is calculated based on the income used to calculate the health insurance contributions. The maximum amount is equal to one-quarter of the annual ceiling for Social Security (10 284 € on the 1 st January 2021) and the minimum amount to 1% of the same annual ceiling (€ 411.36 at the same date).
Who is the Social Security death benefit paid to?
The social security death benefit constitutes an inalienable right conferred by the French State as a counterpart for contributions to the organization's health branch. Consequently, and unlike an individual death insurance contract, the beneficiaries are not identified by name but are determined precisely by law in a well-defined order.
It is, therefore, necessary to distinguish between priority beneficiaries and non-priority beneficiaries in the order of recovery of the death benefit from Social Security. A priority beneficiary is a person who is effectively, totally, and permanently dependent on the insured at the time of his or her death (who, for example, does not exercise any professional activity at that precise moment).
If several priority beneficiaries of the same rank exist - children in particular - the death benefit is shared equally between the persons concerned.
If you are identifiable as a priority beneficiary but do not correspond to any of the above categories, you can still claim the death benefit. The following are particularly concerned:
- collateral (brother, sister, brother-in-law, sister-in-law, nephew, niece, and any other person without direct family relationship);
- cohabiting partners;
- cohabitants (roommates for example);
- Children over 20 years old.
Priority beneficiaries have a period of one month following the insured's death to make themselves known and claim the death benefit. Beyond that, they lose their status and their right of priority and find themselves at the same level as non-priority beneficiaries.
Non-priority beneficiaries can claim the payment of the insured's death benefit but who did not have the practical, total, and permanent charge. They can claim the amount in question after one month if no priority beneficiary has claimed it.
Similarly, as for priority beneficiaries, the death benefit is shared equally between the different people concerned if several non-priority beneficiaries exist (descendants or ascendants).
How to increase the amount of the death benefit?
On 1 st April 2020, the amount of the death benefit provided by Social Security is equal to € 3,472, a relatively small sum. This is a total that can potentially finance the funeral of the deceased in the absence of funeral insurance but will not allow subsequent use.
Anyone can take out individual death insurance, depending on their age, income, and the desired guaranteed capital, allowing beneficiaries to recover a much more considerable amount, between tens and hundreds of thousands of euros.
Proceeding in this way will allow you to further protect your loved ones against the loss of the primary income caused by your premature and sudden death. The death benefit of the CPAM may not be sufficient, and an additional annuity on a higher capital can be an exciting solution.
To optimize your research, you can use our death insurance comparator, a tool available free of charge. By establishing an appropriate simulation and comparison, you will be able to easily and very quickly find the best death insurance contract and thus offer your loved ones a substantial death benefit.
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