Dec 11, 2017 09:08
6 yrs ago
7 viewers *
French term

Assureur gestionnaire

French to English Law/Patents Insurance
This is from a "letter of third party notice" from an accident victim's CPAM to what I suppose is the private insurance company covering the party at fault in the accident. It specifies that the company's member was involved.

"Cet accident a été pris en charge au titre du risque maladie (ou accident du travail).

Veuillez nous confirmer votre qualité d'assureur gestionnaire, par retour de courrier ou courriel. Je
vous prie de croire en l’assurance de ma considération distinguée. "

I have found the following definition of "assureur gestionnaire" but cannot come up with an equivalent term in English:

Avec le Paos, l’assureur gestionnaire est l’assureur tenu d’informer les OS et de procéder au règlement de leurs prestations, dans la limite de l’assiette de recours fixée par le protocole. Il est l’interlocuteur unique de l’organisme social et exerce ce rôle pour son compte ou celui des autres assureurs concernés.

Thanks for any ideas.

Proposed translations

1 hr

Servicing carrier

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10 hrs
French term (edited): (votre qualité d') assureur gestionnaire

that you are the (insurance) claims management company

Or "the company that handling claims for...".
As I note at the end of this post, you may think it reads more naturally in English if you use a verb rather than a noun to express the idea of "gestion". There are solutions with a noun though and this is what insruance cocmpanies of all types describe as "claims handling", "case management", or something similar. I worked as a "claims correspondent" in a shipping mutualin the City of London for a couple of years (known as 'protection and indemnity' or 'P & I clubs'). It is claims handling, case management. You might like to consider searching for your target reader with those terms. You do not specify which target country is concerned.


Unless I am mistaken your context is a workplace accident ("accident de travail"). Here's an example. In France, if an employee falls over and twists his/her ankle when at work, it is classified as an accident in the workplace. The employee does not have to cover any medical expenses at all arising from the incident. It is fully covered for by the employer. Employers have to have insurance that covers this liability towards their employees with regard to accident and injuries in the workplace. A little bit of knowledge about the French health system is neccessary.

What is an "accident de travail"? See:

https://www.service-public.fr/particuliers/vosdroits/F178

https://www.ameli.fr/assure/droits-demarches/maladie-acciden...


What is an "organisme gestionnaire"? See article 3 here:

http://www.mediam.ext.cnamts.fr/ameli/cons/CIRCC/CC8402/8402...

"Définition de l'organisme gestionnaire.
L'organisme gestionnaire est l'organisme chargé de la gestion individuelle du dossier des assurés."


For most employees in France, the "organisme assureur gestionnaire" will be the CNAM, or "Caisse nationale d'assurance maladie": https://www.ameli.fr/l-assurance-maladie/connaitre-l-assuran...

"
'Assurance Maladie.
La Caisse nationale de l'Assurance Maladie gère, au plan national, les branches maladie et accidents du travail - maladies professionnelles du régime général de Sécurité sociale."

Note the verb "gère".

Thereafter, the national "Caisse" delegates the day-to-day handling of files to a network of CPAM, or "Caisse primaire d'assurance maladie". Same soruce, next paragraph:

"Le réseau de l'Assurance Maladie.
La Caisse nationale de l'Assurance Maladie définit les orientations stratégiques et pilote le réseau des organismes chargés de les mettre en oeuvre."

There are 105 of them nationally: https://www.ameli.fr/l-assurance-maladie/connaitre-l-assuran...


As for how you might usefully express the term in your context, I’d naturally go with a verb rather than looks for a noun, which is often more natural in French than in English. Comparing these two documents may be helpful:

http://eur-lex.europa.eu/legal-content/FR/TXT/?uri=CELEX:620...
(75) Beaudout fait toutefois valoir que l’introduction d’un mécanisme autorisant des dispenses d’affiliation ne mettrait pas en péril l’équilibre financier de l’organisme gestionnaire du régime en cause au principal.

http://eur-lex.europa.eu/legal-content/EN/TXT/PDF/?uri=CELEX...
(75) Nevertheless, Beaudout argues that the introduction of a mechanism authorising exemptions from affiliation would not endanger the financial balance of the body which manages the scheme at issue in the main proceedings.

You might find that "claims handling company" "insruacne company handling claims", etc. works better though, which is a noun-based solution:

https://www.enterprise.co.nz/media/enterprise/client/HS Emai...

"An Important Message to All Enterprise Employees about Your
Workplace Accident Insurance Arrangements
The introduction of the ACC Partnership Programme (ACCPP) from 01/07/2000 created a new
environment for the management of workplace accidents and injuries. This important information will
enable you to understand some of the major changes that could affect you now that your employer has
elected to be part of the programme. Please read it carefully and ask if you do not understand any
aspect..
Enterprise Recruitment work place injury claims are handled by Wellnz, an independent third party
provider, who works in partnership with Enterprise. Wellnz is an established claims handling company
with more than ten year’s experience in this field. It handles a range of clients including Enterprises,
and claims’ handling is its core business. Wellnz is staffed by specialist Case Managers. There is one
Case Manager assigned to manage all of Enterprise’s work place accident claims. In the event of a
work place accident Enterprise’s Case Manager will facilitate your rehabilitation to assist you to return
to work and independence and organise for any financial entitlements to be calculated and paid to you
in a timely manner.





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Note added at 10 hrs (2017-12-11 19:28:48 GMT)
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Sorry for the wack typos!
Peer comment(s):

disagree ph-b (X) : Afraid I have to disagree: assureur gestionnaire is an insurer, not a management company, and your 'ref' to organisme gestionnaire refers to the way CPAM, etc. is organised (org. social), not to an assureur gestionnaire.
11 hrs
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21 hrs

managing insurer ("assureur gestionnaire")

The assureur gestionnaire is an insurance company under PAOS, not a management company.

It is short for assureur gestionnaire du dossier de la partie adverse/des parties adverses from CPAM's point of view. Of course, insurers are free to use management companies, and the vast majority of them do for various reasons, incl. managing loss files (gestion(naires) des sinistres although they can also have their own, in-house gestionnaires), but that’s irrelevant where CPAM/PAOS are concerned: under PAOS (protocole assureurs-organismes sociaux), CPAM needs to be able to talk to whoever insures the other party, i.e. the party that may be held legally responsible for the accident (e.g. the employer) and not a mere managing company.

That is primarily what gestionnaire means here: the other party that is responsible for/legally manages the file and that can take decisions, not an administrative entity that may not take legal decisions.

What may happen is that when several parties are involved, one insurer will be asked (mandaté) to deal with the management of the file by/on behalf of other insurers.

See for instance,

…les conventions inter-compagnies (…) peuvent s’analyser comme des contrats de mandat permanent par lesquels un assureur mandataire, dit assureur gestionnaire, s’engage à procéder pour le compte du ou des assureurs mandants au règlement de sinistres déterminés.

L’expérience acquise par les assureurs en la matière a incité le législateur à transposer ici les mandats de gestion entre sociétés d’assurances, puisque « en cas de pluralité de véhicules, s’il y a plusieurs assureurs, l’offre est faite par l’assureur mandaté par les autres » (C. ass., art. L. 211-9, al. 5). Au soutien de cette disposition, la convention « IRCA » gouverne la désignation de l’assureur gestionnaire pour le compte d’autrui…


http://grerca.univ-rennes1.fr/digitalAssets/312/312254_Rappo...

I don't know what country you're translating for but if I were to translate this into English, I'd stick to a literal but accurate translation covering what I've just explained and would add the French term in brackets for reference as this might well be something specific to France, i.e. 'managing insurer' (assureur gestionnaire).

I'm in no doubt that my explanation is correct (CL5!), but a native speaker specializing in insurance might come up with a better linguistic solution, hence only CL3.

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Note added at 21 hrs (2017-12-12 06:37:31 GMT)
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About assureur gestionnaire being an insurer, see your own reference:

Avec le Paos, l’assureur gestionnaire est l’assureur tenu d’informer les OS et de procéder au règlement de leurs prestations, dans la limite de l’assiette de recours fixée par le protocole. Il est l’interlocuteur unique de l’organisme social et exerce ce rôle pour son compte ou celui des autres assureurs concernés.
Peer comment(s):

agree AllegroTrans
18 hrs
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