Insurance in Monaco

Monaco has no single national insurer. Statutory social insurance and private insurance operate alongside each other under Monegasque rules coordinated with France through the 1963 Monaco-France agreement. French insurance rules can apply on points that Monegasque rules do not regulate. The Government of Monaco, the Minister of State, the Ministry responsible for Finance and the Economy, and the competent supervisory services control and authorize insurance companies. Only a société, compagnie or courtier authorized in Monaco, or an expressly authorized foreign insurer, should be used for private cover. Monaco is not part of the European Union, so an authorization or policy from another country does not automatically establish permission to operate in Monaco. Employees are generally covered through the Caisses Sociales de Monaco. The Caisse de Compensation des Services Sociaux, known as the CCSS, covers sickness, maternity, invalidity and death benefits. The Caisse Autonome des Retraites, or CAR, provides old-age insurance for employees and certain non-tenured public agents through a pay-as-you-go points system financed by employers and employees. Since Loi 2023, the Caisse Monégasque de Retraite Complémentaire, or CMRC, has provided mandatory supplementary retirement insurance for private-sector employees through points and joint employer and employee contributions. Unemployment insurance is also included as a social insurance branch in payroll, with a total contribution of 6.40%. CCSS contributions are calculated on reported gross pay within the applicable ceiling. Self-employed people carrying out an authorized artisanal, industrial, commercial or liberal activity generally join the Caisse Autonome des Médecins, Travailleurs Indépendants, known as CAMTI, for sickness, accident and maternity cover and the Caisse Autonome de Retraite des Travailleurs Indépendants, known as CARTI, for retirement cover. CAMTI contributions are a fixed amount for each calendar month and are paid quarterly in advance. CARTI contributions correspond to one to four points per month and are paid quarterly in arrears. Registration normally takes place within one month after the activity starts and requires the NIS record, family information and bank details. The end of the activity must normally be reported within one month. The final month is charged in full rather than prorated. Some benefits may continue for three months, but voluntary continuation after the activity ends is not available. Access to social insurance benefits depends on the employment, residence and cross-border situation. In many cases, healthcare in kind is provided by the fund connected with the place of residence, while cash benefits depend on the territory of employment. Specific rules apply to people living in France or Italy, including certain Monaco-Italian and Monaco-French situations. A person beginning work in Monaco without other cover may receive healthcare in kind through CCSS social assistance for up to three months, subject to the applicable conditions. Dependants may be covered without an independent entitlement when they live in Monaco or France, and special rules can apply to certain Italian residents. Statutory healthcare normally reimburses 80% of the recognized reimbursement basis, leaving a 20% ticket modérateur, meaning the patient share. A 100% reimbursement can apply when an exemption is granted. Certain treatments require prior authorization. A non-contracted doctor may set fees freely, so the amount above the recognized basis can remain payable. Private assurance complémentaire can cover some remaining or additional costs, but it does not replace the statutory social insurance fund. The Commission Médicale Supérieure, or CMS, offers a subsidiary medical arrangement for a Monégasque or a foreign resident who has lived regularly and stably in Monaco for at least five years, has no Monegasque or foreign social insurance, receives no state medical assistance and has been refused by at least three private insurers within one year. CMS cover is based on the Office de protection sociale, limits the patient share to 20% of the reimbursement basis, requires a monthly contribution and is granted for a maximum of one year at a time. A change of status must be reported within 30 days. Private personal insurance in Monaco can cover health, accidents, life, disability, death, maternity and borrower risks. Employers must obtain work-accident insurance from a private insurer. An employer must report a work accident to the Direction de la Sûreté Publique and to the work-accident insurer. The insurer handles medical costs and compensation for the resulting loss of work. Private policies may also cover liability, housing, vehicles and loans. A policy should identify the policyholder, the insured interest, covered risks, exclusions, duration, territory, insured amount, premium, conditions, deductible and cancellation rules. Premiums depend on the market and the risk; Monaco does not set one uniform state premium for private products. Certain liability policies are compulsory. An owner-occupier or non-occupying owner of a dwelling must hold civil-liability insurance with a company authorized in Monaco. A syndicat de copropriétaires, the owners' association for a condominium, must hold civil-liability insurance and insurance against substantial damage. The reviewed Monaco rules do not establish a general compulsory home-building or household-contents policy beyond these specific obligations. Motor vehicles used on public traffic require at least the legally prescribed third-party liability cover. Comprehensive cover remains optional unless a contract or another specific requirement provides otherwise. The applicable minimum cover, exclusions, proof requirements and sanctions follow the current versions of Ordonnance-loi 666 and Ordonnance 2.617. Insurance contracts can attract Monaco's special tax on insurance agreements under Loi 609. The indicative rates are about 4% for general risks and navigation, 25% for fire, 7% for risks exclusively connected with permanent industrial, commercial or artisanal activity, and 7% for fire business-interruption cover and other categories including land transport. Life and annuity insurance is tax-exempt. Certain voluntary or collective health insurance arrangements can also be exempt when statutory conditions are met, and a risk located outside Monaco can be exempt. These insurance taxes are separate from social insurance contributions and from the private premium itself. A claim against CCSS or CAMTI normally requires a feuille de soins or other supporting documents and can be followed through the Espace personnel. An accident caused by a third party should be reported to the fund in writing within 15 days, with complete information and evidence. The fund can then pursue the responsible party or insurer through a recours contre tiers. A work accident must be reported directly to the employer and the work-accident insurer. A private claim should be notified to the insurer without delay in accordance with the policy, while the policyholder preserves evidence, observes deadlines and takes reasonable steps to limit further damage. The reviewed Monaco sources do not establish a general insurance ombudsman. The Commission du droit à l'oubli et de la médiation provides a specific mediation channel for regulated borrower insurance matters. Loi 1.561/2024 regulates certain borrower-insurance situations involving an increased health risk. For the same medical condition, an insurer cannot simultaneously impose a surcharge and exclude that condition when the statutory conditions apply. A right to be forgotten and a reference table can remove the need for some health disclosures or examinations. The statutory thresholds include a consumer loan of at least EUR 17,000 with a maximum term of four years and a borrower aged under 50, a property or professional loan of at least EUR 200,000 with a borrower aged under 60, and qualifying property insurance for a loan of at least EUR 420,000 with a final age of 71 or less. Individual complaints and mediation are handled through the Commission du droit à l'oubli et de la médiation. Changing or ending private insurance depends on the policy, applicable insurance law and contractual notice periods. A change in the insured risk should be reported, and false or withheld information can affect cover or the contract. A change of employment, self-employed status, residence or another social-insurance regime can change the responsible fund and the available benefits. Social-insurance termination for self-employed activity must normally be reported within one month, and any temporary continuation of benefits does not mean that the former scheme continues indefinitely. The policyholder should compare the actual exclusions, deductible, territory, limits and cancellation process rather than relying only on the product name.