SGAM Malakoff Humanis (Malakoff Humanis Group)
Malakoff Humanis
Malakoff Humanis is a travel insurance for the France market with no online purchase and 24/7 assistance.
Direct payment
For hospitalisation abroad, the beneficiary or hospital contacts AXA Assistance (emergency) or WELCARE (scheduled admission after prior agreement) so that direct payment (tiers payant) can be organised with the hospital; under the guichet unique agreement with the CFE, Malakoff Humanis makes a single combined payment integrating the CFE share. Outpatient consultations and ambulatory treatments are not covered by direct billing and must be reimbursed afterwards.
Geographic scope
Worldwide coverage for expatriates, split into geographic zones (Zone A/B/C in the 2016 contract wording, marketed as Zone 1-4 in later commercial documents) selected at subscription; assistance services (AXA Assistance / Inter Partner Assistance) apply during any Déplacement linked to the expatriation, in the country of expatriation, in France, and in the country of origin for stays of limited duration.
Health guarantees apply in the chosen zone; frais engagés hors zone are covered only for professional trips (Souscripteur only) or trips under 30 consecutive days for accident/sudden illness. Assistance guarantees (repatriation, RC, baggage) apply worldwide except Irak, Somalie, Afghanistan, Syrie and Corée du Nord for the Responsabilité Civile guarantee.
Unique selling points
- Five flexible coverage tiers (Santé 1 to Santé 5) let expatriates match benefits and price to the medical costs of their country of expatriation.
- Direct billing (tiers payant) with hospitals abroad, integrating the CFE share, so beneficiaries generally avoid advancing hospitalisation costs.
- Single combined reimbursement: Malakoff Humanis collects the CFE's share and pays out CFE plus complementary benefits in one transfer.
- 24/7 multilingual medical assistance and worldwide repatriation network via AXA Assistance in case of accident or illness abroad.
- Dedicated international-mobility experts and a specialised claims management centre (WELCARE) supporting expatriates worldwide.
Coverage limits
Advance of medical expenses abroad
€150,000
When the Assuré is hospitalised abroad following an Atteinte corporelle, AXA Assistance can advance the medical costs directly to the hospital, on request, within the limit of 150,000 € per Evénement, on behalf of Humanis Assurances.
Emergency medical guidance and network access
Covered
AXA Assistance's medical team contacts the treating physicians on site and orients the Assuré towards a Structure médicale referenced in its network when acts, laboratory exams, ambulatory care or hospitalisation are required; no separate monetary ceiling is stated for this orientation service.
Hospitalisation abroad - direct payment advance
€150,000
AXA Assistance may advance and pay the hospital directly for medical costs linked to a Hospitalisation abroad, within the limit of 150,000 € per Evénement; hospitalisations exceeding 3 days for which AXA Assistance was not previously involved trigger a specific cost-monitoring procedure once costs exceed 10,000 €.
Outpatient / ambulatory consultations (direct billing)
Excluded
Under the assistance and direct-billing procedure, outpatient consultations and/or ambulatory medical treatments are explicitly excluded from direct payment ("ne font pas l'objet d'une prise en charge directe") and must be handled through the standard reimbursement circuit instead.
Emergency dental
Not established from the insurer's documents
Malakoff Humanis does not offer a genuine short-stay travel_medical product for occasional travellers; independent reviews confirm its standard mutuelle/health contracts contain no travel-specific guarantees and travel medical/emergency expenses abroad are simply absent from those contracts. Emergency dental cover (up to roughly €1,000/year in some tiers) exists only inside its long-stay expatriate 'Pack Expat' CFE-linked products, not in a consumer travel_medical policy.
Return transport after medical stabilisation
Covered
Once the Equipe médicale of AXA Assistance confirms the Assuré's health has stabilised, AXA Assistance organises and pays for the additional transport costs necessary for the Assuré's return to their Pays d'expatriation; no monetary ceiling is stated.
Medical repatriation
Covered
If the medical team of AXA Assistance recommends repatriating the Assuré to a Structure médicale in the Pays de Domicile or Pays d'expatriation, AXA Assistance organises and pays for the repatriation; destination, timing and means are decided exclusively by AXA Assistance's medical team, and refusing the proposed solution forfeits the assistance guarantees. No monetary ceiling is stated for this benefit.
Repatriation of remains
€2,300
AXA Assistance organises and pays for the repatriation of the Assuré's body or ashes from the place of death to the place of burial in the Pays de Domicile or Pays d'origine, including post-mortem treatment, coffining and transport arrangements; coffin costs linked to transport are capped at 2,300 €. Funeral, ceremony and burial/cremation costs remain at the family's expense.
Search and rescue costs
Excluded
The contract does not include a distinct search-and-rescue benefit; the only mention is an exclusion of search-and-rescue costs resulting from non-observance of site safety rules or regulations governing the practised activity.
COVID-19 treatment
Excluded
No dedicated Malakoff Humanis travel_medical (short-stay travel insurance) product exists for French residents; reviews state medical expenses from accident or illness abroad are not addressed by their standard contracts. COVID-19 related sanitary repatriation is referenced only within their long-term expatriate CFE-complementary offer, where COVID repatriation is included if hospitalisation exceeds 48h and a medical opinion justifies transport, but hotel quarantine costs are excluded unless an extended assistance option is taken.
Pre-existing / chronic conditions (assistance exclusion)
Excluded
Excluded from the assistance guarantees: pre-existing illnesses or injuries, diagnosed and/or treated, that were the subject of a medical consultation or hospitalisation within the six (6) months preceding the date of the assistance request, as well as convalescences and conditions still under treatment and not yet stabilised.
Winter / ice sports
Conditional
The assistance guarantees exclude the practice of snow or ice sports on a non-amateur basis; practising these sports as an amateur is therefore not excluded by this specific clause, making cover conditional on amateur status.
Adventure / high-risk sports
Conditional
Excluded: participation as a competitor in any competitive sporting event or endurance/speed trial and preparatory trials on any terrestrial or aerial locomotion device, non-homologated aerial activities, and non-professional practice is otherwise not addressed, meaning casual adventure activities are conditionally covered while competitive/professional practice is excluded.
Pregnancy follow-up / delivery (assistance exclusion)
Excluded
The assistance guarantees explicitly exclude the consequences of pregnancy: delivery, caesarean section, newborn care, and voluntary termination of pregnancy.
Private life civil liability abroad
€5,000,000
Covers the pecuniary consequences of the Assuré's private-life civil liability for bodily, material or immaterial damage caused to third parties abroad, up to 5,000,000 € TTC per Assuré for all combined damages (150 € excess); this guarantee is an optional add-on ("option n°0803228 02") for the Santé 1, Santé 2 and Santé 3 formulas, and is included automatically for the Santé 4 and Santé 5 formulas.
Legal assistance abroad
€30,500
If the Assuré faces judicial proceedings abroad for a non-intentional infraction committed during private life, AXA Assistance advances any criminal bail required to secure release/avoid incarceration up to 30,500 € TTC per Assuré, and covers lawyer's fees up to 7,500 € TTC per Assuré.
24/7 assistance hotline
Covered
AXA Assistance can be reached 24 hours a day, 7 days a week, via dedicated numbers for the Americas, Asia, or the rest of the world, before any expense is advanced; medical information and advice lines are also available 24/7.
Key conditions
Assistance call deadline
AXA Assistance must be contacted immediately, before any expense is advanced; for a scheduled hospitalisation lasting more than 3 days for which AXA Assistance was not previously involved, it must be notified within 24 hours of the date stated on the hospitalisation certificate for the cost-monitoring procedure to be set up.
Unauthorized treatment
Organising means/solutions without AXA Assistance's prior agreement cannot give rise to any reimbursement.
Purchase while abroad
The Souscripteur must reside in France on the day of adhesion, or join within 6 months of leaving France to adhere without medical formalities (beyond that period, a health questionnaire is required for all beneficiaries); a Souscripteur expatriating to the United States may only subscribe before leaving France.
Chronic conditions
Convalescences, conditions currently being treated and not yet stabilised, and pre-existing illnesses diagnosed/treated or subject to a consultation/hospitalisation within the 6 months preceding the assistance request are excluded from the assistance guarantees.
Pregnancy
Consequences of pregnancy (delivery, caesarean, newborn care) and voluntary termination of pregnancy are excluded from the assistance guarantees; the base health cover's Maternité benefit only applies to the Souscripteur or their spouse/partner and only for pregnancies starting after the adhesion's effective date.
Pre-existing condition exclusions
Illnesses or injuries diagnosed and/or treated, having led to a medical consultation or hospitalisation within the six months preceding the assistance request, are excluded from the assistance guarantees.
Coverage duration limit
The contract runs for one year from the subscription date and renews automatically by tacit reconduction each year unless terminated; hospitalisation advance-payment and cost-control benefits are assessed per Evénement/per hospitalisation stay.
Where to buy
Documents
Policy specifics
Geographic Zone Coverage
Coverage varies by expatriation zone (MondExpat worldwide or FrancExpat France-only)
SourceSource no longer reachableComplementary Coverage to CFE
Product serves as supplementary health insurance in addition to CFE (Caisse des Français de l'Étranger) base coverage
SourceSource no longer reachableMedical Repatriation Assistance
Includes medical repatriation coverage to most appropriate care facility or country of origin
SourceAge Eligibility Restriction
Product limited to members under 62 years old at time of adhesion; separate Senior variant (Pack Expat' CFE Senior) available for retirees
SourceSource no longer reachableFive Modular Coverage Levels
Five distinct coverage tiers available based on expatriation country medical costs and needs
SourceThird Party Payment (Tiers Payant)
Direct payment to foreign hospitals for inpatient care; no advance payment required by insured
SourceDental and Optical Coverage
Includes essential dental and optical care (glasses, lenses) as part of core guarantees
SourceCivil Liability Insurance
Third-party liability coverage included according to selected plan level
SourceLuggage/Baggage Insurance
Travel baggage coverage included as supplementary guarantee
SourceSource no longer reachableNo Waiting Period with Continuity
No waiting period (délai de carence) if adhesion requested within 6 months of France departure and continues prior complementary coverage
SourceMedical Questionnaire and Medical Underwriting
Subscriber must complete medical questionnaire submitted to insurer medical department at least 15 days before desired effective date
SourceQuarterly Premium Payment in Advance
Premiums including taxes must be paid in advance quarterly in euros; payment due within 10 days of invoice
SourceSource no longer reachableReimbursement Claim Submission Deadline
Reimbursement requests must be submitted to contract administrator within maximum 2 years following date of care
SourceSource no longer reachableCFE Affiliation Requirement
Insured must maintain active affiliation with CFE (Caisse des Français de l'Étranger) for base Maladie-Maternité coverage; loss of CFE status terminates this product coverage
SourceSource no longer reachableProvider Freedom with Reimbursement Limits
No restriction on choice of doctor or hospital provided practitioner is qualified and facility properly authorized; insurer reserves right to limit reimbursement of certain healthcare expenses
SourceMisrepresentation and Intentional Omission
Any intentional concealment or false statement by insured results in nullity of adhesion and forfeiture of all claim rights
SourceSource no longer reachableAnnual Contract Renewal with Tacit Agreement
Contract terminates December 31 annually and renews by tacit agreement unless terminated by insurer or subscriber; new rates and conditions must be communicated at least 2 months before renewal
SourceNo Exemption from Country Social Security
Adhesion to this product does not relieve subscriber from mandatory social security contributions in country of expatriation, including EEA countries
SourceUnified Single Reimbursement Process
Malakoff Humanis collects CFE reimbursements and performs unified reimbursement to insured combining base and complementary guarantees in single payment
Source