Background
This is the maximum derogation period for insured persons with a non-exempt long-term condition (LTD), i.e. not covered by 100% sickness insurance. So far, the daily allowances could be paid to them up to 3 years.
Why it's important
Going from 3 years to 1 year means that part of a long stoppage may no longer be compensated if the insured person does not return to work. For many employees, including foreign persons, these benefits are the main source of income during the illness: it is therefore useful to know to which category of DLI one belongs and what period of compensation applies.
What Changes
The maximum derogation period for compensation for work stoppages is changed from 3 years to 1 years for non-exemptive LCA insured persons. This applies to the prescribed stops from the 15 October 2026 and the current stops reaching 6 months after that date. To qualify for a new one-year compensation period for the same illness, the insured must have returned to work for at least 1 year.
Useful details
- Decree No 2026-866 of the 16 September 2026 on the maximum derogation of compensation and the sanction of abuses; Decree No 2026-867 of the 16 September 2026 on the reform of this duration.
- An exonerating LFA covers a serious illness that has been evolving for more than 6 months and requires expensive treatment: care is covered at the maximum refundable rate and compensation is limited to 3 years.
- A non-exonerant ALD justifies a stoppage of more than 6 months without expensive treatment: care is reimbursed at the usual rates.
- The insured persons who have been on arrest for more than 6 months on 15 October 2026 remain subject to the old rule and can be compensated for up to 3 years.
Terms to know
- ALD exonérante
- Severe illness that has been evolving for more than 6 months with expensive treatment; care for 100 % and benefits paid up to 3 years.
- ALD non exonérante
- Conditions justify stopping more than 6 months without expensive treatment; care reimbursed at usual rates.
- Indemnités journalières
- Amounts paid by sickness insurance to compensate for loss of income during a work stoppage.
- Durée maximale dérogatoire
- Longer period of compensation applicable to certain categories of insured persons, such as those in long-term affection.