You travelled to the maternity ward expecting the happiest day of your life and came home with a child who will never live like other children: a baby starved of oxygen during a labour that went on too long, a shoulder broken by instruments used too forcefully, a mother torn and stitched in conditions no one explained to her. As British parents in France after Brexit, you face the French medical-accident system in a second language, far from the family reflexes that French parents rely on, and often while still coping with night feeds and hospital appointments. France offers something England does not: a free, fast first track for victims of medical accidents, run by regional commissions called the CCI (commissions de conciliation et d’indemnisation, the conciliation and compensation commissions), backed by a national payer called ONIAM (Office national d’indemnisation des accidents médicaux, the national office for medical-accident compensation). This guide explains, with the exact statutory texts and two recent Court of Cassation rulings including an October 2025 decision on a birth injury, how to secure the obstetrical file within days, how to file the free CCI claim for your child, who pays when a delivery goes wrong, and how to challenge a refusal, a silent insurer or an offer that values your child’s whole future too cheaply.

I. Proving What Happened in the Delivery Room: the Obstetrical File in Eight Days and the Free CCI Claim

A. The Birth File Within Eight Days and the Information Trail: What to Demand, What the Clinic Must Hand Over, and How to Challenge a Refusal

Everything starts with paper, and in a birth case the paper is unusually rich. Before any commission, expert or court can judge the delivery, you need the complete dossier médical (medical file) of both mother and child: the pregnancy follow-up, the labour monitoring strips, the delivery report, the cord blood gas results, the Apgar scores, the resuscitation notes, the transfer records if the baby was moved to neonatology, and every exchange between the midwife, the obstetrician and the anaesthetist. French law gives every patient a direct right to the whole file and sets hard deadlines that maternities regularly miss. Article L.1111-7 of the Public Health Code provides that you may obtain communication of the file, directly or through a doctor you appoint, “au plus tard dans les huit jours suivant sa demande” — no later than eight days after your request — once a forty-eight-hour cooling-off period has passed. For older records the same article states: “Ce délai est porté à deux mois lorsque les informations médicales datent de plus de cinq ans” — the deadline is extended to two months. Send the request immediately, in writing, by lettre recommandée avec accusé de réception (registered letter with recorded delivery) to the hospital director, for the mother and separately for the child, asking expressly for “l’ensemble des informations concernant la santé” of each of them, including the labour monitoring strips (le partogramme et les tracés du monitoring), the delivery report, the cord pH and the neonatal resuscitation record. Keep the postal receipts and diary the eight-day deadline from the day after receipt.

If the maternity stalls or sends an incomplete file, challenge it in writing at once. Cite the eight-day rule, demand the name of the person handling your request and the reason for the delay in writing, and keep copies of everything in both directions with a dated diary of calls. An incomplete disclosure is itself evidence the expert and the court will note. The second trail to secure is the information trail. French law required the team to inform the mother before and during care, and Article L.1111-2 of the Public Health Code states the principle plainly: “Toute personne a le droit d’être informée sur son état de santé.” — everyone has the right to be informed about their state of health. In a birth case that means: what the team proposed at each stage, why a caesarean was or was not performed, the foreseeable risks of forceps or suction cup (ventouse), and the alternatives. Write down now, while memory is fresh, everything you were told and not told, who said it, and when: the consent trail often decides whether the merit of the case is fault or national solidarity, and memories of a delivery fade faster than any other. One administrative step matters in parallel and has nothing to do with liability: Article 55 of the Civil Code provides that “Les déclarations de naissance sont faites dans les cinq jours de l’accouchement, à l’officier de l’état civil du lieu.” — births must be declared within five days of delivery to the registrar of the place of birth. Declare the birth at the mairie (town hall) on time, even in the middle of the medical storm, so the child’s civil status never becomes a second battle.

B. Taking Your Child’s Case to the Free CCI Claim: the 24 Percent Threshold, the Six-Month Opinion and the Independent Expert Examination

The CCI claim is free, requires no lawyer, and is the gateway to ONIAM money — but it only hears grave cases, and a birth injury must be framed to pass that gate. The statute reserves national-solidarity compensation for harm that is abnormal in light of the prior state of health and grave under a scale fixed by decree. Article D.1142-1 of the Public Health Code fixes the figure: “Le pourcentage mentionné au dernier alinéa de l’article L. 1142-1 est fixé à 24 %.” — the permanent impairment rate mentioned in the statute is set at 24 percent. For a newborn with a brain injury, a brachial plexus palsy or a fractured bone that heals badly, the rate is assessed on the lasting functional loss, and severe birth injuries typically clear this bar by a wide margin; where the rate is uncertain, file anyway and let the expert measure it, because the commission orders its own independent examination rather than taking your word or the clinic’s. File the claim with the CCI of the region where the delivery happened, for the child, represented by both parents as holders of parental authority, with a dated bundle: the file obtained under the eight-day rule, the pregnancy records, photographs of the injuries, the diary of the labour as you lived it, and every subsequent medical certificate. Keep proof of posting and the commission’s acknowledgement, because every later deadline runs from a written date.

Once seized, the commission moves on rails the clinic cannot slow. Article L.1142-8 of the Public Health Code provides that “L’avis de la commission régionale est émis dans un délai de six mois à compter de sa saisine.” — the regional commission’s opinion is issued within six months of referral. Before opining, the commission appoints an independent expert, usually an obstetrician and, for the child, a paediatric specialist, who examines the baby, questions both parents, and reviews the monitoring strips line by line. Treat that examination as the decisive day of the whole case: attend with both parents, bring the diary, the photographs and a chronological folder, answer precisely about the hours of labour, and never minimise the daily consequences for the child. The same article adds a warning that shapes all challenges: “Cet avis ne peut être contesté qu’à l’occasion de l’action en indemnisation introduite devant la juridiction compétente par la victime” — the opinion can only be contested in the compensation action brought before the competent court by the victim. In plain terms, do not waste months arguing with the commission about an unfavourable opinion; the remedy is the court action, within the limitation period, where the judge hears the expert evidence afresh. If the commission instead finds the case grave and compensable, its opinion names the payer — the clinic’s insurer or ONIAM — and the four-month offer clocks start running, which is the subject of the second part.

For a British family, two practical points make the difference at this stage. First, language: you may bring a trusted interpreter to the expert examination and you may file the CCI claim in French with a short, dated, factual account rather than elegant prose — the commission works from documents, not style, so a clear timeline with dates, names and strip references beats a long letter. Second, development: from the first week, keep a milestone diary for the child with dated videos of feeding, movement, tone and alertness, plus every paediatric and physiotherapy report, because the expert measures the lasting deficit against the child’s evolving condition and a contemporaneous record is worth more than any later recollection.

II. Who Pays for a Birth Injury and How to Fight Back: Fault, Lost Chances, the ONIAM Offer and the Courts

A. Fault, Lost Chances and National Solidarity: Who Pays When a Delivery Goes Wrong and What the Court of Cassation Decided in October 2025

French birth-injury law runs on three tracks, and the October 2025 ruling shows how they combine. The first track is fault: the clinic or the midwife answers for negligence such as ignoring abnormal monitoring strips for hours, delaying a plainly needed caesarean, or using forceps with excessive force. The second track is the hospital-acquired infection, where the establishment is strictly liable: Article L.1142-1 of the Public Health Code provides that “Les établissements, services et organismes susmentionnés sont responsables des dommages résultant d’infections nosocomiales, sauf s’ils rapportent la preuve d’une cause étrangère” — those establishments are liable for harm resulting from hospital-acquired infections unless they prove an outside cause. The third track covers what nobody caused: the therapeutic accident, where the Republic itself pays through national solidarity via ONIAM when the harm is directly attributable to care, abnormal, and grave. For infections specifically, Article L.1142-1-1 of the Public Health Code opens solidarity compensation for “Les dommages résultant d’infections nosocomiales dans les établissements, services ou organismes mentionnés au premier alinéa du I de l’article L. 1142-1 correspondant à un taux d’atteinte permanente à l’intégrité physique ou psychique supérieur à 25 %” — harm from hospital-acquired infections corresponding to a permanent impairment rate above 25 percent. The boundary between the tracks is policed strictly: Court of Cassation, First Civil Chamber, 15 June 2022, No 21-16.022 states that “l’ONIAM n’est chargé d’indemniser les victimes d’accidents médicaux résultant d’actes individuels de prévention, de diagnostic ou de soins que lorsque la responsabilité d’un professionnel de santé, d’un établissement, service ou organisme de santé ou d’un producteur de produits n’est pas engagée” — ONIAM compensates victims of medical accidents only where the liability of a practitioner, establishment or producer is not engaged.

Birth cases often sit across two tracks at once, and that is where the newest ruling changes everything for British parents. In Court of Cassation, First Civil Chamber, 15 October 2025, No 23-23.977, a mother who delivered vaginally suffered a torn perineum with anal sphincter rupture that the midwife tried to stitch before a suture was performed; the appeal court found the midwife’s fault had cost the mother a 50 percent chance of avoiding the injury. ONIAM challenged the solidarity award, and the Court of Cassation rejected its appeal, holding word for word: “Dans l’hypothèse où un accident médical est à l’origine de conséquences dommageables mais où une faute a fait perdre une chance à la victime d’y échapper, un tel accident ouvre droit à réparation au titre de la solidarité nationale si ses conséquences remplissent les conditions posées au II de l’article L. 1142-1, l’indemnité due par l’ONIAM étant réduite du montant de celle mise, le cas échéant, à la charge du responsable de la perte de chance.” — where a medical accident causes harm but a fault cost the victim a chance of escaping it, solidarity compensation is due if the statutory conditions are met, with the ONIAM payment reduced by whatever is charged to the person responsible for the lost chance. The court added that the appellate judges had “exactement déduit que le dommage ouvrait droit à une indemnisation au titre de la solidarité nationale à hauteur de 50%” — exactly deduced that the harm gave a right to solidarity compensation at 50 percent. For your child this is the key that unlocks mixed cases: even where the clinic proves the injury was largely unavoidable, the lost chance of avoiding it still sounds in money, split between the insurer for the fault share and ONIAM for the rest — provided you claimed on both tracks from the start, which is why the CCI bundle must plead fault and solidarity together rather than betting on one.

B. The Insurer or ONIAM Offer, the Ten-Year Clock From Stabilisation and How to Challenge a Refusal or a Low Figure

A favourable commission opinion converts into money through a formal offer (offre d’indemnisation) that must repair the whole of each head of loss, and the statute puts both payers on the same four-month leash. Where the commission finds a practitioner or establishment liable, Article L.1142-14 of the Public Health Code requires the guaranteeing insurer to send the victim or dependants “dans un délai de quatre mois suivant la réception de l’avis, une offre d’indemnisation visant à la réparation intégrale des préjudices subis dans la limite des plafonds de garantie des contrats d’assurance” — within four months of receiving the opinion, an offer aimed at full reparation of the harm, within the policy caps. Where the harm falls under national solidarity, the mirror rule applies: Article L.1142-17 of the Public Health Code requires ONIAM to send “dans un délai de quatre mois suivant la réception de l’avis, une offre d’indemnisation visant à la réparation intégrale des préjudices subis” — within four months of receiving the opinion, an offer aimed at full reparation of the harm suffered. The offer must value each head of loss separately and state the figures openly, deducting only the social benefits already received for the same harm. Diary both four-month deadlines from the written dates on the opinion, chase in registered letters the day each expires, and never accept a figure you have not had independently checked: accepting an ONIAM offer counts as a settlement (transaction) that closes the file, including heads of loss you forgot to claim. For a child, the most frequently undervalued items are the future ones — lifelong assistance by a third person, home and vehicle adaptations, specialised schooling, and the lost earnings of a working life that has not started — and they are precisely the lines an independent medical-legal adviser prices correctly. If the offer is low, refuse it in writing point by point and either negotiate or go to court; refusal never forfeits your rights.

That court action is also the remedy for every other failure in the system, and the deadline that protects a child is generous but must be understood exactly. Article L.1142-28 of the Public Health Code provides that actions against practitioners and establishments, and compensation claims before ONIAM, “se prescrivent par dix ans à compter de la consolidation du dommage” — are time-barred ten years after stabilisation of the harm. Ten years from stabilisation, not from the delivery: for a newborn whose brain injury evolves through childhood, stabilisation (consolidation) may lie years ahead, and each genuine aggravation reopens the analysis. But do not read generosity as an invitation to wait. File the CCI claim while the strips, the witnesses and the neonatal memories are fresh; keep the procedure moving with registered letters; and if the commission declines the case, routes it to mere conciliation, or the payer stays silent past four months, see a lawyer early about the court action. The judge hears the expert evidence afresh, appoints a new expert where needed, values the loss without being bound by the commission figures, and can combine the tracks exactly as the October 2025 ruling allows — the insurer paying for the lost chance, ONIAM for the solidarity share. If the dispute is only about the maternity bill rather than the care itself, the emergency-cover rules are a different matter, explained in our guide to hospital bills and GHIC refunds; where the delivery itself harmed mother or child, this birth-injury track is the remedy, and its general framework is set out in our guide to medical accidents, the CCI and ONIAM.

Conclusion

A birth injury in a French maternity need not leave British parents powerless, provided the case is built in the right order from the first week. Secure the complete files of mother and child within the eight-day rule and the information trail while the delivery is still vivid; declare the birth at the mairie within five days so civil status never becomes a second front; file the free CCI claim for the child pleading fault and solidarity together, with a dated, photographed, receipted bundle; attend the independent expert examination as the decisive day it is; then follow the money along every track the law assigns — the insurer for fault and the lost chance, ONIAM under national solidarity for the rest — and challenge each refusal, silence or low offer in writing and in time. The ten-year clock from stabilisation protects a growing child, but speed protects the evidence better. Keep every deadline in registered letters, never sign a settlement you have not had checked line by line against the child’s whole future, and remember that the commission opinion advises while only the court decides. Treated this way, the French system that first looks like a maze in a foreign language turns out to be a machine: records, commission, expert, opinion, offer, and where needed the judge — each step feeding the next, each document earning its place in the final figure for your child.

Need a quick opinion on your case.

If a delivery in a French maternity has left your baby or the mother harmed, send us the dates, the establishment and the commission or insurer letters you have received. A lawyer of the firm will review your file and call you back with a telephone consultation within 48 hours to tell you which track — fault, lost chance, hospital-acquired infection or national solidarity — fits your case and what to do next. Call +33 6 46 60 58 22 or write via our contact page, and keep the birth file, your diary and your receipts ready for the call.