When an automated system mistakenly cuts off sickness or maternity benefits for insured persons: in an article dated January 27, 2025, Mediapart reports on the malfunctions of Arpège, an automated system currently being tested by health insurance.
Since October 2024, the National Health Insurance Fund (CNAM) has been experimenting with Arpège, a tool for processing sick leave and maternity leave benefits. Before generalizing the latter to the entire territory, the Cnam decided to experiment with it in two departments: Vendée and Loire-Atlantique.
"Instead of getting treatment", patients forced "to fight against" health insurance
Problem: Arpège has proven to be dysfunctional: a problem that would affect more than 10,000 insured persons according to the unions, nearly 3,800 in January 2025 according to health insurance, reports Mediapart. Our colleagues thus recount cases of payments blocked by mistake, with insured persons who no longer receive anything or only part of the payments.
Result: "instead of getting treatment", "people on sick leave" are forced to "fight against the CNAM", deplores one of the "social security victims". Others are struggling to pay their rent and bills due to the lack of payment of their benefits, like Sylvie Dalibert, whose story is also told by Presse Océan, Tuesday, January 28.
On sick leave since March 2024, this resident of Loire-Atlantique has not received her full daily benefits since September, with consequences on his health and financial situation.
Despite numerous actions taken (letters to elected officials, questioning of the Cnam by deputies, demonstrations, walkouts, formation of a collective, etc.), the problems have still not been corrected. Employees of the Cnam of Saint-Nazaire also walked out on Tuesday, January 28 to protest against the use of this software. For this agent interviewed in the pages of the regional daily, "the incompetence and stubbornness of the Cnam management are causing a disaster".
The dysfunctions of Arpège already known
It must be said that the problems raised could, for some, have been avoided, because Arpège is not software unknown to Health Insurance. As the CGT of the CPAM of the 44 recalls, in a press release of October 21, 2024, the automated tool has been used to pay sick leave for self-employed workers since 2020, with, here too, many malfunctions observed.
The union already deplored, in October, the " harmful consequences on the compensation of thousands of cases". He denounced "the stubbornness and incompetence of the Cnam which, at all costs, implemented an unsuccessful tool despite the warnings and endangered the health of employees".
Contacted by our colleagues at Médiapart, the Cnam explained that the identified anomalies are currently being corrected. But the return to normal could take longer than expected. According to a CGT union representative interviewed by Presse Océan, "we were told that things would get back to normal in February, then April, now it's not before a year". At the risk of seeing many policyholders go through a period of "financial complications", or even precariousness.
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