If you become sick or are injured due to the actions of another party
You can undergo treatment under the health insurance system for sickness or injury due to the actions of another party, as in the case of a traffic accident. However, in such cases submit the Notification of Injury or Sickness due to a Third-party Act as soon as possible.
Be sure to notify the Health Insurance Society
You can undergo treatment under the health insurance system for sickness or injury due to the actions of another party. However, in such cases the Health Insurance Society merely pays up front on a temporary basis, the medical care costs that the party responsible for the accident must pay. The Society will bill that party for these costs later.
For this reason, when using health insurance for treatment in such cases, notify the Health Insurance Society and submit the Notification of Injury or Sickness due to a Third-party Act and other necessary documents as soon as possible.
- *The copayment rate for injury or illness caused by the actions of a third party is 20%, even for persons aged 70–74 to whom the 10% copayment rate applies as an exceptional measure.
If you have been in a traffic accident
- STEP1Remain calm
In cases of shock, you may lose the ability to make calm judgments. React as calmly as possible.
- STEP2Check the identity of the party responsible
Check matters such as the license plate no., driver's license, and vehicle inspection certificate.
- STEP3Notify the police
Be sure to notify the police, no matter how small the accident.
- STEP4Be cautious about reaching a settlement
If you waive some of your rights to claim compensation for damages by reaching a settlement with the party responsible, you may be unable to receive the corresponding health insurance benefits. To avoid cases such as inability to use health insurance when you need medical care later for residual effects or other complications, consult with the Health Insurance Society before reaching any settlement.
Injury due to the actions of another party
While most cases of injury due to the actions of another party involve auto accidents, the following cases also are due to the actions of another party:
- Injury due to defective equipment at a school, supermarket, or other facility
- Injury caused by another's dog or other type of pet
- Injury due to inappropriate force or an act of violence
- Food poisoning at a restaurant or other establishment
If the cause is a workplace accident
If you become sick or are injured due to the actions of another party in the workplace or while commuting, Worker's Accident Compensation Insurance applies instead of health insurance. Check with the person responsible at your establishment for more information.
- *When even illnesses and injuries on-the-job are not targeted for benefits of the Worker's Accident Compensation Insurance, benefits of the health insurance are provided except the duties as the officer of the corporation (except for a corporation less than five employees).