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 Association
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 IBM Japan Health Insurance Association merely pays up front on a temporary basis, the medical care costs (70%) 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 Association and submit the Notification of Injury or Sickness due to a Third-party Act and other necessary documents as soon as possible.
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.
- STEP4Contact IBM Japan Health Insurance Association
Submit "Notification of Injury or Sickness due to a Third-party Act" .
- STEP5Be 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 Association before reaching any settlement.
Notify the police and obtain a Certificate of the Automobile Accident.
The Certificate of the Automobile Accident must be attached to receive treatment under health insurance. Follow the procedures below to obtain this Certificate.
- Use the designated postal transfer form to request issue of a Certificate of the Automobile Accident from the traffic safety center of the prefecture where the accident occurred.
- The postal transfer form is available from any police station, police box, police substation, casualty insurance company, or agricultural cooperative.
- After you complete the application procedures, the traffic safety center will send the Certificate to the applicant’s address or designated recipient.
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).