■Filing a Claim: Procedures for Sompo Japan JET Accident Insurance
The following is an outline of claim procedures*:
1 Necessary Claim Documents
【Claim for medical expenses, residual disability or rescue expenses】
1. Claim for Payment of Benefits
2. Authorization and Physician's Statement (Statement of Residual Disability)
or
Documentation of Medical Treatment (with consultation ticket attached)
3. Receipts
【Claim for Liability】
1. Claim for Payment of Benefits
2. Mutual Agreement
3. Receipts
4. Other relevant documents (price estimation etc)
2 Claim Procedure for a sickness or injury happening within Japan
1. The JET participant pays for the medical expenses using the Japanese National Insurance.（It is important to keep all the receipts)
2. The JET participant or their supervisor should telephone the nearest branch of SOMPO JAPAN to report the date, time, place, cause and symptoms of the injury or sickness, and the name of the treating hospital or clinic, to the individual in charge of the “JET Accident Insurance.”
3. The branch office will make a record of the details and explain how to make a claim for payment. The JET participant should fill in all necessary documents and send them to the SOMPO JAPAN Branch.
4. When all the necessary documents are ready, send them to the Service Center Branch Office. The claim will be investigated and the insurance benefits will be remitted to the designated bank account. Transfers to foreign bank accounts are possible, in case the JET participant has returned in their home country.）
3 Claim procedure for a sickness or injury happening abroad （emergency procedures)
1. The JET participant must pay all of the medical fees themselves, and keep all the receipts or doctor’s notes. There is no money advance system.
2. A refund claim must be made to the Japanese National Insurance
To make this claim, the following materials are required:
・Application Form for Reimbursement of Medical Expenses
・Attending Physician’s Statement” (Include a Japanese translation, and the name, address and signature of the translator)
・Medical Receipts
The claim will take about a month.
3. Claim procedures to SOMPO JAPAN
After making this claim, contact the local SOMPO JAPAN ‘Service Center’ branch to claim the portion of the costs not covered by National Health Insurance. Receipts of the medical fees are needed when applying for reimbursement of medical expenses. In case the original receipts were needed to claim the payment back to the National Health insurance, please keep copies of those receipts. Please send copies of 2.a, 2.b and 2.c (see above) as well as a copy of the proof of refund from the Japanese National Insurance.
4. The claim will be investigated and the insurance benefits will be remitted to the designated bank account. Transfers to foreign bank accounts are possible, in case the JET participant has returned in their home country.)
※SOMPO JAPAN will not make direct payments to medical institutions in Japan or overseas
*Note: CLAIR provides this outline for guidance, but all matters regarding the claim must be taken directly to SOMPO JAPAN.
