Either the JET participant or a representative from the Contracting Organisation. If the JET participant does not speak sufficient Japanese, a representative from the Contracting Organisation should make the call.

If you have problems informing the Service Center of the accident or injury, or dealing with claim procedures you may contact the “SOMPO JAPAN Hotline” where English-speaking staff can help you. If you cannot speak to an operator immediately, you will be contacted later by telephone or mail.
Please refer to the following table to ascertain whether to call the “SOMPO JAPAN Hotline” or CLAIR with queries.
Please note that questions about personal reimbursement cannot be answered directly, but will be answered later by phone or by mail by the SOMPO JAPAN Service Center.

Type of Query / Information	Contact
To inform SOMPO JAPAN of an accident or illness and for queries regarding claim procedures. (Individual questions as to whether claims will be granted or not cannot be dealt with on the Hotline)	SOMPO JAPAN Hotline (Tokyo) 0120-08-1572 Toll free Monday to Friday, 9:00-17:00
For general information about the policy or insurance in general	CLAIR ‘JETLINE’ 03-3591-5489

A JET participant can receive assistance from their Contracting Organisation regarding claim procedures or in making telephone calls to the branch office, but other steps such as completing documents, must primarily be taken by the JET participant. If for special reasons you would like to transfer responsibilities for claim procedures to a third party such as your supervisor, complete the 'Letter of Delegation' column in the 'Claim for Payment of Benefits'. The transferee must then sign and stamp (with their personal seal) the transferee column and submit a verification certificate of their personal seal.

To receive medical attention it is usually necessary to present one’s National Health Insurance card at the hospital or clinic before receiving medical attention. After receiving attention the patient pays in cash the amount not covered by the National Health Insurance. In order to use the JET Accident Insurance policy, it is first necessary to present the National Health Insurance card to the hospital or clinic. After receiving medical attention, the JET participant should pay the portion not covered by the National Health Insurance and receive a receipt. This receipt is needed in making a claim for insurance benefits from SOMPO JAPAN.

After receiving medical attention through National Health Insurance, the amount paid by the JET participant less the 5,000 yen deductible will be paid by the insurance policy. Hence, claims cannot be made if the amount paid by the JET is less than 5,000 yen.

1. Firstly, 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." (Please refer to the SOMPO JAPAN Service Center Branch List). The JET participant will be asked for their JET number and the Insurance Policy number).

2. The branch office will make a record of the details and explain how to make a claim for payment. (In cases where the Contracting Organisation contacts SOMPO JAPAN on behalf of the participant, it is requested that this explanation is clearly passed on to the participant.)

3. The following documents will be necessary (Forms available at SOMPO JAPAN Service Center) :
(a) 'Claim for Payment of Benefits'
(b) 'Physician’s Statement and Authorization' (on the reverse of the ‘Claim for Payment of Benefits’). However, if the amount claimed is not more than 100,000 yen, a ‘Documentation of Medical Treatment’ may be submitted in place of the ‘Physician’s Statement and Authorization'
(c) A consultation ticket issued by the hospital or clinic (a copy is acceptable) or a medicine envelope should be attached to the ‘Documentation of Medical Treatment'
(d) Receipts for medical expenses.

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.

The fee varies from hospital to hospital, ranging from 3,000 yen to 5,000 yen. The cost of the ‘Physician’s Statement’ is covered by this policy. When the amount claimed is not more than 100,000 yen, you can use the ‘Documentation of Medical Treatment’ in place of a ‘Physician’s Statement’. Ensure that a hospital consultation ticket or medicine envelope is attached to the ‘Documentation of Medical Treatment'.  

No. This insurance policy covers injuries sustained or sicknesses which began after leaving for Japan. Therefore treatment for this injury (or sickness) is not covered. However, hospital expenses are covered by the National Health insurance up to 70%.

No. This policy does not cover dental treatment for ailments such as tooth decay and gingivitis. Dental treatment for injuries sustained in an accident is covered. However, dental treatment is covered by the National Health insurance up to 70%.

No. This policy only covers medical treatment prescribed by a physician.

Unless there are unavoidable circumstances, payment will not be made for the portion of costs paid by the JET for treatment received overseas (including the JET participant’s home country), as treatment for injuries and sickness which began in Japan is readily available within Japan. Proof from a medical facility in Japan stating that treatment overseas is necessary will be required to show ‘unavoidable circumstances’.

No. This policy is designed to cover the expenses actually paid by the JET participant. In this case the JET participant has incurred no expenses, therefore claims cannot be made. Any expenses that the JET participant has incurred through injuries or sickness sustained in the course of one’s official duties should be covered by the Contracting Organisation. Therefore, claims may not be made on this policy.

No. As explained in Q.11 above, this policy covers expenses that the JET participant has incurred for injuries or sickness. This question concerns expenses borne by the Contracting Organisation. Thus this policy does not apply.

Yes. However insurance payments will be reduced for some dangerous sports. The dangerous sports are the following: Mountain climbing (using climbing tools such as a pickle, climbing irons, rope, hammer, etc.), Luge, Bobsleigh, Skydiving, Hang-gliding, Ultra light power aircraft flying (Motorized hang-glider, micro-light aircraft, ultra-light aircraft, etc.), Gyroplane flying, Other dangerous sports similar to the above. Coverage for sports such as skiing, rugby, scuba diving, hiking (not using climbing equipment) will not be reduced.

(a) This policy covers treatment received within 30 days of the day after entering your home country, for sickness that began or injuries that were sustained in an accident that occurred within that 30-day period. It does not cover the period from the 31st day until the time when procedures for exiting from your home country are completed.
(b) When traveling to a third country, coverage is provided regardless of the destination or length of stay, as long as it is within the period of coverage.

In case a JET participant suffers injury or sickness in a third country, they will have to claim for reimbursment first to the National Health Insurance and then to the SOMPO Japan JET Accident Insurance. Expenses should be paid directly by the JET participant to the hospital overseas. After returning to Japan expenses should first be claimed back from National Health Insurance. The following materials will be required to make this claim:
(a) Application Form for Reimbursement of Medical Expenses Available from Social Insurance Agency (Japanese Only)
(b) 'Attending Physician’s Statement” (Include a Japanese translation, and the name, address and signature of the translator)
(c) Medical receipts

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. SOMPO JAPAN will not make direct payments to medical institutions in Japan or overseas.

Completing the Declaration of Beneficiary form confirms the beneficiary and helps to facilitate the payment process. If a completed form declaring a beneficiary is not submitted, statutory heirs will be required to provide proof that they are the statutory heir in order to receive insurance payments. The cost and time involved in this process will vary from country to country, but will always be the responsibility of the heir. We request that all newly arriving JET participants complete the Declaration of Beneficiary form. (For those participants who are re-contracting, there is no need to complete the form again. The designated beneficiary will be registered for the duration of participation on the JET Programme.) Only the parents, spouse, children, grandparents, or siblings of the participant may be designated as beneficiaries. If none of these family members are alive, please contact CLAIR. You will be required to designate another family member. Please complete the form, retaining the second sheet (carbon copy) for yourself and return the first sheet (original copy) to the insurance company via the Contracting Organisation and the Host Prefecture/Designated City. (You may NOT submit copies.)
NOTE: The Declaration of Beneficiary Form must be submitted when alternate beneficiary(ies) are declared.

The following costs will be reimbursed:
(1) Return air-fare etc. (Limited up to 3 people)
(2) Hotels or Accommodation expenses (Limited to up to 3 people for a maximum of 14 days)
(3) Miscellaneous expenses (Travel within Japan including train and taxi fares, international telephone calls, etc. up to 200,000 yen of actual expenses)
The maximum total claim for such expenses, including all search and rescue expenses is 4,000,000 yen. Receipts will be required for all claims.