REPORTING ACCIDENTS TO THE INSURANCE COMPANY
- Who should make the telephone call to the insurance company to report an accident or sickness?
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.
- I made a telephone call to the insurance company, but could not make myself fully understood. Is there any other way for me to contact insurance company directly?
If you have problems informing the insurance company of the accident or injury, please have your contracting organisation supervisor contact the insurance company on your behalf.
- I do not fully understand the claim procedures, so would like to transfer responsibility for such matters to my supervisor. How do I go about this?
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.
CLAIM PROCEDURES AFTER AN ACCIDENT OR ILLNESS
- I have an injury (or sickness) and wish to use this accident insurance policy to receive medical attention. How should I pay for medical expenses at a hospital or clinic?
To receive medical attention it is necessary to present your Social (Health) Insurance card at the hospital or clinic before receiving medical attention. After receiving attention you pay in cash the amount not covered by the Social (Health) Insurance. Afterwards, you can make a claim to cover the expenses not covered by Social (Health) Insurance through JET Accident Insurance. When paying expenses at the hospital or clinic, be sure to keep all receipts.
- How is the deductible amount applied to the benefits paid from the insurance policy for treating injuries and illnesses?
After receiving medical attention through Social (Health) Insurance, the amount paid by the JET participant minus the ￥5,000 deductible will be paid by the insurance policy. Therefore, claims cannot be made if the amount paid by the JET is less than ￥5,000.
- I have paid the expenses for my injury or sickness and wish to make a claim for payment under the JET Accident Insurance policy. What is the procedure for making a claim?
Information on how to make a claim can be found here, as well as in the JET Accident Insurance Policy Guide.
- The policy states that I need a physician’s statement when making a claim. I have heard that this will cost ￥3,000-￥5,000. Will the insurance company pay for this?
The fee varies by hospital, ranging from approximately ￥3,000-￥5,000. The cost of the physician’s statement is covered by this policy. Refer to the JET Accident Insurance Policy Guide for further information. When the amount claimed is not more than ￥100,000, a physician’s statement is not required.
- I suffered an injury (or sickness) two weeks prior to leaving my home country to participate on the JET Programme. The injury was not cured by the time I came to Japan. Can I make a claim on the JET Accident Insurance policy for reimbursement of the hospital expenses?
No. This insurance policy covers injuries sustained or sicknesses which began after leaving for Japan and does not cover pre-existing conditions or injuries. Therefore treatment for this injury (or sickness) is not covered. However, hospital expenses are covered by the Social (Health) Insurance up to 70%.
- Can I claim for treatment from a dentist for a decayed tooth?
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.
- Can I claim for cold medicine purchased from a pharmacy?
No. This policy only covers medical treatment prescribed by a physician.
- I have been receiving treatment at a hospital for an injury (or sickness) I sustained during the course of my official duties. My contracting organisation has paid all the expenses and I have had no financial burden. Can I claim insurance benefits?
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 his/her official duties should be covered by the contracting organisation. Therefore, claims may not be made on this policy.
- I am the JET participant’s supervisor. Can the contracting organisation claim for expenses incurred in the treatment of the JET participant’s injury or sickness?
No. As explained in I. 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. Therefore, this policy does not apply.
- I play football on weekends. Am I covered for injuries sustained playing physical contact sports such as this?
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 (motorised 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.
ACCIDENTS OCCURING OUTSIDE JAPAN
- What period is covered by this policy for treatment received in my home country/third country?
(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.
- If I suffer injury or sickness during temporary home leave or during a trip to a third country, how should I pay for treatment? How should I claim for reimbursement?
Information on how to make claim while overseas can be found here and in the JET Accident Insurance Policy Guide.
INSURED’S CONFIRMATION OF AGREEMENT FORM
- What is the meaning of the JET Accident Insurance Insured’s Confirmation of Agreement Form? Is it absolutely necessary to indicate a beneficiary on the form?
The Insured’s Confirmation of Agreement 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 form and submit it during Tokyo Orientation.
Only a parent, spouse, child, grandparent, or sibling of the participant may be designated as a beneficiary. If none of these family members are alive, please contact CLAIR. You will be required to designate another family member.
Please complete the form and submit it to CLAIR at Tokyo Orientation.
CLAIMS FOR RESCUER EXPENSES
- If a JET participant is hospitalised for more than 3 consecutive days for an accident or sickness and their parents come to Japan as rescuers, what costs will be covered by the policy?
Please refer to coverage details.
For more information about the JET Program Accident Insurance, please refer to the pages below.