THE INSURANCE POLICY JSPS FELLOWS JSPS

A GUIDE
TO
THE INSURANCE POLICY
FOR
JSPS FELLOWS
日本学術振興会外国人招へい研究者のための
海外旅行保険のご案内
JSPS Summer Program 2014
Japan Society for the Promotion of Science
独立行政法人日本学術振興会
NIPPONKOA Insurance Co., Ltd.
Please be sure to send the "DECLARATION,
AGREEMENT & AUTHORIZATION" attached.
Otherwise, your claim may not be covered.
To JSPS Fellows
Welcome to JSPS Summer Program
All JSPS fellows are automatically insured under the Overseas Travel Insurance Policy of Nipponkoa
Insurance Co., Ltd. in the course of the trip which is defined as commencing when the insured leaves
his or her residence for the purpose of overseas travel stated in the declarations and ending when he or she
returns to the residence, as approved by JSPS (hereinafter, “approved stay in Japan”).
The following policy summary briefly describes the benefits you may receive if you suffer accidental
bodily injury or sickness. If any of the following occur during your approved stay in Japan, please
notify Overseas Claims SC of Nipponkoa thereof without delay and take the steps described below to
receive payment of your claim before departing Japan.
Summary of Coverage
1.Accident Coverage
If you sustain an injury requiring medical treatment within 180 days of the date of the accident, the
policy provides the benefits indicated in the schedule below. Moreover, if the injury results in your
death within 180 days of the date of the accident, the policy provides the benefits indicated to your
beneficiary as defined under your country’s probate laws.
2.Sickness Coverage
If you become ill during your approved stay in Japan or within 72 hours of the termination of the
coverage period and as a direct result of the illness you are required to receive medical treatment, the
policy provides the benefits indicated in the schedule below. Moreover, if a sickness incurred under the
indemnifying conditions indicated in the schedule below results in your death, the policy provides the
benefits indicated to your beneficiary as defined under your country’s probate laws.
3.Rescue Coverage
If you incur an injury or illness within the coverage period that results in three or more days of
hospitalization or your death, the policy provides you or, in the case of death, your beneficiary with the
benefits indicated in the schedule below. (3 rescuers are applicable.)
4.Personal Liability Coverage
Nipponkoa will pay indemnity subject to the terms and conditions of the endorsement of this
insurance policy for loss sustained by the insured as a result of the insured becoming legally obliged to
pay for damage to property of others caused by an accident which occurred during the insured’s stay
in Japan.
5.Exclusions
Nipponkoa will not cover injury or illness resulting from pre-existing conditions, suicide attempts or
other wilful acts, automobile accidents in which you were driving a vehicle without a driver’s license
valid in Japan, air or water contamination, radioactive contamination, whiplash injury or back pain with
no verifiable symptoms, nor will it cover medical treatment related to dental disease(excluding dental
injury), pregnancy, childbirth, premature birth or miscarriage.
6.Notice
The above-mentioned coverage is valid within the territory of Japan during your approved stay as a
JSPS fellow(with the exception of the 72-hour clause in the sickness coverage).
The above-description is an outline of this policy. Whether a particular accident is covered or not, is
dependent on the terms of the Overseas Travel Insurance Policy and its endorsements.
Accident Coverage
Types of Benefits
1. Physical impediment benefit
Indemnifying Conditions
Physical impediment results within
180 days commencing from the
date of an injury caused during the
coverage period
Limit of Nipponkoa’s Liability
From 3% to 100% of physical
impediment benefit ,according to the
predetermined table attached to master
policy
For example
Loss of sight in both eyes :100%
Loss of sight in one eyes:60%
Loss of one thumb:20%
2.Medical Expenses
The insured is treated by a doctor Up to ¥3,000,000- for medical
for an injury caused by accident and
hospitalization
expenses
occurring during the cover period
actually incurred within 180 days
of the date of an accident
(in respect of any one accident)
3.Death Benefit
The insured dies within 180 days
commencing from the date of an accident
occurring during the coverage period
¥30,000,000-
Sickness Coverage
Types of Benefits
1. Medical Expenses
(See Medical Expenses above under
Accident Coverage.)
Indemnifying Conditions
The insured is treated by a doctor for an
injury caused by accident occurring
during the cover period
2.Death Benefit
1. The insured dies of sickness during
coverage period
2. The insured dies of sickness contracted
during the coverage period within 30
days after termination of the covered
period directly on account of the
sickness; provided that the treatment
for the sickness has commenced during
and continued beyond the termination
of such coverage period.
Limit of Nipponkoa’s Liability
¥3,000,000(in respect of any one accident)
¥3,000,000-
Rescue Coverage
Types of Benefits
1.Search and rescue expenses
2.Rescuer’s transportation and lodging expenses (not more than 14days per
one rescuer)
3.Postmortem repatriation expenses
4.Postmortem treatment expenses (not to exceed ¥1,000,000-)
5.Miscellaneous expenses, including passage procedure expenses, expenses for
transportation, international telephone call or other communication, etc. (not to
exceed ¥200,000)
Limit of Nipponkoa’s Liability
¥2,000,000-
Personal Liability Coverage
Types of Benefits
Legal liability arising from any accident with the Exclusion of:
1. Willful acts 2.War and other similar disturbances 3.Radioactive contamination 4.Liability
directly emanating from insured’s duty or business pursuits 5.Liability to relatives of the insured
residing with the insured 6.Damage to property owned, used or controlled by the insured
7.Liability emanating from ownership use or control of aircraft, vessel, vehicle or firearms etc.
Limit of Nipponkoa’s Liability
¥30,000,000(Maximum limit)
Major exclusions（主な免責事由）
(1) willful act of the policyholder or the insured;
(2) willful act of a person who is entitled to indemnity but in case such person is
entitled to a part of the loss of life indemnity, this exclusion does not apply to the
amount which any other person is entitled to;
(3) suicide or attempt thereof or criminal act of the insured, or acts of aggressive
violence initiated by the insured;
(4) accidents occurring while the insured is driving an automobile or a motor-bicycle
without having qualification to drive it in accordance with the laws of the place
where the insured drives or ahen insured operates a motor vehicle under the
influence of alcohol, narcotic, hemp, opium, stimulant, thinner, or the like, to the
extent the insured may be incapable of controlling the vehicle;
(5) sickness, brain disease or insanity of the insured;
(6) pregnancy, childbirth, premature birth or miscarriage of the insured or medical or
surgical treatment of the insured (except such as may be necessary solely by injuries
for which the company will be liable to pay indemnity);
(7) dental diseases;
(8) execution of a sentence on the insured;
(9) war, military act of foreign nations, revolution, insurrection, civil war, armed
rebellion or other similar disturbance or riot (for the purpose of this exclusion “riot"
means the state of affairs in which national or local good order is seriously
disturbed by collective action of a group or groups of persons, and in which a
serious threat to peace and order is deemed to exist);
(10) radioactive, explosive or other hazardous nature of nuclear fuel materials
(including spent fuel) or properties contaminated by nuclear fuel materials
(including products yielded in the process of nuclear fission), or any accident
arising from such nature;
(11) any accident incidental to exclusions stated in the preceding two subsections, or
any accident arising out of the disturbance of good order incidental thereto; or
(12) any nuclear radiation or radioactive contamination not included in subsection (9)
above
(13) cervical syndrome (so called “whiplash syndrome") or back pain, from any cause,
without objective symptom.
(14) diseases that had before the trip;
Only major exclusions are mentioned above. Other exclusions are listed in the Japanese
clause contained in the Overseas Travel Accident Insurance Policy taken out by the
JSPS.
Claim Procedure
When you incur an injury or sickness during your approved stay in Japan, please take the following
steps to make your claim.
First, see a doctor
Consult a doctor.(Medicines bought without a prescription will not be covered by this insurance.) In
some cases, you will have to pay the hospital fees at the time of treatment, but Nipponkoa will
reimburse the full amount of medical expense incurred up to ¥3,000,000 for all injury or sickness
except under the Summary of Coverage “Exclusions” provision above.(Up to 180 days after date of the
first treatment) So you must keep the proof of payment and/or any other required documents.
Identification Card:
After you arrive in Japan, you will get the Identification Card concerning Medical Care in Japan.
Please bring this card together with your passport whenever you visit a hospital.
Medical expenses will be paid directly by Nipponkoa to the hospital, but expenses not payable under
this insurance will have to be borne by the insured.(Cashless service might not be able to correspond at
all in some hospitals.) If you have incurred expenses not payable under this insurance, and have not yet
done so, you are requested to make payment of the required amount upon receiving notification from
the hospital.
After your medical treatment, please fill out the “INSURANCE CLAIM FORM”, which has been
specially prepared for this insurance program, and send it to Nipponkoa in the earliest possible stage of
your treatment.
Person who is not possession as for the Identification Card (Or, improperly
for Cashless service in a hospital):
In the case of treatment at hospitals, you must pay all the medical expenses first, and Nipponkoa will
reimburse you for these expenses based on the proof of payment and/or any other required documents
which you must send to Nipponkoa together with the “INSURANCE CLAIM FORM”.
If the amount of your claim of medical expenses exceeds ¥100,000 for any one injury or sickness, you
are requested in all such cases to obtain a “Doctor’s Statement” and send it to Nipponkoa.
If you need any further explanations, please contact us:
Nipponkoa Insurance Co.,Ltd.
➢For general information(Please contact by E-mail or FAX)
E-mail
: [email protected](Until August31,2014)
[email protected](From September1,2014)
FAX NO. : 03-3593-5128
➢For claims only
PHONE NO.: 03-5913-5201 (Overseas Travel Accident Insurance Claims Third Division)
ADDRESS : 10-2, Nakano 4-chome, Nakano-ku, Tokyo 164-0001
JSPS FELLOWS INSURANCE
HANDLING AGENT
SHIOMI Service co., Ltd.
38-902,
Kandasakumacho3-chome,
Chiyoda-ku, Tokyo 101-0025
Ｔｅｌ：０３－５８２２－５６５１
Ｆａｘ：０３－５８２２－５６５２
NIPPONKOA Insurance Co., Ltd.
Organization & Government Development Dept.
Commercial Account Marketing Sect.1
7-3, Kasumigaseki 3-chome, Chiyoda-ku,
Tokyo 100-8965
Ｔｅｌ：０３－３５９３－５１１２
Ｆａｘ：０３－３５９３－５１２８
添付の「告知書兼医療調査に関する同意
研究者のみなさまへ
書」を必ず送ってください。そうでないと保険
金がお支払いできない場合があります。
ＪＳＰＳサマープログラムへようこそ。
日本学術振興会外国人招へい研究者の皆様は全員日本興亜損害保険株式会社との保険契約
に基づき海外旅行保険に加入しています。この保険はご自身が本招へい制度によりご自宅を出
発されてから、ご自宅へ戻るまでの“JSPS FELLOW”としての旅行行程中（以下、滞在中とい
います。）の事故につき有効となっています。
以下に本保険についての、概略が書いてありますので、滞在中に病気やケガなどの事故に遭
った場合は、本案内を参考にするとともに日本滞在中に速やかに保険請求の手続きを行ってく
ださい。
補償内容の概略
１．ケガの補償
もし、あなたがケガにあい、病院にて治療を受けた場合は次頁表の内容にて１８０日以内に
要した費用をお支払いいたします。万一、ケガをして１８０日以内にお亡くなりになった場合
は、母国の相続法に基づき死亡保険金をご遺族にお支払いいたします。
２．病気の補償
滞在中、および帰国後７２時間以内に発病し医師の治療を受けた場合は、次頁表の内容にて
保険金をお支払いいたします。万一、滞在中に発病した病気が原因で死亡された場合は、母国
の相続法に基づきご遺族の方に死亡保険金をお支払いいたします。
３．救援者費用
滞在中、ケガや病気により３日以上入院した場合、および死亡した場合等には救援者費用保
険金をお支払いいたします（救援者は３人まで対象になります。）。
４．個人賠償責任
偶然な事故により、他人にケガをさせたり他人の物を壊したことにより、法律上の賠償責任
を負ったことにより負担した費用に対し保険金をお支払いいたします。
５．支払われない主な場合
傷疾病補償において、既往症・自殺行為・故意による事故・資格を持たないで運転した自動
車事故・大気汚染による事故・核燃料物質の有害な特性による事故・むちうち症または腰痛で
他覚症状のないもの・予防接種・健康診断・検査についてはお支払いしません。
また、疾病治療費においては、歯科疾病（歯のケガは除きます。）
・妊娠・出産、早産・流産
に起因する疾病もお支払い対象外となります。
６．ご注意
補償を受けることが出来る機関は、日本学術振興会招へいの研究者としての滞在中（疾病に
ついては、帰国後７２時間まで）に限られます。
前述の内容は概要を説明したものであり、実際のお支払いの可否は別途普通保険約款および
各特約条項に基づきますので、詳しくは後述のお問い合わせ先へご照会ください。
ケガの補償
補償内容
お支払いとなる場合
お支払い限度額
１．後遺傷害保険金
事故後、１８０日以内に身体の一部
分や機能を永久に失う等の後遺障害が
生じた場合。
障害の程度に応じて、死亡保険金
の３％から１００％を後遺障害保険
金としてお支払いいたします。
お支払い例：
両眼が失明したとき………１００％
１眼が失明したとき…………６０％
１手の指を全て失った時……２０％
２．治療費用保険金
期間中の事故後１８０日以内に医師
の治療を受けられた場合。
事故日から１８０日以内に実際に
要した治療関係費につき、１回の事
故について３００万円を限度として
お支払いいたします。
３．死亡保険金
期間中の事故によるケガが原因で、
事故の日から１８０日以内に死亡され
た場合。
死亡保険金として３，０００万円
をお支払いいたします。
病気の補償
補償内容
お支払いとなる場合
お支払い限度額
１．治療費用保険金
上記、ケガの補償と同じ。
最初の治療の日から１８０日以内に
要した費用をお支払いします。
１回の事故について３００万円を
限度としてお支払いいたします。
２．死亡保険金
１．滞在中に病気のため死亡された場
合
２．旅行行程中または帰国後７２時間
以内に発病した病気がもとで、帰国後
３０日以内に死亡された場合。
死亡保険金として３００万円を
お支払いいたします。
救援者費用
補償内容
お支払い限度額
１．救助捜索費用
２．現地との交通費及び滞在費（１名あたり１４日まで）
３．遺体移送費用
４．遺体処理費用（１００万円限度）
５．渡航手続費および諸雑費（２０万円限度）
２００万円を限度として実際に要し
た費用をお支払いいたします。
個人賠償責任
補償内容
偶然な事故により法律上の損害賠償責任を負った場合に負担する費用をお支払
いします。
免責事項：
１．故意による事故２．戦争その他事変・暴動３．核燃料物質の特性によ
る事故４．被保険者の職務遂行に直接起因する損害賠償責任５．被保険者
と同居する親族および旅行行程を同じくする親族に対する損害賠償責任
６．被保険者の所有・使用または管理する不動産に起因する損害賠償責任
７．航空機・船舶・車両・銃器の所有、使用または管理に起因する損害賠償責
任、他
お支払い限度額
３，０００万円
（お支払い限度額）
病気や事故にあったら…
日本滞在中に、病気やケガなどの事故にあった場合は下記のとおり対処してください。
まず最初に、病院へ行く
病院へ行って診療を受けて下さい（薬局等で薬を買って済ませた場合は保険の対象となりま
せん）。受診の際、治療費を自分自身でお支払いいただくことがありますが、１回の事故につ
き３００万円までは保険金として後日請求出来ますので（ただし、事故日から１８０日以内）、
病院の領収証は保管しておいてください。
ただし、前述の保険対象外の事故についての保険金はお支払いされません。
付保証明書
日本到着後、診療に関する付保証明書をお渡しいたします。病院へ行かれる場合はパスポー
トとともに本証明書を携帯して受診してください。
治療費は日本興亜社より直接病院へのお支払いとなります。しかし、保険対象外の事故によ
る治療についてはご自身で負担していただくこととなります（病院によってはキャッシュレス
の対応が全く出来ない場合があります。）。
また、治療後、保険対象外であると判明した場合は、病院に対する治療費のお支払いをご自
身で対応くださいますようお願いいたします。
付保証明書をお持ちでない方（またはキャッシュレス対応不可病院の場合）
病院で診療を受ける場合、治療費については一旦ご自身でご負担していただくことがありま
す。その場合、“INSURANCE CLAIM FORM”をご記入いただき、領収証を添付して、日本興
亜社宛ご送付ください。保険対象事故であれば、日本興亜社よりご指定の銀行口座へ保険金が
振り込まれます。
なお、ご請求額が１０万円を超える場合は、医師の診断書を添付のうえ日本興亜社宛お送り
ください。
詳しいお問い合わせについては下記までご連絡ください。
＜一般的なご照会＞
➢日本興亜損害保険株式会社団体・公務開発部第一課
メールまたはＦａｘにてお願いします。
Ｅ－ｍａｉｌ：[email protected](2014 年 8 月 31 日まで)
[email protected](2014 年 9 月 1 日から)
Ｆａｘ
：０３－３５９３－５１２８
＜保険金請求に関してのご照会＞
➢日本興亜損害保険株式会社海外旅行保険金サービス第三課
電話番号
：０３－５９１３－５２０１
住
所
：〒164-0001 東京都中野区中野４－１０－２
日本学術振興会研究者保険取扱代理店
株式会社潮見サービス
〒101-0025
東京都千代田区神田佐久間町
３－３８－９０２
ＴＥＬ：０３－５８２２－５６５１
ＦＡＸ：０３－５８２２－５６５２
〒100-8965 東京都千代田区霞が関 3-7-3
団体・公務開発部第一課
ＴＥＬ：０３－３５９３－５１１２
ＦＡＸ：０３－３５９３－５１２８

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