Traffic Accidents (Illness or Injury Caused by a Third Party)
Third parties (party at fault) are generally responsible for paying medical costs caused by traffic or other accidents through liability or other optional insurance, but insured persons and dependents can use health insurance to receive medical care. However, please contact the Western Digital Technologies Health Insurance Association when seeking medical care through your health insurance, and then promptly file a Notification of Injury or Illness Due to a Third-party Act. Generally, the Western Digital Technologies Health Insurance Association temporarily reimburses the medical costs which should be paid by the party at fault, and then bills the party at fault (insurance company of the party at fault, etc.).
In addition, any medical care for an illness or injury caused at or going to or from work is covered by workers’ compensation insurance rather than health insurance.
Key Points When Victim of a Traffic Accident
| Verify the other party’s information | Verify the name, color and license plate number of the car, the driver’s name, address, workplace, liability insurance certificate, vehicle inspection certificate, and any other relevant information. |
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| Contact the police | Immediately contact the police and request a traffic accident certificate. |
| Contact the Western Digital Technologies Health Insurance Association |
Explain the date and details of the accident and provide the automotive insurance of the third party as well as other relevant information about the accident to check whether or not the health insurance card can be used for any medical care.
*The non-life insurance company may need to assist in the creation and submission of the Notification of Injury or Illness Due to a Third-party Act depending on the non-life insurance the insured person or dependent is enrolled.
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Discretion in Out-of-court Settlements
Using the utmost discretion by considering the ramifications of an out-of-court settlement is critical. Agreeing to an out-of-court settlement without giving it careful consideration may result in an insured person having no choice but to accept a very small sum as compensation or being unable to receive medical care covered by health insurance within the scope of the out-of-court settlement.
Always contact the Western Digital Technologies Health Insurance Association before reaching any type of out-of-court settlement.
If the victim (insured person or dependent) receives compensation of damages that include medical care costs, health insurance will no longer cover medical care after the date of the settlement. The insured person or dependent will be required to pay all of the medical costs even if symptoms change and medical care is prolonged.
The Western Digital Technologies Health Insurance Association cannot request damages for temporary medical costs from the party at fault if you forfeit your right to claim damages for medical expenses. Therefore, the victim (insured person or dependent) will be responsible for paying all medical costs.
Occupational Accidents (Accidents at Work) or Accidents While Commuting
Immediately contact your employer if an accident caused by a third-party happens while at work (on the job) or when commuting to or from the office!
Occupational accidents are not covered by health insurance because the insurance benefits are provided by workers’ compensation insurance.
About Illness or Injury Caused by a Third-party Act
Traffic accidents are the most predominate example of a third-party act, but third parties are also liable for actions such as those below. Therefore, insured persons must notify the Western Digital Technologies Health Insurance Association.
Examples of Third-party Acts
- Fights
- Incidents resulting in injury
- Hit and runs
- Ski and snowboard collisions
- Bicycle collisions
- Bites by another person's dog
Requests for Traffic Accident Certificates
The Japan Safe Driving Center issues traffic accident certificates. This certificate cannot be issued without a notification from the police. Always notify the police of an accident resulting in injury.
Please be aware a traffic accident resulting in property damage may prevent claims for medical care costs.
| Vehicle collisions | Both parties tend to be negligent in some way in vehicle collisions where both people are injured. In these cases, both parties are at fault and a victim at the same time. Therefore, both parties qualify as having had an accident due to a third-party act. |
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| Self-inflicted accident | If a passenger is injured due to a self-inflicted accident caused by the driver taking his/her eyes off the road for example, the driver is at fault, and their actions become the third-party act. |
| Injuries | Third-party acts also include non-traffic related accidents, injuries caused by acts of violence, bites by someone else's pet, or food poisoning caused by a food vendor. Insured persons or dependents need to submit a notification to the Western Digital Technologies Health Insurance Association for injuries caused by any such acts. |