In the case of a traffic accident, an agreement with the insurance company must be made when the ‘treatment’ is completed. If you are in urgent need of money and agree to receive treatment, you are giving up on the insurance you will receive.
Insurance amount: medical institution payment + maintenance contractor payment + insurance premium to be paid to me
Upon agreement with the insurance company, receive the ‘insurance claim statement & deposit statement’ from the medical institution and maintenance company so that there is no unfair processing amount.
Ask for the ‘initial estimate’, ‘accumulated amount of decisions’, ‘residual estimate’, and ‘total loss’ in the insurance payment confirmation form, and receive a final agreement from time to time.
The most important is the 'detailed insurance payment statement by reason for payment', but there is no insurance company that will voluntarily provide it.
When receiving insurance payments
Ask for a ‘Detailed Statement of Insurance Claim Payment’ containing specific details such as ‘the basis for payment, the reason for payment, the payment standard, and the amount of payment’, and check that there is no omission.
If you are hospitalized due to a traffic accident, wait patiently as the insurance company staff will take care of you through the medical institution.
It is enough to know roughly how much insurance you will receive.
When the insurance company is reviewed, the first thing to check is the examiner's identity. Check your affiliation and whether you are qualified as a ‘damage adjuster’ and receive a business card.
A reviewer is a person who confirms ‘violation of the duty to notify’ or ‘false medical treatment’ and is not an official employee of the insurance company. It may be a person who has been entrusted with ‘damage adjustment’, so they must receive a ‘power of attorney from the insurance company for what kind of work they have been entrusted with.
Some insurance companies outsource the review through their 'subsidiaries', but the subsidiaries are not insurance companies, so pretending to be an insurance company employee is 'illegal' and complains to the insurance company.
Their job is to ‘check the facts of the accident and calculate the insurance amount’, and it is illegal to haggle for insurance money. If you feel any humiliation, refuse the examination and ask the insurance company to send an official employee. Illegal acts of an insurance company's reviewers cannot be punished, but the insurance company's joint responsibility for the illegal acts of its executives and employees. Refuse the high-pressure review and never sign the ‘Personal Information Use Agreement’. Disarm the moment you sign. This form is arbitrarily created by the insurance company, not based on the law.
If you sign this document, ask your insurance company to return it and ask for consent each time you access the victim's information in the future to prevent further infringement.
You must inform the medical institution that you must verify your identity when reading all medical records, and if the insurance company wants to see or copy the medical institution, you must accompany or provide it yourself.
If the insurance company suggests MRI scans, etc. / When the insurance company says that the cost of hospitalization for a single room and oriental medicine treatment is not covered by insurance, or when asking for discharge, say, “Give me an official document that contains the legal regulations and reasons for doing so.”
If the insurance company asks you to submit a seal certificate, limit the 'use' if you need to provide a seal certificate.
(If necessary, you can accompany the insured.) When giving other documents, receive a confirmation of what purpose they will be used, and request and receive a 'Memorandum' stating that the insurance company will be held liable in civil and criminal cases if it is used beyond that.
