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Health insurance benefits
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If you take time off from work due to sickness

“Injury and Sickness Allowance” is paid when an insured person unable to earn a salary or other income while unable to work due to a nonoccupational sickness or injury.

Injury and Sickness Allowance

When an insured person is unable to earn a salary or other income while taking time off work due to a nonoccupational sickness or injury, insurance will pay him or her as statutory benefits an amount equal to two-thirds of his or her average standard monthly remuneration over the most recent 12-month period ÷ 30 per day off work, to help protect the livelihood of the insured person and his or her family.

The Suntory society's additional benefits: “Injury and Sickness Allowance Additional Sum”

the Health Insurance Association also provides its own independent benefits (additional benefits) in addition to the Injury and Sickness Allowance in the amount equal to 85% of the average standard monthly remuneration over the most recent 12-month period ÷ 30 per day off work.

Conditions for payment

This benefit is paid when all four of the following conditions are met.

1 You are recuperating under doctor’s instructions, either on an inpatient or an outpatient basis, for sickness or injury.
Not including occupational sickness or injury or those sustained during the commute to or from work
2 You are unable to work.
You have a certificate from your doctor stating that you are unable to work.
3 You have taken at least three consecutive days off.
Payment of this benefit begins on the fourth consecutive day off. The first three days are a waiting period.
4 Your salary is not being paid (not including cases of occupational sickness or injury).
You are not eligible if even part of your salary is being paid—for example, if you take only part of the day or a half-day off.

Cases in which you are eligible to receive the Injury and Sickness Allowance and Maternity Allowance concurrently

If you become eligible to receive the Injury and Sickness Allowance and Maternity Allowance concurrently, payment of the Maternity Allowance will be granted priority.

If you become eligible for Disability Employees’ Pension

If you become eligible to receive Disability Employees’ Pension under Employees’ Pension Insurance (including the Disability Basic Pension under the National Pension program), payment of the Injury and Sickness Allowance will end.
Injury and Sickness Allowance benefits will not be paid after retirement if you receive Old-Age Employees’ Pension or similar benefits.
However, in either case, if the Maternity Allowance paid is less than the Injury and Sickness Allowance, the difference between the two amounts will be paid.

If the cause is a workplace accident

If the cause is an accident at the workplace or while commuting, Worker's Accident Compensation Insurance applies instead of health insurance. Check with the person responsible for more information at your establishment.

  • *When even illnesses and injuries on-the-job are not targeted for benefits of the Worker's Accident Compensation Insurance, benefits of the health insurance are provided except the duties as the officer of the corporation (except for a corporation less than five employees).

Caution

The right to claim health insurance benefits expires in two years.

There is no frequently asked questions and answers that have been registered.

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