Bilingual PIs occasionally conduct investigations on behalf of foreign travel insurance companies. Travel insurance covers injuries and illnesses, property damage, and theft during travel. In addition to research, interpreting, translation, and cross-cultural communication skills are required for insurance-commissioned research.
What is a travel insurance survey?
Travel insurance investigation is investigating the circumstances related to a travel insurance claim. It is conducted to verify evidence, certified documents, medical records, and eyewitness testimony submitted by the insured to ensure fair claims payment and to prevent insurance fraud.
Difficulties in Overseas Insurance Investigations
Language, culture, and law differences: Language barriers must first be resolved. Countries have different insurance industry rules, and cultural barriers and other legal systems may limit the ability to make inquiries and collect testimonials at local police, medical facilities, and related facilities. Geographic constraints: geographic gaps can make access to insureds and related parties difficult and costly in field verification.
Overseas Insurance Certification Process
The general flow of the overseas insurance investigation process is as follows.
- Report of accident or damage: The insured informs the insurance company of the accident or injury abroad.
- Submit insurance claim: The insured person submits an insurance claim form and documentary evidence (medical certificates, accident certificates, damage reports, etc.) to the insurance company.
- Start of investigation: The insurance company starts the investigation. The insurance company’s representative may contact you, or an outsourced investigator or specialized investigation company may conduct the investigation. The investigation aims to confirm the facts of the accident or damage and the validity of the insurance payment.
- Gathering of evidence: The investigator will confirm the situation and testimony of those involved and verify the authenticity of the documents submitted. The insured may be required to submit additional materials or evidence.
- Review and Decision: The insurance company reviews the investigation results and decides whether to pay claims. The decision is based on the terms and conditions of the insurance policy, as well as laws and regulations.
- Claim Payment: If the insurance company approves the claim, the claim will be paid to the insured.
Documents Submitted to Travel Insurance Company
The following is an example of the inquiry documents that the insurance company may require the insured.
- In case of injury or illness
- Medical certificates (diagnosis, prescriptions, receipts, etc.) received during the trip
- In case of accidental injury, documents or testimonies proving the circumstances and circumstances of the accident
- In case of theft or loss
- Police report or theft report
- In case of cancellation, postponement, or delay
- Certificate of postponement, a notice of change of reservation, a certificate of delay, itinerary, etc., for airplanes, trains, etc.
Barriers to Insurance Investigation in Japan
This section describes common barriers to conducting travel insurance surveys in Japan on behalf of insurance companies outside Japan.
Cooperation between International Branches of Insurance Companies
Multinational insurance companies such as AXA, Prudential, and AIG have affiliates worldwide. However, since the insurance company in the country where the insured has contracted with the insurer handles insurance payments, there needs to be coordination among affiliates in different countries in the investigation and payment of insurance. For example, suppose a British traveler meets with an accident in Japan and files a claim for medical expenses. In that case, the contracting country is the UK, so the UK insurance company is responsible for insurance investigation and payment. Even if that insurance company has an affiliate in Japan, an employee of the Japanese affiliate will not oversee the investigation. The insured may complain about this. However, it should be remembered that affiliated companies across borders do not work together on individual cases.
Power of Attorney Issues
A power of attorney from the insured is required to verify the documents submitted and to obtain testimonials from the relevant authorities. In the procedures of out-of-country insurance companies, a document called a Singed Release is usually prepared as the power of attorney of the insured. This document is based on the concept that the person with a power of attorney delegates the authority to obtain his/her information in general to the bearer. However, in Japan, data is often only disclosed if it is clear who specifically delegates what authority to whom. Furthermore, many Japanese authorities will only recognize a power of attorney as valid if it is written in Japanese, which is the biggest barrier to the progress of the investigation. To overcome this cultural and legal barrier, the Japanese investigator has to persistently coordinate with the insurance company, the insured person, and the relevant Japanese authorities.
Investigation at Hospitals
Requests to interview the doctor in charge at Japanese general hospitals are often denied. Obtaining copies of medical records and receipts of medical expenses is usually only possible. Smaller hospitals can obtain direct testimony from the doctor in charge. The health company may also instruct you to get a photograph of the doctor in charge and a copy of his/her ID, but many medical professionals are puzzled by the fact that even a picture is taken.
Verification of Circumstances of Accident
The following are some of the barriers to verifying the circumstances of an accident.
Accident Site
Commercial facilities and train stations require confirmation of the physical condition of the accident site, interviewing staff who witnessed the accident, and obtaining security camera footage. Often, the police will refuse to confirm the security camera footage. When the case is incidental, the police may seize the security camera footage. Information about the circumstances of the accident and what happened to the insured afterward will be reviewed.
Ambulance Destination.
When an accident occurs, the police and an ambulance are called. In Japan, taxpayers pay for ambulances, so everyone feels free to call an ambulance. In countries where ambulances are self-funded, ambulances may not be called. The nearest fire station has jurisdiction over ambulances. At the fire station, you can obtain a certificate called the “emergency activity processing book. This document certifies the date and time of transport, the location of the source, the location of the destination, and the name of the person transporting.
Police
The police will interview the officer in charge of the scene investigation. For cases officially investigated as incidents, there will be an incident report. An incident report is not prepared in cases with no criminal bodily injury or professional negligence. Instead, the police department can obtain the “110 Processing Record” document. This document certifies the content and date, and time of the call. However, the barrier to obtaining this document is high because it requires the foreign-insured person to write the application form in Japanese.
Summary
We have explained the overseas travel insurance investigation process and points to note when conducting an insurance investigation in Japan on consignment. The insurance company in the country where the insured has contracted will handle insurance payments, so the affiliated insurance companies in the local country where the accident happened do not collaborate in insurance investigation and payment. In Japan, institutions related to accidents and injuries, such as hospitals, police stations, and fire stations, have strict protocols for managing personal information. Therefore, testimonials and issuance of certification documents may not be permitted with the documents prepared by foreign insurance companies. Insurance investigators for international insurance cases must be familiar with cultural and legal barriers and be flexible in their investigations.
Please feel free to contact us for any of your insurance investigation needs.