February 18, 2022

To The General Insurance Association of Japan

IKEDA Satoshi, Director of the Insurance Business Division
Supervision Bureau, Financial Services Agency

Responses to COVID-19 Patients Caring for Themselves at Home Using Kanagawa Prefecture's Self-Caring Notification System (Request)

In light of the current seriously tight circumstances faced by medical institutions and health centers, Kanagawa Prefecture (the "Prefecture") has introduced the Self-Caring Notification System (the "System") to allow suspected COVID-19 patients to care for themselves at home without seeing physicians or receiving support from health centers when they test positive using an over-the-counter antigen test kit, etc.

The Governor of Kanagawa Prefecture issued a request as shown in the Attachment to enable users of the System to make insurance claims to private insurance companies.

According to the explanations given by the Prefecture, the System is for managing the self-caring of patients infected with COVID-19 as an emergency measure. It has been formulated under the supervision of physicians, based on the circulars issued by the Ministry of Health, Labour and Welfare and recommendations by experts of the advisory board, by obtaining approval from the Kanagawa Prefectural Infectious Disease Control Council. The System has the following characteristics:

・When receiving a notification, a prefectural government official checks the presented image so as not to accept any notifications from persons other than those testing positive.

・A notifier is required to submit a test result, such as an image of an antigen test kit showing a positive result, for an examination, and therefore basic information similar to physicians' reports of their positive diagnoses is collected.

・Service offices are established to enable daily monitoring via SNS or by phone (AI call) and responses by physicians at any time, thereby ensuring appropriate responses by physicians as necessary.

・The Prefecture is planning to issue an original certificate to users of the System.
Given these, it would be possible to include users of the System in the coverage of "deemed hospitalization,"(*) which general insurance companies are currently adopting as a flexible interpretation and application of insurance conditions in relation to COVID-19.

*Treating cases where patients care for themselves at home based on physicians' diagnoses as cases where they are hospitalized as defined in insurance conditions.

Please properly inform the members of your association so that general insurance companies will surely consider appropriate actions based on the aforementioned effects.

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