How to Claim Compensation
Outline of CALI (Mutual Insurance) System
What is CALI (Mutual Insurance)?
The purpose of compulsory automobile liability insurance (CALI) and mutual insurance is to provide relief to victims of traffic accidents by compensating the financial burden owed by the at-fault party to ensure basic compensation for bodily injury. All motor vehicles (including motorized bicycles and electric scooters / kickboards, etc.) are required to be covered by this insurance.
Victims of accidents caused by uninsured vehicles and hit-and-run accidents are provided with relief through the Government’s Program Guaranteeing Compensation for Automobile Accidents.
Auto Liability Coverage Limits
CALI payments (mutual insurance payments), which are paid in proportion to damages, have payment limits for injury, residual disability, and death resulting from injury and death, respectively.
Damages for injury
Damages for injury include medical expenses, document fees, damages for missed work, and compensation for distress.
- Limit: 1.2 million yen per victim
- Compensation: Medical treatment expenses, nursing care fees, miscellaneous expenses, transportation expenses to and from hospital, prosthetic limb and other expenses, medical certificate and other expenses, document fees (Traffic Accident Certificate, seal registration certificate, etc.), damages for missed work, and compensation for distress
Damages for Residual Disability:
For damages for residual disability, lost earnings, compensation for distress, etc. are paid according to the degree of disability.
(1) Impairment requiring nursing care due to significant impairment of nervous system functions or mental or thoracic and abdominal organs
- Limit per victim:
Cases requiring continuous nursing care (Grade 1): 40 million yen
Cases requiring occasional nursing care: (Grade 2): 30 million yen
(2) Residual disability other than (1) above
- Limit per victim:
(Class 1): 30 million yen - (Class 14): 750,000 yen - Compensation: lost earnings, compensation for distress, etc.
Damages for Death:
Damages for death are paid as funeral expenses, lost earnings, and compensation for the victim and bereaved family members.
- Limit: 30 million yen per victim
- Compensation: Funeral expenses, lost earnings, and compensation for distress
Note: Damages for residual disability apply mutatis mutandis to damages for injuries resulting in death.
Reduction of Payments
In the following cases, the amount paid by CALI (mutual insurance) will be reduced.
- If the victim was grossly negligent
- If it is difficult to determine whether or not there is a causal relationship between the injury and death or residual disability
Cases in which CALI Payments (Mutual Insurance Payments) are Not Paid
Accidents that are 100% the responsibility of the victim (referred to as "no-fault accidents") are not covered by the other vehicle's CALI (mutual insurance) payment.
How to Claim
For claims for CALI payments (mutual insurance payments), etc., the victim may communicate directly with the non-life insurance company (mutual insurance association).
- Claim by the at-fault party
The at-fault party first pays compensation to the victim, and then claims the CALI payment (mutual insurance payment) from the non-life insurance company (mutual insurance association). - Victim's claim
If compensation is not received from the at-fault party, the amount of damages can be claimed directly from the at-fault party's non-life insurance company (mutual insurance association).
Even before the total amount of damages is determined, the victim can make a claim to the non-life insurance company (mutual insurance association) for the CALI payment (mutual insurance payment) within the limit amount any number of times, each time the victim pays medical treatment expenses to a medical institution, and each time the at-fault party compensates the victim.
Note: Lump-Sum Payment System
In many cases, the at-fault party has automobile insurance and mutual insurance (voluntary insurance and mutual insurance) in addition to CALI (mutual insurance). If so, the victim can receive the CALI (mutual insurance) in the event of a traffic accident without having to file a claim against the at-fault party or make a victim's claim for CALI (mutual insurance). The non-life insurance company (mutual insurance association) providing the automobile insurance/mutual insurance (voluntary insurance/mutual insurance) may pay the insured to the extent that it is liable for payment to the insured, including the CALI claim (mutual insurance) for the CALI/mutual insurance on behalf of the at-fault party. This is called the "lump-sum payment system" because the automobile insurance and mutual insurance (voluntary insurance and mutual insurance) pay compensation in a lump sum.
Time Limits for Claims
(1) Claim by the at-fault party
| Claim category | From when | Until when (date of completion of time limit for claims) |
|---|---|---|
|
Injury Residual disability Death |
Within three years of the day after payment of damages | Within three years of the day after payment of damages |
(2) Victim's claim
| Claim category | From when | Until when (date of completion of time limit for claims) |
|---|---|---|
| Injury | Occurrence of an accident | Within 3 years of the day after the accident |
| Residual disability | Fixation of symptoms | Within 3 years of the day after onset of symptoms |
| Death | Death | Within 3 years of the day after death |
Note: The limit for claims for CALI (mutual insurance) expires after three years, and the right to claim CALI insurance payments (mutual insurance payments) is extinguished. If the claim is delayed for some reason, please contact the non-life insurance company (mutual insurance association) to ask about the system for extending the limit for claims.
Note: However, for accidents that occurred on or before March 31, 2010, the claim period is limited to two years.
Note: "Fixation of symptoms" refers to the point where symptoms have stabilized and generally accepted medical treatment can no longer be expected to have any benefit, as determined by a doctor.
Determination of Insurance Amount
CALI (mutual insurance) is paid within a certain limit of CALI (mutual insurance) and other insurance coverage, depending on the degree of personal injury to the victim, in order to secure basic compensation for the victims of automobile accidents. In order to ensure prompt and fair payment of CALI payments (mutual insurance payments), etc., non-life insurance companies (mutual insurance associations) are required to make payments in accordance with the Criteria for Payment (Notification) set by the government for the respective amounts of damages for injuries, residual disabilities, and death.
If You Have Questions or Complaints About Payments
(1) Provision of information by non-life insurance companies (mutual insurance associations) to victims and policyholders
Non-life insurance companies (mutual insurance associations) are obliged to deliver to claimants in writing the payment of CALI claims (mutual insurance payments) (outline of Criteria for Payment, etc.). This allows a victim or CALI (mutual insurance) policyholder who claims payment of CALI claims (mutual insurance payments) to obtain necessary information within the scope of the Act on Securing Compensation for Automobile Accidents to ensure that the payment is made appropriately.
- When you file a claim, you are entitled to information on Criteria for Payment, CALI payment (mutual insurance payment) procedures, and an overview of the dispute resolution system.
- If payment is made, you are entitled to information on the amount of payment, the grade of residual disability and the reason for its determination, the percentage of reduction in the case of a reduction due to gross negligence and the reason for its determination, and the procedures for filing an objection.
- If CALI payments (mutual insurance payments) are not paid, you are entitled to information on the reason why.
In addition to the above, necessary additional (detailed) information can also be requested from the non-life insurance company (mutual insurance association).
(2) Filing an Objection
If you have any objection to the decision of the non-life insurance company (mutual insurance association), such as the amount of CALI insurance payment (mutual insurance payment) (grade of residual disability), you can file an objection with the non-life insurance company (mutual insurance association). For details of the system and specific procedures, please contact your non-life insurance company (mutual insurance association) or the General Insurance Association of Japan.
(3) Free consultation, settlement mediation, and review of damage compensation issues by attorneys
The Nichibenren (Japan Federation of Bar Associations) Traffic Accident Consultation Center provides free telephone and interview consultations by attorneys at 156 consultation centers nationwide (as of April 1, 2023) regarding the following issues related to compensation for damages in automobile accidents.
- Calculation of the amount of damages: existence or non-existence of liability; degree of negligence; recognition of the liable party:
- how to claim damages; CALI, mutual insurance and automobile insurance related issues; Government’s Program Guaranteeing Compensation for Automobile Accidents;
- other civil legal issues related to traffic accidents (how to settle, statute of limitations, etc.)
Telephone consultations:
Tel.: 0120-078325
Hours: Weekdays 10:00-16:30 Monday and Wednesday (except 5th week) - 19:00; 10 minutes per person
Closed: Saturdays, Sundays and national holidays
Interview consultations:
For more information on interview consultations, please contact the office directly. For contact information for each consultation center, please refer to the website of the Nichibenren Traffic Accident Consultation Center below.
For details, please visit the website of the Nichibenren Traffic Accident Consultation Center
(https://n-tacc.or.jp/)
or search for "Traffic Accident Consultation Center."
In addition, when the parties are unable to reach an agreement in negotiations for compensation for damages, Nichibenren attorneys will act as neutral and impartial intermediaries to help resolve the case by setting up a forum for discussion. Nichibenren offers settlement mediation and review procedures free of charge.
Note: If you are considering using the settlement mediation service, please have an interview at your local counseling center first. After the attorney determines whether the case is suitable for settlement mediation, the application procedure will be completed. The review procedure is for cases where settlement mediation is unsuccessful, and is subject to conditions of use. For more information, please visit the Center's website below.
(4) System for dispute resolution by a third-party organization
In the event of a dispute between a victim or policyholder and a non-life insurance company (mutual insurance association) regarding payment of CALI (mutual insurance payment) payments, the victim or policyholder may apply for conciliation at the Foundation Jibaiseki Handling of Disputes Mechanism. This is a general incorporated foundation that provides dispute resolution (conciliation) as a fair, neutral and expertly informed third party organization, in order to achieve a faster resolution than the usual judicial relief.
Foundation Jibaiseki Handling of Disputes Mechanism
Toll free: 0120-159-700
Tokyo Main Office: 11F, Ryumeikan Honten Building, 3-4 Kanda-Surugadai, Chiyoda-ku, Tokyo 101-0062, Japan
Osaka Branch: 2F, Moresco Honmachi Bldg. 3-2-15 Bingo-machi, Chuo-ku, Osaka, Osaka 541-0051
Business hours: 9:00-12:00, 13:00-17:00
Closed: Saturdays, Sundays, national holidays, and year-end and New Year holidays (December 28 to January 4)
For details, please visit the website of the Foundation Jibaiseki Handling of Disputes Mechanism
(https://www.jibai-adr.or.jp/ )
or search for "Handling of Disputes Mechanism."
(5) System for Notifying the Minister of Land,
Infrastructure, Transport and Tourism
If a victim or a CALI policyholder believes that their CALI claim payment from the insurance provider (whether an insurance company or a mutual insurance association) violates the Criteria for Payment, or that the provider has failed to provide adequate written information about these criteria, they may notify this to the Minister of Land, Infrastructure, Transport and Tourism under Article 16-7 of the Act on Securing Compensation for Automobile Accidents.
How to Resolve General Compensation Issues Between the Parties
When there is another party in a traffic accident, common methods of resolving compensation issues between the parties include the following.
Settlement
This is a method in which the parties talk with each other and resolve the issue by putting together a negotiated settlement on terms that are acceptable to both parties. It is the easiest solution, with the least cost and time burden.
mediation
This is a procedure in which a mediation committee member is present at the summary court to resolve the case through discussion, without the strict procedures of a trial.
Trial (Litigation)
In cases where the parties are unable to reach a resolution through discussions, the judge makes a factual determination based on the parties' specific arguments and evidence, and renders a legal judgment as to whether or not the parties are responsible for the accident, the degree of fault ratio, and the amount of compensation to be paid.
Court-Mediated Settlement
This is a judicial procedure that takes place when a party makes a court-mediated settlement offer or when the court recommends a settlement during a dispute in court, in which a judge stands between the parties and resolves the dispute through discussions.
When a settlement has been reached, the procedure to have the summary court prepare a court-mediated settlement agreement is called "summary settlement" in order to make the contents of the settlement enforceable (i.e., to enforce the contents of the settlement by seizing the other party's assets, etc., if the settlement is not honored).
Note: If you are considering these procedures, the automobile insurance company with which the victim has a voluntary policy may be able to provide consultation. We also recommend that you check the special terms and conditions of the automobile insurance policy that the victim has voluntarily contracted.
Note: Consultation is also available at Foundation Jibaiseki Handling of Disputes Mechanism, the Nichibenren Traffic Accident Consultation Center, the Japan Center for Settlement of Traffic Accident Disputes, and the Japan Legal Support Center.
Government’s Program Guaranteeing Compensation for Automobile Accidents
Under the Automobile Liability Compensation Law, the Government’s Program Guaranteeing Compensation for Automobile Accidents is a system under which the government (MLIT) will provide final relief to victims of hit-and-run accidents and uninsured (mutual insurance) accidents that are not covered by CALI (mutual insurance), when the victims still suffer damages even after receiving benefits from other social insurance such as health insurance and industrial accident compensation insurance (other legal benefits) and payment by the party responsible for damages.
Claims to the Government’s Program Guaranteeing Compensation for Automobile Accidents are accepted by non-life insurance companies (mutual insurance associations), so please contact your non-life insurance company (mutual insurance association) for details.
Claims Reception Desk
Insurance agents do not accept claims, so please make your request to the non-life insurance company (mutual insurance association) directly. (Listed in Japanese alphabetical order)
Major differences Between CALI (Mutual Insurance) and the Government’s Program Guaranteeing Compensation for Automobile Accidents
Compensation by the Government’s Program Guaranteeing Compensation for Automobile Accidents will be paid in accordance with the Criteria for Payment of CALI (Mutual Insurance). However, it differs from CALI (mutual insurance) in the following ways.
- Only the victim can file a claim. The at-fault party cannot file a claim.
- If payments from social insurance such as health insurance and industrial accident compensation insurance are to be received, such amounts will be deducted to compensate for the loss.
- The government will seek compensation for the victim from the at-fault party, etc, (the party responsible for damages) up to the amount of the payment.
Type of Claim (Claim Category)
Claims are classified into injury, residual disability, and death, depending on the circumstances of the damage.
The term "residual disability" refers to the mental or physical damage that remains when an injury sustained in an automobile accident is cured, and refers to symptoms for which a reasonable causal relationship between the injury and the residual disability is recognized, and the existence of which is medically recognized. Specifically, those that fall under Appendix 1 or 2 of the Enforcement Order for the Act on Securing Compensation for Automobile Accidents are covered.
Period During Which Claims May Be Made
| Claim category | From when | Until when (date of completion of time limit for claims) |
|---|---|---|
| Injury | Date treatment was completed | Within 3 years from the date of accident |
| Residual disability | Date of fixation of symptoms | Within 3 years from the date of fixation of symptoms |
| Death | Date of death | Within 3 years from the date of death |
Note: "The date of fixation of symptoms"refers to the point where symptoms have stabilized and generally accepted medical treatment can no longer be expected to have any benefit, as determined by a doctor.
Persons Who Can Claim (Claimants)
| Claim category | Claimant |
|---|---|
| Injury or residual disability | Victim |
| Death | Legal heirs and claimants of compensation for bereaved family members (spouse, children and parents of the victim) |
Note: If the victim is a minor at the time of the claim, the person with parental authority shall be the claimant. In addition, if the claimant is unable to perform the procedure in person due to severe residual disability, etc., procedures for the appointment of a guardian may be required.
Note: A claim for compensation of damages may be delegated to a third party.
Basic Documents Required for Claim
Depending on the claim category and the scope of damages, the documents listed in the following table are required. (Other documents may also be required.) For more details, please ask at the claims desk of the non-life insurance company (mutual insurance association).
Please note that the original of each document must be submitted, except for those marked "copy." (◎ indicates a document that must be submitted, and ○ indicates a document that must be submitted if necessary). Please use the forms for the documents marked with an asterisk (*) available at the counter of the non-life insurance company (mutual insurance association).
| Document name | Created/issued by |
Classification of claim | ||||
|---|---|---|---|---|---|---|
| Injury | Residual disability |
Death | ||||
| * | 1 | Purpose of Action at Time of Accident |
Claimant | ◎ | ◎ | ◎ |
| * | 2 | Claim for Compensation for Damages |
Claimant | ◎ | ◎ | ◎ |
| * | 3 | Confirmation of Claim for Personal Accident Compensation Insurance (Mutual Insurance) |
Claimant | ◎ | ◎ | ◎ |
| 4 | Copy of Family Register (removal from Family Register) (Notes 1 and 2) |
Municipality | ○ | ○ | ◎ | |
| * | 5 | Copy of Power of Attorney Agreement or Power of Attorney (Note 1) | Proxy | ○ | ○ | ○ |
| 6 | Memorandum of Understanding (Note 3) | Claimant | ○ | |||
| 7 | Traffic Accident Certificate (Note 4) (for claims to be treated as a personal injury accident) |
Japan Safe Driving Center | ◎ | ◎ | ◎ | |
| * | 8 | Accident Report | In principle, victims of accidents | ◎ | ◎ | ◎ |
| * | 9 | Letter of Intent | Accident victims | ◎ | ◎ | ◎ |
| * | 10 | Medical certificate (Note 5) | Hospitals & clinics | ◎ | ◎ | ○ |
| * | 11 | Medical fee statements (hospitalization) (Note 5) | Hospitals & clinics | ◎ | ◎ | ○ |
| * | 12 | Medical fee statements (inpatient/outpatient) (Note 5) | Hospitals & clinics | ◎ | ◎ | ○ |
| 13 | Pharmacy receipts (for out-of-hospital prescriptions) | Non-hospital pharmacies | ○ | |||
| 14 | Certificate of Treatment and statements of treatment expenses (Note 6) | Osteopathic clinics, bone-setting clinics, acupuncture and moxibustion massage clinics, etc. |
○ | ○ | ○ | |
| * | 15 | Copy of Health Insurance Card (Note 7) | Claimant | ○ | ||
| * | 16 | Hospital out-patient expenses statements |
Claimant | ◎ | ||
| 17 | Other documents proving damages, receipts, etc. | Relevant institution, receipt issuer, etc. | ○ | ○ | ||
| * | 18 | Letter of Intention to Claim for Damages for Missed Work | Claimant | ◎ | ||
| * | 19 | Certificate of Damages for Missed Work | Employer | ○ | ||
| 20 | Matters relating to all family members and their relationship to the victim Certificate of Residence (Note 8) |
Municipality | ○ | |||
| 21 | Medical Certificate of Residual Disability (Note 6) | Hospitals & clinics | ◎ | |||
| 22 | Postmortem Certificate or Death Certificate (Note 9) | Hospitals & clinics | ◎ | |||
| * | 23 | Instructions for Payment of Compensation Amount (Transfer Request Form) | Claimant | ◎ | ◎ | ◎ |
(Note 1) In the case of a claim by proxy, a copy of the Power of Attorney Agreement is required. If there is no Power of Attorney Agreement, a Letter of Attorney and a certificate of seal registration of the person claiming power of attorney are required. If the victim is a minor at the time of the request and his/her parents have parental authority, an extract from the Family Register (certified copy) confirming the parental authority is required. However, if the request is not made in joint names, a Letter of Attorney from one person with parental authority to the other person with parental authority and a certificate of seal registration are also required.
(Note 2) In the case of a death claim, please submit a copy of the Family Register (removal from Family Register) of the deceased person, with details from birth to death without omission in order to confirm the heirs. In addition, please submit a copy (or extract) of the Family Register of each legal heir and person entitled to claim compensation for bereaved family members (spouse, children, and parents of the victim).
(Note 3) Please submit this form if the legal heir is a minor at the time of the death claim. Forms are available at the reception desk of non-life insurance companies (mutual insurance associations).
(Note 4) Application forms are available at the nearest Japan Safe Driving Center as well as at police stations, police boxes, and police substations.
(Note 5) Medical certificates and medical fee statements from all hospitals where the patient was treated for the accident are required for the claim. If the insurer number or the symbol/number of the insured person are written, please mask them before submitting.
(Note 6) Available at the reception desk of non-life insurance companies (mutual insurance associations)
(Note 7) Please submit the form on the attached mounting sheet. Please mask the insurer number and insured person symbols/numbers before attaching.
(Note 8) A Certificate of Residence is required only when claiming damages for missed domestic work.
(Note 9) If it is difficult to submit the original document due to circumstances of the preparer/issuer, please contact the reception desk of the non-life insurance company (mutual insurance association).
For details of the claim documents, etc., please refer to the website of the General Insurance Rating Organization of Japan (GIROJ).
Compensation Cases Not Covered by the Government’s Program Guaranteeing Compensation for Automobile Accidents
Please note that the following cases are not covered by the Government’s Program Guaranteeing Compensation for Automobile Accidents, even if you file a claim.
- If a settlement regarding a personal injury accident has been reached between the victim and the at-fault party, and the terms of the settlement have been fulfilled, and compensation has been paid to the victim.
- If you were injured in a self-inflicted accident (if the Traffic Accident Certificate that the accident was a "single vehicle/turnover" accident, or if the existence of another vehicle or a causal relationship with another vehicle is not recognized)
- If the total of the deduction due to the victim's gross negligence, the amount of benefits provided under other laws and regulations, and the amount payable by the party responsible for damages exceeds the total amount of damages
- If the accident was caused by the victim's unilateral negligence (in the case of an accident caused 100% by the victim's negligence)
- If the total amount of benefits under other laws and regulations such as health insurance and industrial accident compensation insurance, as well the amount of damages payable by the party responsible for damages, is the statutory limit (the same as CALI (mutual insurance) specifically, 1.2 million yen for injury, 30 million yen for death, and 750,000 to 40 million yen for disability depending on the degree of residual disability)
- If the residual disability does not reach or does not correspond to the grade stipulated in the Act on Securing Compensation for Automobile Accidents
- If the victim's right to claim against the Government’s Program Guaranteeing Compensation for Automobile Accidents has already been extinguished due to the expiry of limit for claims
- If you are a passenger in the victim's vehicle and can make a claim to CALI (mutual insurance) in cases such as those where the victim's vehicle is also at fault
- In the case of a multiple-vehicle accident, where the claim can be made against the CALI/mutual insurance of any one of the vehicles
- If the offending vehicle is a small special motor vehicle for agricultural work (such as a small cultivator) or a light vehicle (such as a bicycle) or other vehicle type that is not covered by CALI (mutual insurance)
- If you have already received payment for the damage from automobile insurance or mutual insurance (voluntary insurance or mutual insurance)
- Damage to property (e.g., damage to a vehicle)
Standards for Damage Compensation under the Government’s Program Guaranteeing Compensation for Automobile Accidents
MLIT has established legally based compensation standards to ensure fair and prompt payment, as for CALI (mutual insurance). The compensation standards are set in accordance with the Criteria for Payment for CALI (Mutual Insurance), and the amount of compensation is calculated by totaling the damages within the legal limit.
Since the Government’s Program Guaranteeing Compensation for Automobile Accidents is a final remedy, by law, the amount of benefits under other laws and regulations, such as health insurance and industrial accident compensation insurance, as well as the amount paid by the party responsible for damages, are deducted.
For more information, please refer to the PDF file " Standards for the Compensation for Damages by the Program Guaranteeing Compensation for Automobile Accidents[PDF/265KB]."
Please use this information to ease your
concerns and for support.
If You Are Involved in a Traffic Accident
The Ministry of Land, Infrastructure, Transport and Tourism (MLIT) has prepared a pamphlet titled "If You Are Involved in a Traffic Accident." This pamphlet informs and guides people who have been involved in a traffic accident about various systems and procedures. The challenges you face due to a sudden traffic accident will change over time. Please use the information in this pamphlet according to your situation at the time.
Traffic Accident Victim's Notebook
MLIT has created the “Traffic Accident Victim's Notebook” with the hope of providing support to automobile accident victims. The notebook allows victims and their families to record accident details and provides information about support systems available through police, local governments, and private victim support organizations. We also hope that it will provide support to all accident victims, and help to ease their concerns.