Sony Health Insurance Society

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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

If an insured person is unable to work, undergoes treatment for a nonoccupational sickness or injury, and is unable to earn a salary or other income (or his or her income falls below the amount of injury and sickness allowance) during this time, he or she will be paid insurance benefits to help cover his or her costs of living.

 Injury and Sickness Allowance Additional Sum

The Society also pays an injury and sickness allowance additional sum as its own independent benefit (additional benefit).

Conditions for payment

The injury and sickness allowance and injury and sickness allowance additional sum are paid when all three of the following conditions are met:

  • You are unable to work because you are being treated for and recovering from sickness or injury.
    This means you are unable to do your previous job because you are recovering from your sickness or injury.
    • * This benefit is not paid if you are taking time off at your own discretion without undergoing treatment at a medical care institution (i.e., if the case has not been certified by a medical care institution).
  • You have taken off at least four days (of which the first three were consecutive days off).
    Payment of this benefit begins on the fourth consecutive day off. The first three days are a waiting period. No benefits are paid for those days.
  • You are unable to earn a salary or other income during your time off work.
    Even if you are receiving a salary or other income from the company, if the amount of such income is less than the injury and sickness allowance, the Society will pay the difference.

Payment period

Up to 18 months from the date of first payment (paid for calendar days, not total days off work).

Amount paid

The amount shown below will be paid per day away from work.

Extended injury and sickness allowance additional sum

If you are unable to work due to failure to recover even after the end of the period of payment of injury and sickness allowance and injury and sickness allowance additional sum, the Health Insurance Society will pay this benefit for up to 18 months.

Conditions for payment

The extended injury and sickness allowance additional sum is paid when all three of the following conditions are met:

  • You are unable to work because you are being treated for and recovering from a sickness or injury, even after the end of the period for which the injury and sickness allowance and injury and sickness allowance additional sum are paid.
    This means you are unable to do your previous job because you are recovering from the sickness or injury.
    • * This benefit will not be paid if you take time off at your own discretion without undergoing treatment at a medical care institution (i.e., if the case has not been certified by a medical care institution).
  • You are unable to earn a salary or other income during your time away from work.
    Even if you are receiving a salary or other income from the company, if the amount of such income is less than the injury and sickness allowance, the Society will pay the difference.
  • You remain employed by the company.
    This benefit will not be paid after you leave your job.

Payment period

Up to 18 months from the day after the ending date of the period of payment of injury and sickness allowance and injury and sickness allowance additional sum (paid for calendar days, not total days off work).

Amount paid

Adjustments vis-a-vis other benefits

In addition to salary or other pay from your employer, the amount of the benefit paid will be adjusted if you receive the following benefits:

Type of benefit Adjustment method
Adjustment for Disability Employees’ Pension If the amount equal to 1/360 of the amount of Disability Employees’ Pension (the total of both pensions for those receiving the Disability Basic Pension) is less than the daily amount of the injury and sickness allowance, the difference will be paid.
Adjustment for old age or retirement pension If the amount equal to 1/360 of the old age or retirement pension is less than the daily amount of the injury and sickness allowance, the difference will be paid.
Adjustment for childbirth allowance The childbirth allowance takes priority; payment of the injury and sickness allowance will be suspended. However, from April 1, 2016, if the amount of childbirth allowance is less than the amount of the injury and sickness allowance, the difference will be paid.
Adjustment for absence from work compensation benefit from Worker’s Accident Compensation Insurance If the daily amount of absence from work compensation benefit is less than the daily amount of the injury and sickness allowance, the difference will be paid.

Continuing to receive the injury and sickness allowance after leaving your job

You can continue to receive the injury and sickness allowance even after losing your eligibility for coverage because you leave your job if you meet certain other conditions:

  • * However, in such cases only the injury and sickness allowance will be paid. The Society’s additional benefits (injury and sickness allowance additional sum and extended injury and sickness allowance additional sum) will not be paid.

Conditions for payment

You can continue to receive the injury and sickness allowance if you qualified as an insured person for a continuous period of at least one year through the day before the date on which you lost your eligibility for coverage and if all of the conditions 1–4 below are met.

  • * Even if you joined the Health Insurance Society less than one year ago, if the date on which you lost eligibility for coverage under your previous health insurance is the same as the date on which you gained eligibility for coverage with the Society, you can combine the two periods. However, you cannot combine periods for which you were insured under the Voluntary Continuation Health Insurance System or a mutual aid association.
  • On the date on which you left your job, you must have been receiving or have been eligible to receive the injury and sickness allowance (e.g., you were taking time away from work with pay). (You are not eligible if you worked even half a day on the date on which you left your job.)
  • You must remain unable to work even after leaving your job due to the same condition for which you received the injury and sickness allowance while employed (includes cases of identical conditions and causes, even if the name of the condition has changed).
    • * This benefit will not be paid if you are taking time off at your own discretion without undergoing treatment at a medical care institution (i.e., if the case has not been certified by a medical care institution).
  • No more than 18 months have passed since you began receiving the injury and sickness allowance.
    You cannot receive the allowance intermittently after leaving your job. (If you were ineligible for the allowance for even one day, you cannot receive it again thereafter, even if you are unable to work again due to the same condition. A day on which you were unable to receive the allowance refers to a day on which you worked or a day for which doctor will not certify that you were unable to work.)
  • You must not be receiving unemployment benefits (employment insurance)
    Receipt of unemployment benefits after leaving your job means that the Public Employment Security Office recognizes that you are willing and able to work. In such cases, you cannot receive this allowance, for which the inability to work is a requisite.
  • You are ineligible if you are a Special-Case Retired Insured Person.
    You are not eligible for the injury and sickness allowance if you retired and became a Special-Case Retired Insured Person by joining Sony’s Medical Care System for Retired Persons.

Adjustments vis-a-vis other benefits

See here.

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 at your establishment for more information.

  • *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).

Expiration of health insurance benefits

The right to claim health insurance benefits expires in two years. For the injury and sickness allowance, this time frame is deemed to begin on the day after each date on which you were unable to work (pursuant to Article 193 of the Health Insurance Act).

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