Protection of Personal Information

PwC Health Insurance Society (hereinafter referred to as "the Society") not only provides health insurance benefits to its insured persons and dependents, but also provides various other health services to maintain and promote their health. In order to fulfill our responsibilities and to maintain your trust, we respect the following policy on personal information protection and ensure appropriate handling and protection of your personal information.

Fundamental policy on the protection of personal information (Privacy Policy)

PwC Health Insurance Society (hereinafter referred to as "the Society") makes efforts to safeguard members' personal information (hereinafter referred to as "personal information") as follows:

  • The Society takes appropriate measures to safeguard personal information against divulgence, loss, damage or improper access.
  • The Society uses personal information provided by members solely for purposes considered beneficial for members, such as health maintenance and promotion. It also uses Individual Numbers only for the purposes specified in the Act on the Use of Numbers to Identify a Specific Individual in Administrative Procedures.
  • Unless it has obtained prior consent from a member, the Society will not provide personal information to any third party. It will also not provide personal information containing Individual Numbers (hereinafter referred to as "identifying personal information"), even if the individual has consented, except in cases specified in the Act on the Use of Numbers to Identify a Specific Individual in Administrative Procedures. However, in the following cases, it may provide personal information on members other than identifying personal information to third parties without obtaining prior consent from the members:
    • As stipulated by law or regulation,
    • When needed to protect the life, safety, or property of an individual in cases in which obtaining the consent of the member would be difficult,
    • When needed to improve public health or to promote the healthy growth of children in cases in which obtaining the consent of the member would be difficult, and
    • When needed to cooperate with national governmental bodies or local governmental authorities, or parties entrusted by national governmental bodies or local governmental authorities to execute affairs as specified by law or regulation in cases in which obtaining the consent of the member could impede their execution.
  • In addition to training of, and raising awareness among, employees regarding personal information protection, the Society will strive to manage personal information appropriately by assigning responsible persons for such management in each section that handles personal information.
  • When subcontracting its business operations, the Society will carry out reviews and implement improvements to strengthen personal information protection measures.
    When concluding business subcontracting agreements, it will carefully examine the competence of subcontractors and consider issues relevant to personal information protection in the content of such agreements.
  • The following contacts are available for inquiries, consultations, claims, and cessation of use regarding the handling of personal information. We will address them as quickly as possible, within a reasonable range.
  • In addition to complying with laws, regulations, and other standards concerning the handling of members' personal information, the Society continually reviews and strives to improve the content of this Privacy Policy.

Personal information held by the Society

Types of personal
information
Content of information
Related to
certification
  • Symbol/number, name, date of birth, gender, individual number, number of insured person, address, telephone number, e-mail address, bank account information
  • Date of eligibility/loss of eligibility, remuneration/bonus amount, dependent(s), income of the previous fiscal year, employee number
*(For dependents) In addition to the above, information on the relationship concerning their livelihood (relationship, living together or not etc.)
Related to insurance
benefits
(benefits-in-kind)
  • Information on the medical bill
    (Information on the date/number of days of medical consultation, name and address of the medical institution, name of the illness or injury, content of the medical consultation, and medical costs)
Related to insurance
benefits
(cash benefits)
  • Information related to medical care expenses, transportation expenses etc.
    (Information on the details of therapeutic equipment and the date of applying them, information regarding visits to judo therapists, massager, acupuncturists, moxa or shiatsu massage therapists, reasons/cost of transportation, and reasons for other applications)
  • Information related to injury and sickness allowance
    (Information on the name of the disease/injury, period of disability to work, income during the period of disability to work, amount of pension benefits, work attendance, and the doctor's opinion)
  • Information related to maternity allowance/ childbirth and childcare lump sum grant
    (Information on the date of birth, work attendance, income during the period of disability to work, and childbirth procedures)
  • Information related to funeral expenses
    (Information on the date of death, funeral costs, and expense claims)
Related to health
services
  • Information related to health checkup and health guidance (including specific health checkup/specific health guidance, and Collabo-Health with other service providers)
    (Dates, name and address of the medical institution, results of the health checkup and consultation, results of health guidance)

Purpose of use of personal information

  • Purposes concerning the provision of insurance benefits to insured persons etc.

    (Examples of use within the Society)

    • To check eligibility as insured persons, certify dependents, issue health insurance cards
    • To provide insurance and additional benefits
    • Utilization as stipulated in the Act on the Use of Numbers to Identify a Specific Individual in Administrative Procedures

    (Examples of use entailing provision of information to other service providers)

    • Payment to the payroll account (the employer) to enable automated payment of highcost medical care benefits, partial cost-sharing reimbursements, etc.
    • To subcontract translation related to medical care costs incurred overseas to outside parties
    • To submit claims to casualty insurance companies or other parties for damages attributable to the actions of a third party
    • To engage in joint operations to provide benefits for high-cost medical care by the National Federation of Health Insurance Societies
    • Information-sharing as stipulated in the Act on the Use of Numbers to Identify a Specific Individual in Administrative Procedures
    • To subcontract data processing regarding the eligibility of insured persons to outside parties
  • Purposes concerning collection of insurance premiums, etc.

    (Examples of use within the Society)

    • To ascertain standard monthly remuneration and standard bonuses
    • To collect health insurance premiums, long-term care insurance premiums, and adjusted insurance premiums
  • Purposes related to health services

    (Examples of use within the Society)

    • To enable health screenings, health guidance, and health consultations for health maintenance and promotion
    • To provide specified health checkups and health guidance
    • To implement health promotion activities (events etc.)

    (Examples of use entailing the provision of information to other service providers)

    • To implement specific health checkups and health guidance and report the results to the government
    • To subcontract health guidance and health consultations to industrial physicians
    • To subcontract health checkups to medical care institutions
    • To subcontract the implementation of health promotion activities (events etc.)
    • To provide health checkup results to service providers, as part of Collabo-Health
    • To notify medical costs to insured persons etc.
  • Purposes related to screening and payment of service fees

    (Examples of use within the Society)

    • To check or review the content of medical bills etc.

    (Examples of use entailing the provision of information to other service providers)

    • To subcontract checks/reviews of the content of medical bills
    • To subcontract data entry for computer processing of the content of medical bills, image loading/processing
  • Purposes to ensure the stability of Health Insurance Society operations

    (Examples of use within the Society)

    • Analysis of medical costs and diseases

    (Examples of use entailing the provision of information to other service providers)

    • To subcontract data processing and other activities related to analysis of medical costs and notification of medical costs
    • To engage in medical cost analysis projects of the National Federation of Health Insurance Societies
  • Others

    (Examples of use within the Society)

    • To prepare basic data for maintaining and improving operations related to management and administration of the Health Insurance Society

    (Examples of use entailing the provision of information to other service providers)

    • To engage in consultations with or notification of insurers, medical care institutions, etc. when demanding compensation from third parties
  • Specific personal information
    Purposes of use concerning information-sharing with other insurers or administrative agencies (hereinafter referred to as "other agencies"), as stipulated in Act No.7 Article 19 of the Act on the Use of Numbers to Identify a Specific Individual in Administrative Procedures

    (When receiving information from other agencies for the purpose of the Society's administrative work)

    • Information on the insurance benefits related to screening for sickness and injury allowance, high-cost medical care benefits etc.
    • Information on tax payments related to the classification of elderly insured persons
    • Information on other agencies' eligibility standards of insured persons for the certification process
    • Information on taxation related to certification process of dependents, information related to the certificate of residence etc.

    (When the Society provides information to other agencies for their administrative work)

    • High-cost medical care benefits, maternity allowance, funeral fee and other information related to insurance benefits that concern other agencies
    • Eligibility, certification of dependents, and other information related to eligibility and certification of dependents that concern other agencies

Joint use of personal information

  • Sharing the information of health checkup results with the employer

    • Purpose of joint use of personal information

      • PwC Health Insurance Society will utilize health checkup results and health guidance based on the health checkup results and collective disease analyses of the insured persons etc. in order to effectively provide health guidance and health education to the insured persons etc.
      • The employer ensure the provision of routine health checkups in compliance with the Industrial Safety and Health Act and will take subsequent measures based on the health checkup results.
    • Items of personal information to be jointly used

      • The name, date of birth, gender, name of the employer, date of health checkup, name of the medical institution at which health checkup was performed, examination results, findings, etc.
  • Sharing the information related to high-cost medical care benefits with the National Federation of Health Insurance Societies

    • Purpose of joint use of personal information

      • If the services that are provided jointly by the National Federation of Health Insurance Societies and PwC Health Insurance Society results in high-cost medical cost burden for PwC Health Insurance Society, the Society will receive a part of the medical cost, based on the Article 2 of the Supplementary Provisions of the Health Insurance Act
    • Items of personal information to be jointly used

      • Items in the medical bill (name, gender, insured person/family, inpatient/outpatient, duration of medical consultation, total invoice amount etc.)

Providing personal information to third parties

The Society will not provide an insured person's personal information to a third party without the consent of the insured person. However, based on laws and regulations, the information may be provided to a third party without his/her consent in the following cases. Meanwhile, if the said information is specific personal information, the information will not be provided to a third party with or without the consent of the insured person, pursuant to Article 19 of the Act on the Use of Numbers to Identify a Specific Individual in Administrative Procedures.

Exceptions to the rules on the provision of information to third parties

  • Cases in which the provision of personal data is based on laws and regulations
    If the provision of information is required based on laws and regulations, e.g. in the case of an on-site inspection stipulated in Articles 29 and 188 of the Health Insurance Law.
  • Cases in which the provision of personal data is required to protect the life, safety, or property of an individual, and in which obtaining immediate consent from the person would be difficult
  • Cases in which the provision of personal data is especially important to safeguard public health or to promote the sound growth of children, and in which obtaining immediate consent from the person would be difficult
  • Cases in which the provision of personal data is required to comply with a government body, local governmental authorities, or an individual or a business operator entrusted by a government body or local governmental authority to execute the affairs specified by laws and regulations and in which obtaining consent from the person would likely impede their execution

Please be aware that notification of medical costs is and will continue to be prepared for each household, considering the benefits to the insured persons etc. and the administrative burden of the service providers in a comprehensive manner. High-cost medical care benefits and additional benefits are provided with or without application. If you find these arrangements inconvenient, please contact the Society (TEL 03-6380-1610).

Disclosure, correction, or cessation of use of personal data

Regarding our policy for disclosure, correction, or cessation of use of personal data, please contact the Society for more information.
However, we will not be able to disclose information in the following cases, following the laws and regulations.

Exceptions for disclosure

  • If there is a risk of imposing harm to the life, body, property, and other rights and interests of the insured person or third parties.
  • If there is a risk of significantly obstructing the Society's appropriate operations
  • If it violates laws and regulations

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