保険金不払い 顧客軽視の悪弊を断ち切れ

The Yomiuri Shimbun February 17, 2014
Irresponsible practices of insurance firms must be thoroughly addressed
保険金不払い　顧客軽視の悪弊を断ち切れ（2月17日付・読売社説）

It is a problem if practices of making light of customers still remain in corporate culture in a leading nonlife insurer.
　顧客軽視の企業体質が根強く残っているとすれば問題である。

It came to light recently that Tokio Marine & Nichido Fire Insurance Co. had failed to partially pay out automobile insurance benefits that policyholders were entitled to over a period of more than 10 years.
　損害保険大手の東京海上日動火災保険が、自動車保険の保険金の一部を契約者に支払わず、１０年以上も放置していたことが判明した。

The unpaid cases concerned special benefits in auto insurance to cover extra costs, such as consolatory money to be paid to victims injured in accidents or otherwise. According to the insurer, there may be more than 100,000 special benefit policies left unpaid.
　不払いが見つかったのは、交通事故でけがをさせた相手への見舞金などを補償する特約で、１０万件を超える可能性もあるという。

Through an inspection of the life and nonlife insurance sectors led by the Financial Services Agency in 2005, nonpayment cases were discovered on an alarmingly large scale. The agency imposed a series of administrative punishments, resulting in a wave of corporate manager resignations.
　生命保険と損害保険では、２００５年の金融庁検査で大規模な不払いが発覚し、行政処分や経営トップの辞任が相次いだ。

With costly lessons learned, the insurance companies involved have taken measures to prevent a recurrence of nonpayments in the future.
　これを教訓に、保険各社は再発防止策を講じ、新たな不払いは起きにくくなっている。

However, it is a problem that Tokio Marine has decided to exclude the special benefits contracts when the company conducted internal inspections in 2005 and 2006.
　問題なのは、東京海上日動が０５～０６年に行った社内調査の対象から、これらの特約を除外していたことである。

Claiming that the company had applied the corporate rules of paying out the special benefits only if claims were made, Tokio Marine has still insisted that the company’s previous actions did not constitute nonpayment. However, this argument suggests that the company places the logic within its own circles rather than interests of its customers.
　当時は請求があった分だけに保険金を支払う社内ルールを適用していたとして、今も「不払いにあたらない」との説明を繰り返している。顧客の利益より、内輪の論理を優先した解釈と言えよう。

Some policyholders unfamiliar with insurance contracts failed to claim special benefits, which are in themselves quite diverse.
　保険に詳しくない契約者が、多種多様な特約の請求を忘れることもあろう。

Insurers must explain

Responsibility lies with an insurance company to clearly explain the contract to policyholders, ensuring they do not fail to make their claims when they are most likely to be in a state of confusion after being involved in an accident.
突然の事故に動揺する契約者に丁寧に説明し、請求漏れを防ぐことは、保険会社本来のサービスである。

Tokio Marine said the company changed its policy in July 2003 so that it would pay insurance benefits even if claims are not made. But the company failed to brief policyholders with the change in rules, at a time when they should have solved the nonpayment cases retrospectively.
　東京海上日動は０３年７月、請求がなくても保険金を支払うよう対応を変えたという。この時にルールの変更を対外的に説明し、過去の契約にさかのぼって不払いの解消を図るべきだった。

At a press conference, Tsuyoshi Nagano, president of Tokio Marine, said, “We did all we could at the time,” justifying the company’s actions in the past. It is not surprising that the policyholders who were unable to claim their insurance benefits may be left unconvinced with such an explanation.
　東京海上日動の永野毅社長は記者会見で「当時としては最善を尽くした」などと述べ、過去の対応を正当化した。この説明では保険金を受け取れなかった契約者は、納得がいかないのではないか。

Many of them are just as skeptical about the stance of the Financial Services Agency, which considers the insurer’s actions as “not being a problem.”
　金融庁が当時の対応を「問題なし」としている点も、不可解に感じる人は多いだろう。

Consumers may grow more distrustful of insurers that, while they have people sign insurance contracts by capitalizing on various kinds of special benefits, are unwilling to pay insurance benefits when accidents occur. To prevent such feelings, expectations are rising for Tokio Marine to explain itself and sincerely respond to policyholders.
　盛りだくさんの特約を売り物に契約させておいて、事故が起きると保険金を出し渋る――。そんな消費者の保険不信が高まらないよう、東京海上日動には、誠意のある説明と対応を求めたい。

Nagano has said that the company will flexibly deal with benefit payouts if claims are made from now on. But uncertainty hangs in the air because the company stores relevant data for nine years, meaning most of the data related to the unpaid special benefits have already been destroyed.
　永野社長はこれから請求があれば支払いに柔軟に応じる方針を示したが、実効性は不透明である。東京海上日動のデータ保管期間は９年で、当時の記録の大半が破棄されてしまったからだ。

Tokio Marine should do all in its power to remedy the situation by consolidating what details can be gleaned from memory of its employees and examining any remaining copies of relevant documents with great care.
　社員の記憶や書類のコピーなどを丹念に調べ、適正な支払いに全力を挙げねばならない。

Other nonlife insurance companies would do well to heed Tokio Marine’s case not just as “someone else’s misfortune” but as a wake-up call to look out for and address any outstanding nonpayment cases.
　他の損保各社も「対岸の火事」とせず、類似の不払いがないか、念入りに点検してほしい。

(From The Yomiuri Shimbun, Feb. 17, 2014)
（2014年2月17日00時04分 読売新聞）