コミサポ - 民間保険の請求漏れサポート

くらしごとDr.の「せいど窓口」は、制度調査事務所コミットサポート

「民間保険の請求漏れを調べ、請求できるようにアドバイス・支援を行うサービス」です。

つまり、保険金を代わりに請求する（代行）業務ではなく、調査と助言を中心にした業務になります。

It is a service that investigates missed private insurance claims and provides advice and support so that claims can be made.

In other words, it is not a service of claiming insurance money on behalf of others (acting as an agent), but rather a service that focuses on investigation and advice.

あなただけではありません。　世の中、こんなに保険会社の “支払漏れ／請求案内漏れ”があるんです。

保険会社の “支払漏れ／請求案内漏れ” の公表例

複数の生命保険会社が、支払った保険金・給付金について後から“支払漏れ／請求案内漏れ”が判明して追加支払いを行った件数・金額を公表しています。

例えば：

第一生命：2024年度で 59件・2,100百万円（21億円）の追加支払いを実施。うち、内部発見分 30件・600百万円（6億円）、外部（契約者申出等）発見分 29件・1,500百万円（15億円）
アフラック：支払漏れ・請求案内漏れが判明した事象について、契約者への追加支払い実績あり
メットライフ生命：2021年度で支払漏れ 24件・5百万円（500万円）などの報告あり
MS＆AD（MSA生命他）：2024年度で 42件・10百万円（1,000万円）の支払漏れ等、うち給付金関連は 30件・3百万円（300万円）

You're not alone. There are so many insurance companies out there who "miss out on payments" and "miss out on providing claims information."

Examples of Insurance Company Disclosures of Missed Payments/Claims

Several life insurance companies have disclosed the number and amount of additional payments they made after discovering missed payments/claim notification for claims that had already been paid.

For example:

Dai-ichi Life: In fiscal year 2024, it made additional payments totaling ¥2.1 billion in 59 cases. Of these, 30 cases totaling ¥600 million were discovered internally, and 29 cases totaling ¥1.5 billion were discovered externally (through policyholder requests, etc.).

Aflac: Has made additional payments to policyholders for cases where missed payments/claim notification were discovered.

MetLife: In fiscal year 2021, it reported 24 missed payments totaling ¥5 million.

MS&AD (MSA Life, etc.): In fiscal year 2024, it reported 42 missed payments totaling ¥10 million, of which 30 cases totaling ¥3 million were related to benefits.

契約者視点での請求漏れリスク

特約部分（がん特約、通院給付、先進医療特約など）を認識せず、請求し忘れる
➀入院・手術をしたが「保険適用でない／支給対象外だと思った」ため請求せず
②死亡後、遺族が契約一覧を把握できず請求権を行使できない
③書類準備・手続きが煩雑で、体調不良や忙しさで後回しになり、期限（時効）を経過
④契約更新・特約改定の際に契約内容（保障範囲）を理解できていない
これにより、「もらえるはずの保険金・給付金を請求できずに終わる」ケースが散見されます。

Risk of missed billing from the policyholder's perspective

Not being aware of special provisions (cancer rider, outpatient benefits, advanced medical treatment rider, etc.) and forgetting to claim them

➀ Being hospitalized or undergoing surgery, but not claiming because "I thought it wasn't covered by insurance/was not eligible for payment"

② After death, the surviving family members are unable to understand the list of contracts and are unable to exercise their right to claim

③ The paperwork and procedures are cumbersome, and due to poor health or being busy, they are put off, allowing the deadline (statute of limitations) to pass

④ Not understanding the contract contents (scope of coverage) when renewing the contract or amending the special provisions As a result, there are many cases where "people end up not being able to claim the insurance money or benefits they should have received."

民間保険の請求漏れの現状

多くの人が、入院・手術・通院・死亡・がん治療などで保険金を請求し忘れているのが現実です。
調査によると、加入者の約3〜4人に1人が何らかの請求漏れを起こしており、特に次のようなケースが目立ちます。

　➀特約（がん・先進医療・通院・骨折・後遺障害など）を請求していない
　②家族が亡くなり、契約内容や保険会社を把握できていない
　③体調不良や忙しさで手続きを後回しにし、時効（3〜5年）を過ぎてしまう
保険は「入って安心」ではなく、請求してはじめて意味がある資産です。

The current situation regarding missed claims for private insurance

The reality is that many people forget to claim insurance benefits for hospitalization, surgery, outpatient treatment, death, cancer treatment, and more. According to a survey, approximately one in three to four policyholders misses a claim of some kind, with the following cases being particularly notable:

1. Not claiming special provisions (cancer, advanced medical treatment, outpatient treatment, fractures, permanent disability, etc.)

2. A family member dies and the policy details or insurance company are no longer understood

3. Poor health or being busy puts off procedures, allowing the statute of limitations (3 to 5 years) to expire. Insurance is not just a way to "gain peace of mind"; it is an asset that only becomes meaningful once you claim.

私共の保険請求漏れサービスを使う “必要性／メリット”

民間保険の請求漏れサポートは、「払い過ぎた保険料を取り戻す」「本来もらえる給付を逃さない」ための実務支援です。

Why Use Our Insurance Claim Mistake Service?

Our private insurance claim mistake support service provides practical assistance to help you recover overpaid premiums and avoid missing out on benefits you're entitled to.

請求漏れの発見

専門家が契約内容・通院歴・手術履歴を精査し、もらい忘れを見つけ出します。

Detecting Missing Claims: Experts will thoroughly examine your contract details, medical history, and surgery history to discover any missed claims.

時効前の申請支援

時効が迫る契約を優先的にサポートし、期限切れを防ぎます。

We provide priority support for contracts that are about to expire, preventing them from expiring.

書類手続きの代行

保険会社への問い合わせ・診断書準備・必要書類の確認を支援します。

We assist with paperwork procedures, including inquiries to insurance companies, preparing medical certificates, and verifying required documents.

契約の整理・一覧化

複数の保険契約を1枚に整理し、今後の見直しにも役立ちます。

Organize and list multiple insurance policies on one page, which is useful for future review.

会社が、存在事実を証明する公証制度の確定日付を利用するメリット

The benefits of using the confirmed date of the notarization system to prove the existence of a company

1. 契約リスクの低減

1. Reduced contract risk

➀業務委託契約、取引基本契約、債権譲渡契約などに確定日付を付すことで、トラブル時に「この日付までに契約が存在していた」ことを客観的に証明できる。

②取引先や金融機関に対して信頼性が増し、交渉力が強化される。

➀ By attaching a fixed date to contracts such as outsourcing agreements, basic transaction agreements, and receivables assignment agreements, you can objectively prove that the contract existed on that date in the event of a dispute.

② This increases your credibility with business partners and financial institutions, strengthening your negotiating power.

2. 知的財産・ノウハウの保護

2. Protection of intellectual property and know-how

➀企画書・開発資料・デザインデータに確定日付を付しておくことで、「先に作成した証拠」として権利主張しやすい。

②特許出願前のアイデア盗用防止、競合とのトラブル防止に役立つ。

➀ By attaching a confirmed date to proposals, development materials, and design data, it becomes easier to assert rights as evidence that the data was created first.

② It helps prevent idea theft before a patent application is filed, and helps prevent trouble with competitors.

3. コンプライアンス・　内部統制の強化

3. Strengthening compliance and internal controls

➀契約書や社内規程に確定日付を付与 → 改ざん防止・社内ガバナンス強化。

②監査や株主対応において、文書の信頼性を高められる。

➀ Assigning fixed dates to contracts and internal regulations → Preventing falsification and strengthening internal governance. ② Increasing the reliability of documents for audits and shareholder correspondence.

4. 低コストで導入可能

4. Low-cost implementation

➀公証人役場で1件　数千円と、コスト負担は軽微。

②「大きな法務リスク回避を、低コストで実現」できる点が企業経営にメリット。

➀ The cost burden is minimal, at just a few thousand yen per transaction at a notary public's office.

② The benefit to business management is that it allows you to "avoid major legal risks at low cost."

私共のサービス内容

私共として行うのは「請求代行ではなく、調査・アドバイス・同行支援」です。
非弁行為にならない範囲で、情報提供と伴走支援を行います。

Our Services

Our services are not just billing representation, but investigation, advice, and accompanying support. We provide information and accompanying support within the scope of our unauthorized practice of law.

保険契約チェック

（診断シート作成）

保険証券・契約一覧を基に、請求可能性を判定（特約別・時効確認含む）

Insurance Contract Check

(Creating a diagnostic sheet)

Assess the likelihood of a claim based on a list of insurance policies and contracts (including checking special provisions and statutes of limitations)

請求可能性レポート作成

請求漏れの可能性をA〜C評価で提示、請求方法と必要書類を一覧化

Create a billability report

Grades potential missed claims from A to C, lists billing methods, and lists required documents

保険会社への連絡サポート

電話・メールでの問合せ手順を具体的に指導（必要に応じて同行）

Support for contacting insurance companies

Specific guidance on procedures for inquiries by phone and email (accompanying if necessary)

請求完了フォロー

結果確認と、次回見直しや保障バランスの提案（無理な保険勧誘はなし）

Follow-up on claim completion

Confirm results and propose next review and coverage balance (without aggressive insurance solicitation)

「保険を見直す前に、まず請求を見直す」

これが、私共が行う“請求漏れサポート”の基本方針です。
払い忘れたお金を取り戻し、正しく保険を活かすことで、「知らずに損をしない暮らし方」をサポートします。

"Before reviewing your insurance, review your claim first." This is the basic principle of our "missed claim support." By recovering forgotten payments and properly utilizing your insurance, we support you in "living a life without unknowing losses."