JA Group’s Non-Life Insurance Company More “Groundbreaking” than Sompo Japan? Intimate Line” circulated at the Big Motor factory

The author has independently obtained a line sent to BM sheet metal shops nationwide by Mr. A, the former head of the sheet metal division of Big Motor (hereinafter referred to as “BM”). The message was sent around September 2006, before the insurance fraud issue came to light, but it is graphic and shocking. The last sentence of the article is particularly noteworthy.

＜The last sentence is particularly noteworthy: “Compared to the current SJNK agreement-less, this is a breakthrough in that the entire process is delegated to our company without the need for an adjuster.

SJNK” is an abbreviation for “Sompo Japan Nipponkoa,” which was the company name of Sompo Japan Insurance Inc. in September 2006, the month President Giichi Shirakawa resigned on April 8. The company name was changed to “Sompo Japan Insurance Inc. on April 1, 2008.

Agreement-less” means that there is no agreement between the insurance company and BM regarding the amount of the claim in relation to the repair estimate after an accident. The “no adjuster” policy means that the insurance company does not need to be present to confirm or estimate the repair work, and that the insurance company delegates all estimates of the repair cost to BM. In other words, Kyoei Fire & Marine will pay the insurance claim at BM’s price, which is truly a “breakthrough” for BM.

The staff member on site who received the line continued, “We had a meeting with Kyoei Fire & Marine.

The line (1) from October to December of 2006 and (2) from January to February of the following year, ’19. . The last line, <agreement-less>, began to be implemented around October ’18 as a trial. It will start at all plants in April ’19, the same time as Sompo Japan.”

When an accident occurs, how do BM and non-life insurance companies get involved in the repair process?

When an accident involving a car occurs, the first thing that happens is that if someone is injured, they are given first aid and the police are notified. While waiting for the police to arrive, the accident center of the non-life insurance company is called. At this time, the non-life insurance company will always ask, “Have you decided on the factory where you will enter? Most people have not decided. Since most people have not decided, the non-life insurance company that does business with BM will ask, “Well, how about the BM00 store? and have been guiding them to BM by suggesting the nearest store with a sheet metal shop. This was because the non-life insurance company was promised a “quid pro quo” if they induced even one more car to enter the shop. As we mentioned in our article published on July 28, BM was promised a “quid pro quo” of selling the non-life insurance company’s liability insurance policy for each vehicle it induced to enter the garage.

Once the car was safely received at BM’s sheet metal shop, the damage to the car was checked. Normally, an “adjuster” is dispatched by the non-life insurance company for major accidents involving 200,000 to 300,000 yen or more. The adjuster plays an important role in the insurance repair process, and his/her primary job is to fairly calculate the amount of the insurance claim. The adjuster checks the damage against the estimated damage and makes an “agreement” with the repair shop on the amount to be repaired.

Recently, non-life insurance companies have become more reluctant to pay out, and even if the estimated repair cost is 300,000 yen, for example, the adjuster can lower the cost to about 150,000 yen with the help of the adjuster. However, this was not the case with some non-life insurance companies that were doing business with BM.

In light of the text of the opening line, what was “groundbreaking” about Kyoei Fire & Marine compared to Sompo Japan for BM? That would be what is written in line (1) of the line.

<The process is completed by a woman at the reception desk, not by an adjuster.
<We (BM) will make the decision on consistency, etc.
<The trial period will certainly concentrate on the incoming orders.

Another employee, Mr. B, who worked at BM, revealed, “The process is completed by the woman at the reception desk.

The “completed by the woman at the reception desk” and “leave the judgment of integrity to our judgment” means that no matter how high the estimate is, the estimate is passed based on the judgment of Big Motor alone, and even if there is an improper claim, it is not checked. ＜The “During the trial period~” part is considered to be a request to proactively introduce Big Motor’s sheet metal shop to those who have contacted us after an accident.

Normally, when a car involved in an accident comes into the shop, the repair shop can only see the side of the car that has been entrusted to them, so they cannot see what part of the other car was hit. Therefore, the insurance company will make a judgment as to whether the damage was caused by the accident or not, or whether it is an existing damage. The lack of confirmation means that even if there are existing scratches, they can be repaired if the customer says they were caused by the accident. I think it was significant that no adjusters were involved and that the entire process was led by Big Motor.

If this statement is as Mr. B interpreted it, it is highly likely that Kyoei Fire & Marine was at BM’s “mercy” in determining the amount of the repair cost in order to get the “quid pro quo” of CALI. This is a very strong possibility.

Mr. C, who was deeply involved in the situation at the time, revealed, “Sompo Japan and Kyoei Fire were both involved in the same situation.

There were definitely times when Sompo Japan and Kyoei Fire & Marine had ‘no agreement. What I mean by ‘no agreement’ here is that the estimates and requests for agreement made by BM (without confirmation by the non-life insurers) became the agreed-upon amounts as they were. However, later, due to the poor results of the discrepancy verification (verification of the extent of the discrepancy in the amount of the insurance claim between the estimate made by BM and the estimate confirmed by the insurance company based on the actual damage), “agreement-less” was eventually revised. At that time… we honestly could have done anything if we wanted to.”

Kyoei Fire & Marine was established in July 1942 at the height of the Pacific War, and is a 74%-owned subsidiary of the National Mutual Insurance Federation of Agricultural Cooperatives (JA Kyosairen), a group company of a huge organization like JA. When FRIDAY Digital sent a letter of inquiry to Kyoei Fire & Marine, the response was as follows.

Kyoei Fire & Marine has never made an agreement to pay insurance claims without an agreement. In order to improve policyholder service by realizing prompt payment of insurance claims, we have been operating since August ’19 to certify factories with facilities and capabilities of a certain standard and pay insurance claims through an agreement based on a simplified vehicle damage survey, and Big Motor Co. Although it is true that Big Motor was an eligible factory until August 2010, it has since been removed from the list of eligible factories.

Kyoei Fire & Marine also suspected that Big Motor did not use adjusters dispatched by the non-life insurance company to estimate repair costs, but instead delegated the estimation of repair costs to BM, as follows.

Kyoei Fire & Marine continued, “There is no evidence that Big Motor was delegated the responsibility of estimating repair costs without the use of adjusters. Our payment staff determine whether or not a vehicle is subject to the simplified vehicle damage investigation based on photographs and estimates submitted by the subject factory, not limited to Big Motor. In cases where a high claim payment is expected, the payment manager consults with the adjuster, and if the adjuster determines that the claim should not be subject to the simplified vehicle damage survey, the adjuster inspects the actual vehicle and prepares an estimate.

When we sent a letter of inquiry to the BM side where the above line was allegedly circulated, we received the following response.

In the accident repair agreement with Kyoei Fire & Marine, we have paid insurance claims based on a simple investigation that did not involve an adjuster, but there is no evidence that we have paid claims without an opportunity for an agreement to be made. We are no longer operating under the agreement based on a simplified investigation.

According to Kyoei Fire, the agency agreement with BM has been agreed to be terminated. Kyoei Fire & Marine responded to FRIDAY Digital as stated above, “We have been operating with an agreement based on a simplified investigation of vehicle damage since August ’19,” but based on the images on the line and the testimony of related parties, it is possible that they had been paying insurance claims without an agreement before that time. However, based on the images on the line and testimonies from related parties, it is possible that the company had been paying insurance claims without an agreement even before that.

Note that Kyoei Fire & Marine is also among the seven companies (Sompo Japan, Mitsui Sumitomo, Tokio Marine & Nichido, Aioi Nissay Dowa, AIG, Kyoei Fire & Marine, and Nisshin Fire & Marine) that the Financial Services Agency issued a report collection order based on the Insurance Business Law on July 31. Here, false reports and refusal to submit documents are punishable by imprisonment and fines. We hope that the seven companies that were involved with Big Motor will submit correct and truthful reports.