Article 55Coordination with Insurance Benefit Pursuant to Other Laws and Regulations
第五十五条（他の法令による保険給付との調整）
Benefits for medical treatment, or dietary treatment expenses for inpatients, living support expenses for inpatients, medical expenses combined with treatment outside insurance coverage, medical expenses, medical expenses for home-nursing, transport expenses, injury and sickness allowance, burial charges, dependent's medical expenses, dependent's medical expenses for home-nursing, dependent's transport expenses, or dependent's burial charges in relation to an insured person are not paid if the insured person may receive payment corresponding to those for the same sickness, injury, or death pursuant to the provisions of the Industrial Accident Compensation Insurance Act, the National Public Officers' Accident Compensation Act (Act No. 191 of 1951; including when this is applied mutatis mutandis to other laws and the same rule governs; the same applies in the following paragraph and Article 128, paragraph (2)), the Local Public Officers Accident Compensation Act (Act No. 121 of 1967), or a Prefectural or Municipal Ordinance based on the same Act.
被保険者に係る療養の給付又は入院時食事療養費、入院時生活療養費、保険外併用療養費、療養費、訪問看護療養費、移送費、傷病手当金、埋葬料、家族療養費、家族訪問看護療養費、家族移送費若しくは家族埋葬料の支給は、同一の疾病、負傷又は死亡について、労働者災害補償保険法、国家公務員災害補償法（昭和二十六年法律第百九十一号。他の法律において準用し、又は例による場合を含む。次項及び第百二十八条第二項において同じ。）又は地方公務員災害補償法（昭和四十二年法律第百二十一号）若しくは同法に基づく条例の規定によりこれらに相当する給付を受けることができる場合には、行わない。
When an insurer finds it necessary for the payment of injury and sickness allowance, the insurer may request those who pay benefits pursuant to the provisions of the Industrial Accident Compensation Insurance Act, the National Public Officers' Accident Compensation Act, or the Local Public Officers Accident Compensation Act, or a Prefectural or Municipal Ordinance based on the same Act, to provide necessary materials about the status of payment of those benefits.
保険者は、傷病手当金の支給を行うにつき必要があると認めるときは、労働者災害補償保険法、国家公務員災害補償法又は地方公務員災害補償法若しくは同法に基づく条例の規定により給付を行う者に対し、当該給付の支給状況につき、必要な資料の提供を求めることができる。
Benefits for medical treatment, or expenses for dietary treatment for inpatients, living support expenses for inpatients, medical expenses combined with treatment outside insurance coverage, medical expenses, medical expenses for home-nursing, dependent's medical expenses, or dependent's medical expenses for home-nursing in relation to an insured person are not paid if the insured person is eligible for benefits equivalent thereto for the same illness or injury pursuant to the provisions of the Long-Term Care Insurance Act.
被保険者に係る療養の給付又は入院時食事療養費、入院時生活療養費、保険外併用療養費、療養費、訪問看護療養費、家族療養費若しくは家族訪問看護療養費の支給は、同一の疾病又は負傷について、介護保険法の規定によりこれらに相当する給付を受けることができる場合には、行わない。
Benefits for medical treatment, or expenses for dietary treatment for inpatients, living support expenses for inpatients, medical expenses combined with treatment outside insurance coverage, medical expenses, medical expenses for home-nursing, transport expenses, dependent's medical expenses, dependent's medical expenses for home-nursing, or dependent's transport expenses in relation to an insured person are not paid to that extent if the insured person received medical treatment or medical expenses for the same sickness or injury from the national government or local government pursuant to the provisions of other laws and regulations.
被保険者に係る療養の給付又は入院時食事療養費、入院時生活療養費、保険外併用療養費、療養費、訪問看護療養費、移送費、家族療養費、家族訪問看護療養費若しくは家族移送費の支給は、同一の疾病又は負傷について、他の法令の規定により国又は地方公共団体の負担で療養又は療養費の支給を受けたときは、その限度において、行わない。