Responding to a Super-Ageing Society:
Meeting the Challenges Stemming from Dementia

April 2021

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Responding to a Super-Ageing Society:
Meeting the Challenges Stemming from Dementia

Contents
Introduction
Chapter 1: Situational Analysis of the Super-Ageing
Society
1. Progression of the super-ageing society
2. Increasing number of people with dementia
3. Public initiatives on dementia

・・・・・・・

4

・・・・・・・・・・・・・・・・・・・・・

4
5
6

Chapter 2: Past Measures of the Life Insurance Industry
in Dealing with the Super-Ageing Society
1. Initiatives in response to the super-ageing society(1) Initiatives by the LIAJ
(2) Initiatives by life insurers
2. Initiatives related to dementia(1) Initiatives by the LIAJ
(2) Initiatives by life insurers

・・・・・・・

10

・・・・・・・

10

・・・・・・・

17

Chapter 3: Challenges Stemming from Dementia in theLife Insurance Industry
1. Uncertainty about life insurance coverage
2. Provision of information on insurance coverage to family
members
3. Procedures on behalf of the impaired right holder
4. Careful approach and response to the elderly (from theperspective of financial inclusion)・・・・・・・

23

・・・・・・・・・・・・・・

23
24

・・・・・・・・・・・・・・

24
25

Chapter 4: Finding Solutions to Dementia Issues

・・・・・・・

27

Conclusion

About The Life Insurance Association of Japan (LIAJ):
The Life Insurance Association of Japan is an incorporated association to which all life insurers who
engage in the life insurance business in Japan belong. It operates to contribute to the improvement ofpeople’s lives, seeking for the sound development of the life insurance business and the maintenance of
its reliability.

-2-Introduction
The life insurance industry has long focused on making reliable and prompt claims payments
to provide security to policyholders. Thus, life insurers make contact with individual
customers to check whether any insured event has occurred, and encourage them to makeclaims in relevant cases.
Now that Japan has reached the era of a super-ageing society, a large number of elderly
people are given opportunities to buy life insurance or review their existing coverage. Under
these circumstances, we are aware that our existing efforts must be supported by measures
to ensure new or continuing life insurance coverage for the elderly. In recognition of thisnecessity, the life insurance industry has been promoting a wide range of initiatives such asencouraging the attendance of family members upon contract signing, followed by regular
visits to explain the policy terms, in view of the declining mental and physical capacities that
may accompany ageing.
With the progression of the super-ageing society, how to address dementia has become aserious social issue in recent years. Accordingly, each life insurer is doing its best to offer
insurance products that cover dementia and ancillary services to prevent the disease.
Nevertheless, we believe the life insurance industry’s efforts to address dementia still haveroom for improvement. We therefore examined the challenges stemming from dementia inthe life insurance industry and considered possible ways to resolve those challenges. This
proposal also presents recommendations for policyholders and their family members to
prepare for dementia and for measures expected to be taken by the government.

April 2021
The Life Insurance Association of Japan-3-

Chapter 1: Situational Analysis of the Super-Ageing Society
The rising elderly population in Japan is leading toward a hyper-ageing society in theforeseeable future. The progression of the super-ageing society has also been accompanied
by an increase in the number of people with dementia, prompting a range of social measures
to address related issues in recent years.
This chapter examines the following issues: progression of the super-ageing society;increasing number of people with dementia; and public initiatives on dementia.

1. Progression of the super-ageing society
Japan’s elderly population (those aged 65 and over) was around 35.92 million as of 2019.
The elderly population has been rising, and is expected to increase further in the years ahead.
The Japanese government estimates that the population ageing rate (share of those aged
65 and over in the total population) stood at 28.6% in 2019, and is expected to reach 32.8%
in 2035 and 38.4% in 2065, which means that one in about 2.5 persons in Japan will be aged
65 or over.
The population aged 75 and over has also continued to rise, and was already greater than
the number of people aged 65–74 as of 2017. By 2065, one out of every 3.9 citizens is
expected to be 75 years or older (see Chart 1).

Chart 1: Trend of elderly population and future projections(million)
140

Actual1965
98.28 million

120

Aged 19 or under100
80

36.02 million(36.6%)

202019125.77 million

56.08 million(57.1%)
4.31 million(4.4%)
1.87 million(1.9%)

2065
88.08 million

121.01 million(16.7%)

Population ageing rate (percentageof the population aged 65 or over)
28.6% in 2019 (35.92 million)
Aged 20–64 68.84 million(54.7%)

60
40

Peak of total population
128.06 million in 2010

Estimate

12.37 million(14.0%)

41.89 million(47.6%)

11.33 million(12.9%)
17.4 million Peak of population aged 65+
22.48 million(13.8%) 39.35 million in 2042
(25.5%)
Peak of population aged 75+
Aged 75 or over 18.52 million
24.49 million in 2054
(14.7%)
Aged 65–74(Source) Prepared by the LIAJ based on “Population Estimates” by the Ministry of Internal Affairs andCommunications, and the results of the medium variant projection of “Population Projections for Japan(2017)” by the National Institute of Population and Social Security Research-4-2. Increasing number of people with dementia
The number of people with dementia continues to increase in line with the progression of thesuper-ageing society. According to an estimate, 4.62 million people aged 65 or over had
dementia in 2012, with a prevalence rate of 15.0% (about one in seven), but this ratio will
increase to 29.9% (about one in five) in 2025 and 34.3% (about one in three) in 2060 (seeChart 2).

Chart 2: Estimated cases and prevalence of dementia among people aged 65 or over(million)140

1 out of 7
withdementia

1 out of 3
withdementia

1 out of 4
withdementia

120
100

Percentage of the population
with dementia aged 65 and over

80
60
8.30

40
20

9.53

10.16

11.54

6.31
4.62

(Source) Prepared by the LIAJ
based on the preliminary resultsfrom “Research on Future
Estimates of the Elderly
Population with Dementia inJapan” (Special Research
Project for the MHLW Healthand Labor Sciences Research
Grants of FY2014 by Professor
Ninomiya of Kyushu University)and projected number ofpeople/(rate) with dementia on
the assumption that theprevalence of dementia for eachage group increases

Data also indicate a sharply rising prevalence of dementia in the 75+ age groups: 11.7%
among men and 14.4% among women aged 75–79, 16.8% among men and 24.2% among
women aged 80–84, and 35.0% among men and 43.9% among women aged 85–89 (seeChart 3).

Chart 3: Prevalence of dementia by age group

Men
Women

65-69 70-74

75-79 80-84 85-89 90-94

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95+

(Source) Prepared by the LIAJ
based on the FY2011
summary/shared research report“Incidence Rate of Dementia in the
Urban Area, and Response to
Living Functional Disability Caused
by Dementia” of theComprehensive Research Projecton Measures against Dementia for
the MHLW Health and Labor
Sciences Research Grants(Takashi Asada et al.)

3. Public initiatives on dementia
As seen, the government and other public agencies have taken various initiatives to addresssocial issues related to dementia in recent years, in view of the increasing number of people
with dementia.
The government has drawn up the Framework for Promoting Dementia Care following
discussions at the Ministerial Meeting on the Promotion of Dementia Care. Also, the Japan
Public-Private Council on Dementia, established as a key driver in the government sector,
has been considering specific measures to build a barrier-free society for people withdementia. How to provide financial services for customers with limited cognitive or mental
capacity has also been considered by the Working Group on Financial Markets of the
Financial System Council, Financial Services Agency in its reports.
Framework for Promoting Dementia Care
In January 2015, the government adopted the Comprehensive Strategy to Accelerate
Dementia Countermeasures (New Orange Plan). This was followed by the formation of the
Ministerial Meeting on the Promotion of Dementia Care in December 2018 to promotecomprehensive measures to address challenges pertaining to dementia with a whole-ofgovernment approach, in close coordination with relevant government agencies. Discussions
at this Ministerial Meeting, as well as the Expert Advisory Panel and the Executive Committee,
culminated in the Framework for Promoting Dementia Care, which was adopted in June 2019to present basic ideas and concrete measures for addressing dementia issues (see Chart 4).
The Framework is intended to ensure steady implementation of measures for proactive,
international communication of the national model to address the fastest-progressing
population ageing in the world, and for the realisation of a society in which people withdementia can live their own lives in quality local community settings whenever possible.

Specific measures

Chart 4: Overview of the Framework for Promoting Dementia Care
Details
Promote measures with the two objectives of inclusion andrisk reduction with due consideration to the views of people
with dementia and their family members, aiming for a
Fundamental concept
society in which the onset of dementia can be delayed andpeople can live everyday life with hope after developing
dementia.
1. Promoting publicawareness andefforts to support
 Promote dementia supporter training among companies
people withand occupational fields.
dementia by widely Help spread messages of hope for living with dementia,
sharing theiretc.
stories andopinions with the
public Increase social locations which are easily accessible tothe elderly, etc.
2. Risk reduction
 Gather and disseminate evidence regarding risk
reduction, etc.
3. Medical, health and Improve the quality of existing systems, and enhancenursing carecoordination for early detection and early response.
services and Develop infrastructure, and recruit human resources forsupport for
nursing care services, etc.
caregivers
4. Promote a barrier Develop a living environment accessible to individuals-6-free environment
for dementia,
support forindividuals withearly-onset
dementia, andsupport for social
interaction
5. R&D, industrial
promotion andinternational
implementation

with dementia.
 Promote various private insurance options related todementia.
 Promote the use of the adult guardianship system.
 Support individuals with early-onset dementia.
 Promote social inclusion and contribution activities.

 Research on dementia prevention, diagnosis, treatment
and care, etc.

(Source) Prepared by the LIAJ based on the Ministerial Meeting on the Promotion of Dementia Care,“Framework for Promoting Dementia Care”

Japan Public-Private Council on Dementia
The Japan Public-Private Council on Dementia was established in April 2019, with theobjective of mobilising the national and local governments, industry groups and people
affected by dementia to promote measures to build a barrier-free environment for people withdementia in a more integrated and timely manner. As a player in the governmental structure
described above, the Council is tasked with deliberating concrete measures, among others.
Indeed, specific topics are being considered by the two working groups placed under theCouncil: MHLW’s Working Group on a Barrier-free Environment for People with Dementia
and METI’s Working Group on Innovation Alliance for Dementia (see Chart 5).

Chart 5: Government structure for promoting dementia care
Ministerial Meeting on the Promotion of Dementia Care
Leadership on comprehensive government policy on dementia
Chair: Chief Cabinet SecretaryVice-Chairs: Minister of State in charge of health/medical carestrategy; and Minister of Health, Labour and Welfare
Executive Committee
Chair:
Special Advisor to the
Policy measures overall
Prime Minister(Recommendation) Acting Chair: Chief Medical andGlobal Health Officer, MHLWTechnical Committee
Membership: Director-Generals
and Deputy Director-Generals ofSpecific
disciplines
relevant government agencies(R&D, etc.)

Expert Advisory Panel

Japan Public-Private
Council on Dementia

Consultation on concrete(Partnership) measures
Secretariat: MHLW, METI

Working Group on
Barrier-free Environmentfor People with Dementia(MHLW)

Working Group on
Innovation Alliance for
Dementia (METI)

Secretariat
・・

R&D, industrial promotion, international
cooperation (Cabinet Secretariat)
Planning and making of public policies (MHLW)(Source) Prepared by the LIAJ based on the Japan Public-Private Council on Dementia website

The Working Group on a Barrier-free Environment for People with Dementia examined thechallenges and possible solutions to achieving a “barrier-free society for people withdementia,” culminating in the publication of the Guidance for Realising a Barrier-free Society
for People with Dementia (Finance Industry) in April 2021.1 The Guidance is intended to help
relevant industries and companies develop their own manuals by providing information to
help correctly understand dementia and how to treat people with dementia in industry (see1

The Guidance was also issued for the retail, housing and leisure/consumer goods industries.

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Chart 6). The life insurance industry has also helped to develop the Guidance as a memberof the Working Group.
Chart 6: Outline of Guidance for Realising a Barrier-free Society for People with
Dementia (Finance Industry)
Concept
I. Realising a barrier-free society for people with dementia
Knowledge: Understanding symptoms of dementia
II. Correct understanding of dementia
III. Basic interaction with people with dementia
Cases
IV. Concrete symptoms of dementia and proper response
ActionV. Efforts for realising a barrier-free society for people with dementia
The Working Group on Innovation Alliance for Dementia published an interim report in March
2021, following discussions on how to drive innovations through collaboration with a wide
range of livelihood supporting industries on the one hand, and public institutions and those
involved in healthcare, welfare or people with dementia themselves, on the other.

Report of the Working Group on Financial Markets, Financial System Council,
Financial Services Agency: Toward Progress in Customer Oriented BusinessConduct
The Working Group on Financial Markets, established under the Financial System Councilof the Financial Services Agency, also deliberated on customer oriented business conduct
and the vision of financial business in the super-ageing society, culminating in the publicationof the “Report of the Working Group on Financial Markets, Financial System Council: Toward
Progress in Customer Oriented Business Conduct” in August 2020. The Report sets forth
how financial business should ensure reliable and convenient services for customers withdeclining cognitive and mental capacities and their family members from a customercentered perspective (see Chart 7).
Chart 7: Outline of the Report of the Working Group on Financial Markets, Financial
System Council: Toward Progress in Customer Oriented Business Conduct
Theme
Description
Services for customers with declining cognitive and mental
capacities
The finance industry should develop guidelines on:
 How to transact with customers, as well as their family
members and agents;
Vision of financial
 Closer coordination with welfare institutions; andbusiness in the Curation and replication of good practices in providing
super-ageing
services for elderly customers, etc.
society (excerpts)
Research on refining existing systems leveraging digital technology
in light of the cognitive and mental capacities and situations ofindividuals
Consideration of a system allowing other persons to verify theexistence of a financial contract on behalf of the customer-8-Reference 1: Global Partnership for Financial Inclusion (GPFI)“G20 Fukuoka Policy Priorities on Ageing and Financial Inclusion”
Financial inclusion is a critical social issue in a super-ageing society, as it ensures that
senior citizens—who may have difficulty in visiting banks or making financial transactions
due to age-related decline—can continue to use financial services with confidence andbenefit as much as possible from these services.2
In this light, the Global Partnership for Financial Inclusion (GPFI), a platform of the G20,
launched the G20 Fukuoka Policy Priorities on Ageing and Financial Inclusion in June
2019. As the world faces emerging challenges that cannot be met by traditional financial
services due to the rapid progression of population ageing, the international community
set eight policy priorities to address the challenges of ageing under the theme of “ageing
and financial inclusion” (see Chart 8).
Chart 8: Outline of the G20 Fukuoka Policy Priorities on Ageing and Financial
Inclusion
Priority

Description

Use data and evidence

Use various sources of data and evidence to show
which policies are working and identify what else
needs to be done.

Strengthen digital and financial
literacy

Aim to provide everyone with practical skills andknowledge to manage a changing financial
landscape.

Support lifetime financial
planning

Develop programs and products to encourage longterm plans.

Customise－address the diverse needs ofolder people

Innovate－harness inclusive technologies

Protect－tackle financial abuse and fraud ofolder people

Encourage stakeholder
engagement－a multi-sectoral approach

Target key audiences－address vulnerabilities

Create products and services that are tailored to
the range of needs of older people.
Make the most of technologies in developing
financial products, protecting consumers anddelivering financial education.
Identify problems quickly and use multi-pronged
approaches to prevent older people from becoming
victims of financial abuse or fraud.
Work with different sectors to ensure a consistentand comprehensive approach toward financial
inclusion.
Consider the needs of groups who may bevulnerable or underserved.

Taken from the keynote speech at the G20 High-Level Symposium on Ageing and Financial Inclusion(GPFI Forum) in Tokyo (by Haruhiko Kuroda, Governor of the Bank of Japan)
2-9-Chapter 2: Past Measures of the Life Insurance Industry in
Dealing with the Super-Ageing Society
In order to fulfill its mission to provide security to customers by ensuring prompt claims
payment, the life insurance industry has been making contact with policyholders to check
whether any insured event has occurred, and encouraging them to file insurance claims. In
the aftermath of the Great East Japan Earthquake in March 2011, we provided livelihood
support to affected communities and confirmed the safety of policyholders, while seeking todevelop solid infrastructure to ensure claims payment, including the launch of the System for
Searching for Life Insurance Contracts in Disaster Areas, which requires life insurers to check
whether a policy exists for those who have lost track of their insurance coverage.
Leveraging such experience in response to the super-ageing society, we have enhanced our
initiatives for the benefit of the elderly. In recent years, we have focused on how to address
dementia, one of the most urgent challenges facing Japan. This chapter outlines the life
insurance industry’s response to the super-ageing society, and its efforts to address theissues of dementia.

1. Initiatives in response to the super-ageing society(1) Initiatives by the LIAJ
A. Vision of life insurance services in the super-ageing society
In view of the rising number of insurance policies held, and procedures performed, by elderly
customers, the LIAJ has been continuously considering a vision of life insurance services inthe super-ageing society, publishing reports and proposals, and providing information
brochures for older people.
(i) Release of “Life Insurance Services for the Elderly in the Super-Ageing Society:
Initiatives to Better Serve the Elderly”
Published in June 2013, this report summarises the challenges related to serving the elderly
when purchasing a life insurance policy, managing the contract after purchase, and filing an
insurance claim, as well as initiatives by life insurers which take the traits of the elderly into
account.
The report is based on experience gained in responding to the progression of population
ageing and to the Great East Japan Earthquake, and discussions made at a public-private
sector roundtable held on “Improving financial services in response to the ageing society”
with the participation of the LIAJ.
(ii) Preparation and provision of an information pamphlet for the elderly entitled “I wantto ask now! A guide to life insurance”
As part of our efforts to develop an environment that helps the elderly to buy and continue
insurance coverage, we prepared and distributed in March 2014 a pamphlet with informationand points to note for each of the steps in life insurance, from contract signing to the insured
period, and to procedures for making claims and receiving benefits.
(iii) Release of “Recommendation on Promotion of Friendly Life Insurance Services
for the Elderly – Recommendation on Utilisation of the Social Security and Tax Number
System in the Private Sector”
In April 2017, we released our recommendation on private-sector use of the Social Security
and Tax Number System, believing that life insurers’ use of this new social infrastructure
launched in 2016 could effectively improve convenience for the elderly in particular, as wework to sophisticate our initiatives for prompt and reliable claims payment, and improved
customer convenience.

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(iv) Release of “Report on the Role of the Life Insurance Industry in the 100-Year Life
Era”
Recognising public concerns about emerging issues such as insufficient financial resources
for life after retirement and rising cases of dementia, which accompany the various
environmental changes in an ageing society dubbed the “100-year life era,” this report,
released in April 2020, summarises the role of the life insurance industry in helping toalleviate such concerns by providing “three-pronged security (security of ‘comprehension’,security ‘just in case’ and security ‘to live one’s own life’).”B. Development of voluntary guidelines and support for PDCA efforts by life insurers
The LIAJ has developed the Life Insurance Service Guideline for Elderly Customers,summarising basic ideas and perspectives for providing proper and easy-to-understandservices for older people. We also conduct an annual “Value Up Survey” to evaluate life
insurers’ progress in implementing the voluntary guidelines, and to collect and share casesof how life insurers are responding to consumers’ views and requests. We thus aim to help
life insurers carry out the PDCA cycle and upgrade their services for the elderly (see Chart
9).
Chart 9: Survey regarding initiatives by life insurers carried out in line with thevoluntary guidelines (Value Up Survey)

Develop the voluntary
guidelines; life insurers to
draw up their own operationalrules
Review the voluntary
guidelines; life insurers toreview their own operational
rules

Provide services based on thevoluntary guidelines and life
insurers’ own operational rules
Collect and share good
examples of initiatives gatheredby the Value Up Survey(2) Initiatives by life insurers
Individual life insurance companies have also been implementing initiatives in response to
the super-ageing society. This chapter presents some of the measures taken by insurers inline with the voluntary guidelines developed by the LIAJ at three stages: contract signing,
contract renewal (post-purchase), and (preparing for) procedures including for insurance
claims.3
A. Measures taken at the time of contract signing (see Chart 10)
When the prospective policyholder is an older person, proper and adequate explanations of
the insurance product are required, given that comprehension ability tends to decline withage. Actions taken by life insurers to that end include requiring the presence of family
members when explaining the product and checking with the policyholder whether the
product truly matches their intentions shortly after contract signing.
Chart 10: Examples of measures taken at the time of contract signing
Guideline
Measures taken by insurance companies
Attendance of family
 The policyholder is asked to enter the details of any attendant
membersfamily member on the screen of the portable terminal tostrengthen evidence management.
 The presence of a designated proxy claimant is generally
The cases presented in this section refer to specific measures taken by life insurers; they do not indicate
the existence of any standard action.
3- 11 -



Insurance sales bymultiple agentsMultiple opportunities
to meet for insurance
sales
Confirmation that the
product offeredcontains terms in linewith the customer’s
intent







Other







Contactless approachrequired at the time of explanation for any prospective
policyholder aged 70 or over who seeks to purchase insurance
product covering dementia. In addition, the contact centerchecks whether the designated proxy claimant understands thepolicy terms before finalising the contract signing procedure.
The presence and signature of a family member are required
when explaining substantive matters, where a person aged 70
or over seeks to purchase a foreign currency denominatedinsurance product.
The presence of a sales office manager is required for (partial)
conversion. The Additional Attendant Explanation Report has
been revised to clarify the matters to be explained to thepolicyholder and those on which the policyholder’s
understanding should be verified.
Ensuring the policyholder’s understanding of the insurance
coverages, including by having two meetings in principle or
having an interview with a family member, is made mandatory.
In making a call to a prospective foreign currency denominatedpolicyholder, items specific to foreign currency denominatedinsurance are added to the warning statement.
For all contracts underwritten (except for those contracts
executed in person in the presence of a family member), it isrequired to make a call to the policyholder to confirm theirunderstanding of the policy terms and request them to ensurethat family members also understand such terms.
The relevant Head Office department is responsible for
confirming the customer’s intent by a videophone call at thetime of contract signing.
Internal rules were revised to allow a key assistant to sign
application documents on behalf of a customer with difficulty
signing the documents due to weakening eyesight, for example.
A leaflet with a smartphone-compatible voice code (including
useful information such as a toll-free number for elderly
consumers) was prepared and provided for customers withdifficulty reading the letters due to ageing, etc.
Training documents and tools (Consideration points to Identify
Potential Dementia) were developed to build correct knowledgeof dementia for use in providing customer services.
A form for the cooling-off procedure was prepared and attachedto the solicitation kit so that a customer who wants to think twice
about purchasing a product after making an application may
perform the procedure.
Agencies are given training in financial gerontology.
Every online insurance contract application is to be followed up
by a confirmation call to the applicant over the phone, as in thecase of a salesperson recruitment contract.

B. Measures taken at the time of contract renewal (see Chart 11)
Elderly policyholders may become oblivious of insurance coverages or even the fact that they
are covered by an insurance policy at all, while the policy is being renewed several times.
Measures taken by life insurers in this regard include regular notifications and visits to explain
the insurance coverages.
Also, communications from the life insurer, including notifications, may fail to reach elderly
policyholders due in particular to moving at the time of mandatory retirement or
institutionalisation. In that case, the policyholder may become incapable of initiating any
procedure or face a prolonged procedural period. To prevent any such eventuality, insurers- 12 -

are taking appropriate action such as registering family members and recommending using
a forwarding service upon moving, etc.
Chart 11: Examples of measures taken at contract renewal
Guideline
Measures taken by insurance companies(1) Communication of insurance coverages and payment procedure
Creating opportunities  The Notification of Insurance Coverages includes language toto verify the existenceencourage the policyholder to provide information to familyof policy, as well as
members, with the purpose of better informing the beneficiaries.
insurance coverages
 The delivery of a booklet to elderly policyholders living in certain
and payment
areas including remote communities has been scaled up toprocedures, among
cover the whole country. Following delivery of the booklet, theotherscall center makes calls to identify any missing claim or
unreported change in address, for example.
Documents using The Universal Communication Design Association’s (UCDA)
easy-to-read, concise“eye-friendly design” certification served to improve thesentences in largepresentation and design of the text.
letters
 At the request of visually impaired policyholders, insurance
policies (including reissuance) and the Notification of Insurance
Coverages are provided as Braille documents or data for
conversion to speech.
(2) Prevention of inability in or prolongation of procedures
Upgrading of address  A postcard is attached to the annual Notification of Insurance
management
Coverages to facilitate registration with the family contact
including throughaddress scheme, modification of registered information and theregistration of multiple
registration of a secondary contact address. Registration withaddresses
the family contact address scheme can be made from either a
PC or smartphone.
 A service to provide information on insurance coverages tofamily members was introduced to manage contact addressesof registered family members. The registered family members
are also sent annual notifications of information on insurance
coverages.
 Internal rules were revised to allow (or require, in principle) the
registration of the address and phone number of a designatedproxy claimant to enhance communication with policy
stakeholders at the time of new contract procedures.
Recommendation to The Address Change Guidance Service, provided by Japan
notify address change
Post, is used to recommend policyholders to notify any address
at the time of moving
change.
 A Postcard for Address Change is attached to the annual
Notification of Insurance Coverages to request notification of achange of address at the time of moving. The policyholder isalso informed that the change-of-address procedure can be
performed on a website for policyholders.
Ongoing process to Policyholders who could not be reached in the previous year
identify any change inare asked to fill in a form attached to the annual Notification of
the status of
Insurance Coverages regarding change of contact address andcustomers
the occurrence of any insured event, to be sent back in a selfaddressed envelope.
Confirmation of Members of the Insurance Coverages Notification Scheme arelegitimate destination
provided with a service to confirm addresses by contacting aof correspondence inpolicy stakeholder including the beneficiary when a notificationcase of undelivered
remains undelivered. The address may also be confirmed
notification
through SMS (short message service) instead of inquiring at agovernment office.

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C. Measures taken at the time of (preparing for) procedures (see Chart 12)
It may not be possible to encourage a policyholder to file an insurance claim if thepolicyholder does not notify an address change upon moving to another place to live alone
or becoming institutionalised, as a result of retirement or children leaving home. Older
policyholders may also struggle to perform any procedure due to physical inability to sign adocument, for example.
To address this issue, life insurance companies are taking measures to ensure insurance
claims payment, such as regularly confirming policyholders’ contact address and status, andsimplifying the forms required for various procedures.
Chart 12: Examples of measures taken at the time of (preparing for) procedures
Guideline
Measures taken by insurance companies(1) Identification of address/domicile
Continued monitoring  A system has been established to identify policyholders whoof the contact
have made no claim or a deficient claim and follow up withaddress andnotifications or calls.
whereabouts ofpolicyholders, etc.
Measures to identify
 Where no claim is made for the maturity value or annuity, thethe contact address
relevant department of the head office obtains a copy of theof the beneficiary tofamily register and attachments thereto, and instructs thethe extent possible
branch or sales office where the beneficiary might be domiciled
when the beneficiaryto make further inquiries.
becomesunreachable(2) Improved convenience (simplification of claim procedure)
Measures to improve  As in the case of conservation procedures, electronic andconvenience,customised claim forms have been introduced, which only
including therequire the policyholder’s signature to perform a procedure.
simplification of A new service has been introduced to obtain a medical
documents required
certificate from the medical institution in cases where thefor various
customer is unable to obtain the certificate for a procedure due
proceduresto health and other reasons, thus ensuring that all the insured
events are covered in procedures for making claims andreceiving benefits.
Development of The scope of persons who qualify as an agent to sign thealternative ways torelevant documents where the claimant is unable to do so has
perform procedures
been extended to include relatives in the third degree of kinshipincluding by an agent
and beyond as well as third parties closely related to thecustomer.
 In order to ensure smooth claim procedures for older persons
living alone without any relatives to rely on, a system wasintroduced to allow an employee to sign on behalf of thepolicyholder, with another employee checking the purpose offiling a claim via videophone call.
(3) Other
Readiness to provide  For customers who have made a claim on the helpline reserved
easy-to-understandfor elderly policyholders, explanations about the required
explanations anddocuments are provided over the phone, timed with the arrival
respond properly toof the claim documents sent by the life insurance company.
inquiries from the Specific services are added to suit the characteristics of thebeneficiaryelderly, such as using red marking ink instead of yellow sticky
notes for the documents for a procedure to be sent tocustomers.
 Staff training including through encouragement to attend a
lecture for developing dementia supporters and the distribution- 14 -

Development of anadequate procedure
to allow an agent tofile a claim andreceive insurance
benefits on behalf ofthe beneficiary

of a guidebook on how to treat the elderly.
A policyholder agency system has been developed to allow anassigned “policyholder agent” to perform a specified procedureregarding an insurance policy on behalf of the policyholder, who
is incapable of indicating their intention to perform theprocedure, for example.
The scope of assigned agents authorised to file a claim has
been expanded to include institutional caregivers, among
others.
The Family Registration Service, Policyholder Agency Scheme
and Insured Agency Scheme have been unified to create anenabling environment for family members to check on policy
terms and perform a wide range of procedures on behalf of thepolicyholder.

Reference 2: Life insurance industry’s response to the ageing society in major
European countries and America
To help upgrade our customer services, we also researched initiatives undertaken by thelife insurance industry to address the ageing society in major European countries andAmerica (US, UK, Germany and France) faced with similar issues to those of Japan due tothe progression of population ageing.
Measures such as the attendance of family members at contract signing and the registrationof a secondary contact address at contract renewal have not been observed in any of thosecountries.
Meanwhile, significant progress has been observed in the use of the adult guardianshipsystem, from which Japan has much to learn.
(For further details, see the Research Report on the Life Insurance Industry’s Response to
the Ageing Society.)- 15 -

Reference 3: Initiative taken by the life insurance industry in the aftermath of the Great
East Japan Earthquake
Following the Great East Japan Earthquake on 11 March 2011, the LIAJ worked with its
member companies on industry-wide efforts to support livelihoods in the affected areas,
confirm the safety of customers, and develop infrastructure to ensure claims payment, withthe basic policy of “doing whatever possible to alleviate the affected population as soon as
possible.” This experience highlighted the importance of the life insurance industry’s function
to pay claims promptly and thus reassure customers.
During the following decade, the life insurance industry has taken a variety of initiatives as
the super-ageing society has progressed. For example, the System for Searching for Life
Insurance Contracts in Disaster Areas, launched in the wake of the earthquake, will be
developed into an Industry-wide Policy Inquiry System to improve convenience forcustomers.4 We are committed to further upgrading customer services in the super-ageing
society going forward.
Initiatives taken by the life insurance industry in the aftermath of the Great East Japan
Earthquake
Description(1) Delivery of In order to support livelihoods in the affected areas, the LIAJ
livelihood supportand member companies provided financial support (donation
and reassuranceof relief money), physical support (food, clothing, hygieneto the affected
goods, electrical appliances, etc.) and human support
population(dispatch of helping staff, volunteers, etc.).
 The following “policy conservation measures” wereimmediately adopted to provide assurance to affected
policyholders concerned about receiving insurance benefits
or paying insurance premiums: non-application of theearthquake exclusion clause; extension of a moratorium on
premium payment; special treatments including reduction or
forgiveness of interest payment; and prompt, simplified
insurance claims and benefit payments (exemption of someof the required documents).
(2) Response to Given that many of the affected population were forced to live
inquiries andin an evacuation center, a consultation system mindful of theprocedures in lightsituation of the affected areas (consultation provided by callof specific aspects
centers of the member companies, Life Insuranceof the disaster
Consultation Center and its local liaison offices, and outposts
established at evacuation centers) was developed alongside
the launch of the System for Searching for Life Insurance
Contracts in Disaster Areas (member companies to check on
the existence of any insurance policy on behalf of those who
had lost track of their life insurance coverages).
(3) Activities to Activities to confirm the safety of customers and secure
confirm the safety
communication channels were conducted industry-wide toof customers
provide information on necessary procedures. Good
practices were shared across the industry to upgrade theefforts of member companies.
(4) Multi-faceted Multi-faceted communication activities were conducted tocustomerdeliver necessary information to all affected policyholders
communication
including at evacuation centers located across the country.
activities(5) Network to Member companies built a network to ensure claim payments
ensure claim
through industry-wide sharing of information that cannot be
4

See pp. 27-28 for details of the Industry-wide Policy Inquiry System.

- 16 -

payments
collected by any single company, with the LIAJ serving as an
information platform.
Coordination with relevant government agencies was also
pursued to ensure claim payments. Policyholders withlegitimate insurance claims were identified, and necessary
documents sent, by obtaining the disclosure of family
registers and residence certificates in a simplified way.
To ensure proper insurance claims payment to disasterorphans and other affected children, the Life Insurance
Support Network for Minors was established in coordination
with local bar associations and local governments.

2. Initiatives related to dementia
In the preceding section, we examined how the life insurance industry has been responding
to the super-ageing society, focusing on initiatives for the benefit of the elderly. As indicatedin Chapter 1, the number of people with dementia has been increasing with the progressionof the super-ageing society, and dealing with dementia has become a major social issue.
The life insurance industry has also taken various initiatives in support of the rapidly
increasing number of people with dementia and their family members, such as promoting
understanding of dementia and providing related products and services. Given that “Toward
Progress in Customer Oriented Business Conduct”, a Report of the Working Group on
Financial Markets, Financial System Council, Financial Services Agency published in August
2020, refers to how financial business should be operated in the super-ageing society, we
have provided an information brochure to prepare for dementia, created a policy inquirysystem in case the policyholder develops dementia5, and published our recommendations
on dementia.
This section highlights some of the initiatives taken by the LIAJ and individual life insurers.

(1) Initiatives by the LIAJ
A. Building an enabling environment for the development of Dementia Supporters
The term “Dementia Supporter” refers to a person with correct knowledge and understandingof dementia who assists people with dementia and their family members in the local
community or workplace to the extent possible.6
Recognising the importance for the employees of life insurers to acquire knowledge of
dementia in order to provide better service to people with dementia and their family members,
the LIAJ has been building an enabling environment for the development of Dementia
Supporters in member companies (see Chart 13). We aim to increase the number of
Dementia Supporters in the life insurance industry, estimated to be about 110,000 as of
October 2020.

See pp. 27–28 for details of the policy inquiry system.
Anyone can become a Dementia Supporter by attending the Dementia Supporter training sessionsorganized by the local government or an industry/professional association.
56- 17 -

Chart 13: Key initiatives taken by life insurers to build an enabling environment for thedevelopment of Dementia Supporters
Initiative
Description
The total number of Dementia Supporters in the life
insurance industry has been counted and published in
Counting the number oforder to monitor the efforts made by life insurers.
Dementia Supporters(The number is estimated at some 110,000 as of
October 2020.)
Support for initiatives taken
 Preparation of teaching aids for Dementia Supporterby member companies fortraining sessions
deepening their employees’ Organisation of Dementia Supporter training sessions
understanding of dementia
for life insurers(upcoming)
B. Preparation and publication of an information brochure for life policyholders “To
Life Insurance Policyholders, Preparing Family Members for Dementia”
The decline in mental capacity due to dementia not only affects the daily life of thepolicyholder but also deprives them of the ability to manage their assets, making it difficult tomanage life insurance and other contracts and perform related procedures. In many cases
the policyholder requires family members’ support, but the family members may not know if
the policyholder has any life insurance coverage or the exact terms of the policy involved. To
avoid such eventualities, it is crucial for policyholders and their family members to beprepared for dementia in advance. Accordingly, we prepared a brochure to provide relevant
information, which was published in February 2021 (see the next page). Professor Jin
Narumoto of the Graduate School of Medical Science, Kyoto Prefectural University of
Medicine7, kindly served as editorial supervisor for this project.

7

Title as of April 2021.

- 18 -

Reference 4: Brochure “To Life Insurance Policyholders, Preparing Family Members
for Dementia” (excerpts)
Example 1: Do not know whether family member is insured
 The policyholder (individual) is enrolled in health insurance. His judgment has been
impaired for several years. Recently, he was hospitalised for pneumonia.
 Policyholder: individual; insured: individual; beneficiary: individual
Difficulties faced by family members

Wife

If he is enrolled in life insurance, I would like to claim benefits, but I don’teven know if he is enrolled.

Preparations to make beforehand✔Make sure that family members know which insurance company and the details of thepolicy before developing dementia.
Example 2: Do not know the details of the policyThe policyholder (individual) is enrolled in insurance payable at death. Recently, his
judgment has become impaired. His wife came across an insurance certificate that she
did not know about.
 Policyholder: individual; insured: individual; beneficiary: wife
Difficulties faced by family members

Wife

I called the life insurance company to check the details of the policy, but I
was told that I would need the consent of my husband, the policyholder.
However, he has dementia, so I cannot ask him.

Preparations to make beforehand✔Tell family members about life insurance while healthy and let them know the details of
the policy. (It is also important to come up with ideas, such as checking on an ongoingbasis on special occasions or at other times.)✔ Decide on a place to store insurance certificates and other documents related to thepolicy and let family members know.
Example 3: Do not know whether benefits can be claimed on behalf of the insuredThe policyholder (and insured) let his family members know that he was enrolled inhealth insurance. His judgment has been impaired for several years. Recently, he washospitalised for pneumonia.
 Policyholder: individual; insured: individual; beneficiary: individual
Difficulties faced by family members

Wife

My husband has dementia, so he can’t file a claim.
I’m concerned that I may just not be able to get the benefits.

Preparation to make beforehand✔Check to see if a proxy claim scheme (designated proxy claim scheme/ designated proxyclaim riders) is used.
✔If used, check to see who the designated proxy claimant is and let that person know they
have been designated.
Example 4: Beneficiary passes away
The policyholder (individual) is enrolled in insurance payable at death. Recently, his
judgment has become impaired. His wife, the beneficiary, passed away. As such, thebeneficiary needs to be changed.
- 19 -

 Policyholder: individual; insured: individual; beneficiary: wife (⇒ needs to be changed tohis child)
Difficulties faced by family members

Child

I would like to make myself the beneficiary, but I was told that my father hasdementia, so the change cannot be made. What do I do?
*Handling of cases such as that in the example varies depending on the life
insurance company. Reach out to your life insurance company for details.

Preparation to make beforehand✔If you have wishes for how your property will be managed when you develop dementia,
discuss them with your family and loved ones.
✔Consider deciding on a voluntarily appointed guardian or a family trust as ways todetermine how your property will be managed before you develop dementia.
The brochure also explains various schemes and mechanisms such as the designated proxyclaim scheme/rider, the adult guardianship system (statutory guardianship and voluntary
guardianship systems) and family trusts.
From the editor-in-chief (Jin Narumoto, Professor, Graduate School of Medical Science,
Kyoto Prefectural University of Medicine)
We all share the desire not to develop dementia. Unfortunately, no matter how many
preventive steps we take, a certain percentage of us will develop some type of dementia.
Since a lot of people feel that thinking about developing dementia is depressing, they try
not to think about it. However, developing dementia does not mean you cannot doanything anymore. As long as you have the proper support, you can still enjoy life evenafter developing symptoms.
It is important to make preparations now to ensure that the benefits make it into the handsof the family member(s) who will support you so that you can live a fulfilling life even if
you develop dementia. This is also a difficult subject for family members to broach. Thus,
we suggest that you share information with your family members during a holiday season,such as year-end/New Year’s and Obon (Lantern Festival). Sharing your thoughts withyour family members is sure to strengthen those bonds as well.

(2) Initiatives by life insurers
A. Provision of products covering dementia and similar impairments
In view of the increase of people with dementia in recent years, more life insurers are now
offering products covering dementia and mild cognitive impairment (MCI)8. (The Frameworkfor Promoting Dementia Care, developed by the Ministerial Meeting on the Promotion of
Dementia Care in June 2019, also identifies the “promotion of various private insurance
products covering dementia” as one of the key policy measures.9)
Various types of product have been offered to meet customer needs, including: products to“Mild cognitive impairment” refers to a state between the normal state and dementia, characterised byoccasional memory loss that does not seriously affect daily living. About 4 million people are estimated tosuffer from MCI as of 2012. It is reported that 10–30% of the MCI cases progress to dementia each year.
9 Chapter 4 of the Framework (Promotion of a Barrier-free Environment for People with Dementia) includes
the following explanation under Item xii (Promotion of Various Private Insurance for Dementia) of Section (1)(Promotion of a Barrier-free Environment for People with Dementia, support for individuals with early-onset
dementia, and support for social interaction): “Initiatives by life insurers will be encouraged to popularize
private insurance products to prepare for the onset of dementia as well as private liability insurance providing
coverage for those with dementia and those responsible for supervising them.” The KPIs/targets for thismeasure include the number of life insurers dealing in private insurance to prepare for the onset of dementia.
8- 20 -

cover dementia and similar impairments in the base policy (Case 1); products to coverdementia and similar impairments by adding a rider to the base policy, such as healthinsurance (Case 2); and care insurance products that accept claims for dementia and similar
impairments (Case 3).
Insurance coverages vary depending on the insurer. For further information, please refer tothe exhibit “Dementia Insurance and Dementia-related Services Offered by Life Insurers.”
Case 1: Products to cover dementia and similar impairments in the base policy
Illustration of the mechanism
Whole life
coverage rider
for MCI

MCI benefit
Subject to confirmed diagnosis as MCI

Base policy

Dementia benefit(dementia
insurance)

Subject to confirmed diagnosis as qualified dementia

Case 2: Products to cover dementia and similar impairments by adding a rider
Illustration of the mechanism
Whole life
coverage rider
for MCI

MCI benefit
Subject to confirmed diagnosis as MCI

Dementia benefit
Dementia rider

Subject to confirmed diagnosis as qualified dementia

Base policy(healthinsurance)

Health insurance

Case 3: Care insurance products that accept claims for dementia and similar impairments
Illustration of the mechanism
Care benefit
Base policy(care insurance)

・・

Subject to Level 1 certification of long-term care need under the
public long-term care insurance plan
Subject to confirmed diagnosis as a qualified state requiring longterm care that has continued for at least 180 days

B. Provision of services related to dementia
In addition to insurance coverage of dementia and similar impairments, efforts are needed todetect dementia and similar impairments at an early stage and support the policyholders andtheir family members. Thus, life insurers are actively providing ancillary services to theirproducts covering dementia and similar impairments (see Chart 14).
Many of the services to support early detection of dementia leverage digital technology, suchas an application dedicated to checking the state of cognitive function.
It is difficult for a policyholder with dementia to perform life insurance procedures and asset
management due to the deterioration of mental capacity. Services to support thepolicyholders and their family members in such cases include assistance in selecting an adult- 21 -

guardian10 authorised to act on behalf of the policyholder with dementia, and consultation
on family trusts,11 an asset management technique.

Chart 14: Services related to dementia
Service
Description(1) Services for prevention and early detection of dementia
MCI/dementia
A service for prevention/early detection of, and consultation on mild
helplinecognitive impairment (MCI) and dementia
Test for checking
A service to check the state of cognitive function over the phone or
cognitive function
with the help of an application
A test for early detection of mild cognitive impairment (MCI)MCI screening test
symptoms by drawing blood
Brain training app
A gaming application to prevent dementia
A health promotion application to help enjoy daily health monitoring
Healthcare app
including using a pedometer(2) Support services in case the policyholder develops dementia
A service to introduce a judicial scrivener who can provide support
for legal procedures to customers who require consultation on an
Support on the adultasset management delegation agreement to prepare for future
guardianship system
claim procedures or the appointment of an adult guardian including
for filing a claim
A service to appoint a tentative guardian for convenience with the
Deemed guardianship approval of other presumptive heirs where the claimant lacks
systemmental capacity or does not have any appointed statutory agent
including an adult guardian
A service to make available a judicial or administrative scrivener for
Consultation on family
consultation over the phone or in person on a family trust to guard
trust
against assets being frozen as a result of dementia
A counseling service for care-giving family members on troubles
Family mental careand concerns(3) Other services
A service to dispatch a security guard to check the safety of the
Visiting service on
policyholder at home on behalf of family members following thebehalf of family
latter’s request for a visit when they cannot get in touch with themembers
policyholder
Representative
An insurer’s service to obtain the medical certificate required forservice to obtainfiling a claim on behalf of a customer who finds it difficult to obtain
medical certificatesthe certificate on their own
Service of referral to
A service to refer to an agency to perform claim procedures, wherean agency forthe procedure requires the submission of a copy of the family
obtaining family
register and the policyholder is incapable of performing theregisters
procedure
A service to provide information on medical institutions and local
Helpline on medical
comprehensive support centers nearby that can accept dementia
institutions
patients and consultation on medical care in general
A service to provide information on care facilities and visiting
Helpline on careservices nationwide and consultation on livelihood support andfacilities
nursing care
A service to allow registered family members to inquire about policy
Family registration &terms, change the address, request policy reissuance and delivery
inquiry serviceof various forms for filing a claim, etc.

1011

See p. 25 for details of the adult guardianship systems.
See p. 29 for details of family trusts.

- 22 -

Chapter 3: Challenges Stemming from Dementia in the Life
Insurance Industry
The preceding chapter described the proactive response to the super-ageing society
promoted by the life insurance industry, including actions taken on dementia. However, there
is still room for improving the various measures taken to address dementia in view of therapidly increasing number of cases in recent years, including promoting understanding andproviding products and services related to the disease.
In order to identify some of the challenges stemming from dementia, we examined thefeedback provided by customers to the life insurance industry. The table below (see Chart
15) shows the four most common types of customer inquiry. These inquiries are expected toincrease as more people develop dementia in future. It is therefore important for the entire
life insurance industry to share the challenges regarding dementia and promote effective
countermeasures.
This chapter outlines the challenges stemming from dementia in the life insurance industry,based on the four types of inquiry listed in the table below.
Chart 15: Types of inquiry from policyholders’ family members
Inquiry
Category(1) I don’t know if the family member with dementia has a
Uncertainty about life
life insurance policy.
insurance coverage
Provision of policy(2) I don’t know anything about the policy that the family
information to family
member with dementia has purchased.
members(3) I would like to perform a procedure on behalf of theProcedures on behalf of thefamily member with dementia.
impaired right holder
Careful approach and(4) Inquiry regarding decline in mental capacity (stemming
response to the elderly (fromfrom the policyholder forgetting that they had bought
the perspective of financial
insurance)
inclusion)

1. Uncertainty about life insurance coverage
People often ask the LIAJ if their family member with dementia has life insurance coverage.
Life insurers remind policyholders of the existence of a policy as well as insurance coverages
through regular visits and so forth. If a policyholder’s mental capacity declines due todementia before sharing such information, however, the inability to easily confirm theexistence of a life policy may cause considerable problems. (Since there is no industry-widemechanism for family members to inquire about the matter, they have to check with individuallife insurers (see Chart 16)).
Chart 16: Current response to type 1 inquiries from family members, and relevant
challenges recognised by the life insurance industry
Description
 Life insurers are taking measures to remind policyholders of
the existence of a policy as well as insurance coverages,
including through regular visits.
Current response The LIAJ launched the System for Searching for Lifeby the life
Insurance Contracts in Disaster Areas in the aftermath of theinsurance industry
Great East Japan Earthquake, requiring life insurers to check
whether a policy exists for anyone who has passed away orremains missing in an area covered by the Disaster Relief
Act, at the request of the affected person’s family member or- 23 -


Recognised
challenges

survivor.
Since there is no industry-wide mechanism for family
members to inquire about the existence of an insurance
policy, it is not easy for them to confirm the existence of sucha policy if a policyholder’s mental capacity declines.

2. Provision of information on insurance coverage to family members
The second type of inquiry made to life insurers concerns the exact insurance coverages tocheck whether a claim may be filed for an insurance benefit. This applies to cases wherefamily members only discover the existence of a policy after the policyholder has been
affected by dementia. At present, a life insurer can only respond to an inquiry about insurance
coverages from the policyholder or adult guardian (voluntary guardian) in general. Thus,
problems may arise from the rule that insurance coverages may not be disclosed at therequest of any other family member (see Chart 17).
Chart 17: Current response to type 2 inquiries from family members, and relevant
challenges recognised by the life insurance industry
Description
 In principle, insurance coverages may only be disclosed toCurrent response
the policyholder.
by the life Exceptionally, insurance coverages may be disclosed at theinsurance industry
request of the adult guardian (voluntary guardian), etc.
 Disclosure of insurance coverages requires the consent of
the policyholder. Even though the policyholder may not be
Recognised
capable of giving consent if affected by dementia, the above
challenges
rule prevents the insurer from disclosing insurance coverages
at the request of any family member who is not the adultguardian (voluntary guardian), etc.

3. Procedures on behalf of the impaired right holder
The third type of inquiry from family members concerns contractual procedures for filing aclaim or changing the beneficiary on behalf of the policyholder with dementia. (Inquiries may
also concern cancellation or a change of account.) In general, any life insurance proceduremust be performed by the policyholder, as the legitimate right holder. However, it may bedifficult for a mentally-impaired policyholder to perform such procedures. Thus, a family
member may file a claim on behalf of the policyholder under the designated proxy claim
scheme.12 Problems can emerge for some of the other procedures, including for changing
the beneficiary, because a family member who does not have contractual rights is not allowed
to act on behalf of the policyholder. (In this case, the policyholder may only be represented
by the adult guardian (voluntary guardian), etc. (see Chart 18).)
Chart 18: Current response to type 3 inquiries from family members, and relevant
challenges recognised by the life insurance industry
Description
 Family members may file a claim on behalf of theCurrent response
policyholder under the designated proxy claim scheme.
by the life Only the adult guardian (voluntary guardian) or anotherinsurance industry
authorised person can perform the procedure for changing
the beneficiary on behalf of the policyholder, as it involves
The designated proxy claim scheme refers to a system adopted by specific life insurers to allow adesignated agent to make a claim on behalf of the insured. The policyholder designates the agent at thetime of, or after, contract signing.
12- 24 -


Recognised
challenges

transfer of contractual rights.
Any change of the beneficiary needs to be initiated by thepolicyholder, who has all contractual rights. If thepolicyholder’s mental capacity deteriorates due to dementia,
no family member may perform the procedure unless he/sheis the adult guardian (voluntary guardian) or otherwise
authorised to do so.

Reference 5: Adult guardianship system
Procedures such as management of assets including real estate and saving deposits,
conclusion of a contract including on nursing care services and institutionalisation, anddiscussion on inheritance allocation may be difficult for anyone mentally affected bydementia. The national adult guardianship system is intended to protect and support thosewith limited mental capacity; the system comprises the following two subsystems.
Outline of system

Legalguardianshipsystem

A system whereby an adult guardian, etc. is selected by a family
court, following an application by a family member, etc., to provide
daily protection and support for the person in terms of livelihood,
healthcare, nursing care and welfare, after the person loses the ability
to make proper judgments and decisions due to dementia and similar
impairments. The system offers three choices – guardianship,
curation and assistance – which can be used depending on the levelof mental capacity of the person, for example.

Voluntary
guardianshipsystem

A system in which an individual appoints in advance, while still
possessing sufficient mental capacity, a person to act as his or her
voluntary guardian in case he/she experiences mental decline andspecifies in an agreement the details of duties to be entrusted to that
guardian in the future. When the person’s mental capacity does
deteriorate, the voluntary guardian files an application to a family
court for the appointment of a supervisor of the voluntary guardian tooversee the protection and support to be provided to the person withdementia.

4. Careful approach and response to the elderly (from the perspective offinancial inclusion13)
In a super-ageing society, it is necessary to create an environment where older people, andnot only those with dementia, can have secure access to financial services. The life insurance
industry must provide careful attention to the elderly, particularly in view of their specificities,
at the stages of contract signing, contract renewal (post-contract signing) and (preparationfor) procedures including for insurance claims.
At the time of contract signing, insurance coverages must be explained thoroughly to ensure
full understanding, in anticipation of the cognitive decline that the prospective policyholder
might experience with ageing. When renewing the contract, regular explanation of the“Financial inclusion” is the concept of ensuring that senior citizens—who may have difficulty in visitingbanks or making financial transactions due to age-related decline—can continue to use financial services
with confidence and benefit from them as much as possible (taken from the keynote speech at the G20 HighLevel Symposium on Ageing and Financial Inclusion (GPFI Forum) in Tokyo (by Haruhiko Kuroda, Governorof the Bank of Japan).
13- 25 -

insurance coverages is also needed to remind the policyholder that he/she is covered by life
insurance as well as the details of the insurance coverage. As the number of persons withdementia is expected to increase, a careful approach is required if we are to ensure financial
inclusion (see Chart 19).
Chart 19: Current response to type 4 inquiries from family members, and relevant
challenges recognised by the life insurance industry
Description
 In line with the Guidelines for Providing Life Insurance
Services to the Elderly developed by the LIAJ, member
Current responsecompanies have taken specific measures in view of theby the life
specificities of elderly policyholders at the stages of contract
insurance industry
signing (attendance of family members, etc.), contract
renewal (communication on insurance coverages and how tomake a claim for payment) and (preparing for) procedures(identification of address or domicile).
 Meticulous customer service is needed to ensure financial
Recognised
inclusion, particularly in anticipation of declining mental
challenges
capacity.

- 26 -

Chapter 4: Finding Solutions to Dementia Issues
The preceding chapter provided an overview of the challenges stemming from dementia
facing the life insurance industry. Life insurance typically involves multiple stakeholders
including the policyholder, the insured and the beneficiary among others. Claims and benefits
often sow seeds of conflict among family members. It is for this reason that robust rules areapplied when dealing with inquiries regarding insurance coverages and various procedures,
which may only be performed by legitimate right holders (usually only the policyholder).
However, it is difficult for a legitimate right holder (including the policyholder) with dementia
to understand insurance coverages or perform procedures. Family members would like toprovide necessary support in many of such cases but are often frustrated precisely becauseof the strict rules of the life insurers.
With the progression of the super-ageing society and the increasing number of persons withdementia, such cases are expected to keep increasing. This chapter presents some of theefforts made by the life insurance industry to solve such inconveniences withoutcompromising the protection of policyholders. It also outlines the preparations that should bemade by the customers and their family members,14 as well as the actions to be taken by
the government.

1. Uncertainty about life insurance coverage(A) Initiatives by the life insurance industry
The life insurance industry does not currently have any mechanism to allow family membersof a person suffering mental decline to inquire if any life insurer has issued a policy covering
the person. To remedy this situation, the LIAJ has decided to launch an Industry-wide Policy
Inquiry System so that family members may confirm the existence of a life insurance policy
and file a claim for the relevant benefit15. The existing System for Searching for Life Insurance
Contracts in Disaster Areas imposes some restrictions on inquiries, including a geographicallimitation to the areas covered by the Disaster Relief Act. Under the new system, family
members of a person suffering from mental decline will be able to make an inquiry about life
insurance coverage at normal times as well as after a disaster (see Chart 20).
Chart 20: Outline of the Industry-wide Policy Inquiry System and differences from the
System for Searching for Life Insurance Contracts in Disaster Areas

For more information, please refer to the brochure entitled “To Life Insurance Policyholders, Preparing
Family Members for Dementia.”
15 The system will enter operation in July 2021.
14- 27 -

Industry-wide Policy Inquiry
SystemNormaltimes
Conditions
for inquiry
about life
insurancecoverage

System for Searching for Life
Insurance Contracts in
Disaster Areas(not allowed)

In both cases: The policyholder or insured
has passed awayor
Afterdisaster  The policyholder or insured
suffers from mental decline The policyholder or insured
has passed away or remains
missing in an area covered by
the Disaster Relief Act, andthere is no way to find out
about insurance coverage as
the person’s house waswashed away or burnt down,
for example.

(B) Preparations to be made by the customers and their family members
Policyholders are recommended to talk to family members about the existence of a life
insurance policy, the scope of its coverage, etc., in case family members are troubled byinsurance coverage should the policyholder develop dementia. (You can also find out about
the coverage by reading the notifications about insurance coverages regularly sent by thelife insurer.)

2. Provision of information on insurance coverage to family members(A) Initiatives by the life insurance industry
As a way of providing information to family members, a handful of life insurers provide aservice to register the contact address of a specific family member with the consent of thepolicyholder, who will be notified of the insurance coverages and other relevant matters if
and when the policyholder suffers from mental decline. In general, no information on
insurance coverages may be provided to a family member unless he/she is the adult guardian(voluntary guardian), for the policyholder with dementia is not capable of giving consent.
Securing prior consent from the policyholder in this way is effective for avoiding such an
eventuality. We will enhance customer convenience by sharing these good practices acrossthe industry and upgrade the services of member companies as a result.
(B) Preparations to be made by the customers and their family members
Policyholders are recommended, for example, to talk to family members about insurance
coverages or agree with them on where to keep the policy and related documents in casefamily members do not know about insurance coverages if and when the policyholder
develops dementia.

3. Procedures on behalf of the impaired right holder(A) Initiatives by the life insurance industry
In general, any procedure regarding life insurance must be performed by the policyholder.
However, a policyholder with dementia may struggle to perform any procedure due to mental
decline. To address this situation, a handful of life insurers provide a service to enable afamily member (acting as an agent) to perform specified procedures16 when the policyholder
suffers from mental decline by obtaining the latter’s prior consent to that effect. As mentioned
in paragraph 2(A) above, a service to secure prior consent from the policyholder to allow afamily member to act as an agent is an effective way to avoid problems later.
Policy cancellation, reduction of insurance amount, change of address, etc. (depending on the insurer
concerned)16- 28 -

With regard to other procedures, including for changing the beneficiary, the adult guardian(voluntary guardian) is the sole person who is authorised to act on behalf of the policyholder
in general, as the transfer of contractual rights is involved. In this light, the life insurance
industry has been conducting awareness activities to provide information on the adultguardianship system. As mentioned in pages 18–20, the LIAJ published in February 2021 an
information brochure on how to address issues related to dementia entitled “To Life
Insurance Policyholders, Preparing Family Members for Dementia.” Presenting an outline of
the adult guardianship system, the brochure recommends optionally designating a voluntary
guardian before the policyholder develops dementia to allow a family member to perform
procedures on his/her behalf. With the help of this brochure, the life insurance industry willcontinue communication activities to raise awareness of the adult guardianship system.
(B) Preparations to be made by the customers and their family members
Performing a legal procedure or concluding a contract becomes difficult for a policyholder
with dementia, whose intention can never be confirmed. In such cases, only the adultguardian (voluntary guardian) is authorised to act on behalf of the policyholder in principle.
Designating a voluntary guardian in advance just in case is one way for family members to
act on behalf of the policyholder.
Reference 6: Family trusts
It is important for a policyholder to talk with family members in advance about any
preference for asset management in case he/she develops dementia. A family trust is one
way to proactively decide how to manage assets.
A family trust allows a person to entrust his/her family with the management and disposalof his/her assets including real estate and saving deposits for specified purposes (e.g.
coping with dementia, funding for post-retirement life or covering nursing care expenses).
Three parties are involved in a family trust: trustor, trustee and beneficiary.
Description
Trustor

Person who entrusts his or her own assets

Trustee

Person entrusted to manage, invest and dispose of the assets within
the purposes of the trust

Beneficiary

Person who benefits from the proceeds derived from the entrusted
assets(C) Actions to be taken by the government
The government developed a Master Plan for Promoting the Use of the Adult Guardianship
System in March 2017 (see Chart 21). The Master Plan introduces measures to encourage
the use of the adult guardianship system in an integrated and systematic manner.
Although the government has been implementing various measures to promote the use of
the adult guardianship system, as illustrated by the Master Plan, further efforts are needed,
including enhancing communication activities to raise awareness of the system andimproving the system and its implementation in terms of user-friendliness.
Chart 21: Overview of the Master Plan for Promoting the Use of the Adult Guardianship
System(1) Improvement of the system and its implementation so that users can fully appreciate
the benefits⇒Appropriate selection and replacement of the guardian prioritising not only asset
management but also decision-making support and personal custody- 29 -

⇒Consideration of medical certificates in which diagnosis details based on the living
conditions of the individual can be written(2) Creation of a local network for cooperation to support rights advocacy⇒Establishment of functions including: (i) publicity for the system; (ii) consultation on
using the system; (iii) promotion of the use of the system (matching); and (iv)
support for guardians⇒Development of a team to observe the behavior of the individual, a mechanism forcollaboration among local professional associations (Council) and a centralisedmechanism (Center) for coordination(3) Balance between prevention of fraudulent use and ease of use⇒Consideration of new measures that provide an alternative to or supplement legal
guardianship support trusts

4. Careful approach and response to the elderly (from the perspective offinancial inclusion)
Initiatives by the life insurance industry
Life insurers have already introduced various initiatives to take into account the specificitiesof the elderly. Initiatives at the time of contract signing include the attendance of family
members to ensure a full understanding of the product features, given the possible decline
in mental capacity due to ageing. At the time of contract renewal, explanations about
insurance coverages have been provided including through regular notifications and visits,
in order to remind policyholders that they are covered by a life insurance policy and the scopeof the coverage. We believe it is important to ensure that life insurers keep pursuing thisobjective.
As mentioned in the section on life insurers’ services for people with dementia (pages 2122), recent years have seen the emergence of new services leveraging digital technology.
Further expansion of those services will improve convenience for elderly consumers in future.
Provision of meticulous customer services from the perspective of financial inclusion entails
improving knowledge about dementia and enhancing industry-wide training on how to
respond to customers with dementia. It should be noted that the Guidance for Realising a
Barrier-free Society for People with Dementia (Finance Industry), published in April 2021 by
the Working Group on a Barrier-free Environment for People with Dementia, Japan PublicPrivate Council on Dementia, highlights knowledge about dementia, cases of behavior of
people with dementia, and considerations for their treatment. The LIAJ will seek todisseminate such knowledge and considerations across the life insurance industry and boost
relevant training provided by life insurers.

Conclusion
This proposal examined the challenges stemming from dementia in the life insurance industry
and sought to find solutions to related issues. Although we mentioned preparations to bemade by the customers and their family members and actions to be taken by the government,
the life insurance industry must assume primary responsibility for most of the solutions.
As the super-ageing society is expected to progress in the years ahead, more issues
surrounding dementia will emerge throughout society. The life insurance industry iscommitted to helping find solutions to those social issues by encouraging member companies
to respond to the super-ageing society including through initiatives to meet the challenges
stemming from dementia.

* *** *
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Reference 7: Utilisation of the Social Security and Tax Number System in the private
sectorThe Social Security and Tax Number System was launched in January 2016. Believingthat this system can be used to upgrade services for the elderly, the life insurance industry
presented the following recommendations in April 2017 to consider possible utilisation of
the Social Security and Tax Number System in the private sector.
As the super-ageing society is likely to keep progressing, we recommend that the private
sector be allowed to utilise the Social Security and Tax Number System to improve
convenience for the elderly and build a society where every citizen can live in greater
security.
By utilising the Social Security and Tax Number System, the life insurance industry could
improve services for the elderly in terms of prompt and reliable claim procedures andsimplified paperwork, as illustrated in cases (1) to (3) below, subject to the consent of
the person concerned.
To facilitate the spread and consolidation of the Social Security and Tax Number
System, the government should continue developing an enabling environment for thesystem, including by promoting public understanding of the system’s merits and building
a user-friendly mechanism.
Possible cases of utilisation by life insurers(1) If life insurers can access the survival/death data of the elderly held by thegovernment, they can pay claims more quickly and reliably and reduce the burdenof claims procedures for customers.
(2) If life insurers can access the address data of the elderly held by the government,
customers can expect to receive services from life insurers timely and reliably.
(3) If life insurers can provide information for the elderly through the Mynaportal,customers can expect to receive material notifications from life insurers timely andreliably.
Our recommendations specifically refer to using Social Security and Tax Numbers, publicpersonal authentication service and Mynaportal. 17 Of these, the public personalauthentication service system is now being revised, raising expectations for improved
customer convenience.
The public personal authentication service, used for preventing impersonation and data
falsification by third parties in making an application or declaration online, provides
effective tools for personal identification.
Personal identification is performed with an electronic ID card called an “e-certificate.”
The e-certificate is recorded and stored in an IC card (Individual Number Card)
protected against skimming.
When making an application or declaration online, users can give an electronic
signature or perform user authentication by reading out the e-certificate from theIndividual Number Card.

The Mynaportal is a highly scalable web-based service that allows users, mostly citizens, to monitor theuse of their personal information by administrative institutions such as the national and local governments
and health insurers, to verify the content of their personal information and to check various notifications
including from administrative institutions, while seamlessly linking public and private online services
including through systematic coordination of delivery services provided by private entities with social
insurance premium, tax and other public payment services.
17- 31 -

This public personal authentication service could be used to track the life/death andaddress information of customers.
Life insurers could learn about a customer’s survival/death and change of name/addressby using this service for personal identification at the time of contract signing, andsubsequently for checking information about the expiry of the e-certificate (two types ofcertificate: e-certificate for signature (“Signature Certificate”) and e-certificate for user
identification (“User ID Certificate”)) with the consent of the customer.
The survival of the customer will be confirmed if the User ID Certificate is valid.
Even if the Signature and User ID Certificates have both expired, however, the customer
could have left the country and not be dead. Life/death information would have to beobtained from an alternative source in this case18.
If the Signature Certificate has expired and the User ID Certificate has not, it can be
confirmed that either the address or the name was changed, but there is no way to identify
which of the two was changed, or to obtain information on the new address or name.
Address or other information would also need to be obtained from another source in thiscase (see Chart 22).
Looking ahead, such problems are expected to be solved with the amendment to the
Public Personal Authentication Act in 201919 to allow citizens to use the public personalauthentication service even after moving overseas, and with the adoption of a bill to amend
the Public Personal Authentication Act20, presented to the ordinary Diet session in 2021,
which will allow the provision of four basic categories of information with the consent of theperson concerned.
Thus, following the entry into effect of the Public Personal Authentication Act as amended
in 201921, the e-certificate will not expire even if the person leaves Japan. This means thatthe death of the customer can be confirmed by looking at the reason for expiry where the
Signature and User ID Certificates have both expired22.
When the bill to amend the Public Personal Authentication Act is adopted, promulgatedand comes into effect, the insurer will be able to check with the Japan Agency for Local
Authority Information Systems on new address information, etc. with the consent of thecustomer, if the Signature Certificate is found to have expired (see Chart 22).
Those upcoming amendments are expected to improve customer convenience including
through more prompt and reliable claims payment, reduced burden for claims procedures
and timely and reliable provision of services by life insurers.23

It is possible to confirm that the Signature and User ID Certificates have both expired because of deathor moving overseas, but it is not possible to identify the exact reason for the expiry (either death or moving),
thus requiring another way to obtain life/death information.
19 Act for Partial Amendment of the Act on Use of Information and Communications Technology in
Administrative Procedures, etc. to Improve Convenience of Stakeholders in Administrative Procedures andSimplify and Streamline Administrative Operation by Leveraging Information and Communications
Technology (Digital Procedure Act) (promulgated on 31 May 2019)
20 Bill on Development of Relevant Acts to Build a Digital Society (presented to the Diet on 9 February 2021)
21 The Act will come into effect on a date specified by a Cabinet Order within five years from the date ofpromulgation (31 May 2019).
22 Where the Signature and User ID Certificates have both expired following a report of the loss of the cardby the person concerned, for example, life/death information will have to be obtained in an alternative way
because the person might still be living.
23 It is up to the management of life insurers to decide on the necessity and method of utilizing the publicpersonal authentication service.
18- 32 -

Survival
Death
Address

Availability of customer information

Chart 22: Utilisation of the public personal authentication service
Current
Future△○Whereas a valid e-certificate The survival of the customer can beproves the survival of the confirmed in general if the ecustomer, an expired certificate certificate is valid, as it does notdoes not necessarily mean that the expire for a citizen moving overseas.
customer is dead. Another sourceof information is required.
×○
Although it is possible to know that The death of the customer can be
the customer might be dead, confirmed by looking at the reason
another source of information is for the expiry of the e-certificate, as
required to confirm the death.
it does not expire for a citizen moving
overseas.
×○
Although it is possible to know that If the e-certificate is found to have
either the address or name has expired, it is possible to check with
been changed, another source of the Japan Agency for Local Authority
information is required to confirm Information Systems on the newwhich of the two has been address or name with the consent ofchanged, as well as the new the customer.
address or name.

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