Is a traffic accident during commuting workers' accident insurance or compulsory auto insurance? The third-party-action report and subrogation

Bottom line first: When an employee meets a traffic accident with another party during commuting, it can be a commuting injury covered by workers' accident insurance (Article 7, paragraph 1, item 3 of the Workers' Accident Compensation Insurance Act). Because there is a counterparty (a third party), it is a "third-party-action accident," and when claiming workers' accident insurance you file a third-party-action report with the Labour Standards Inspection Office without delay. The injured side may choose whether to use compulsory auto insurance (jibaiseki) or workers' accident insurance first, but cannot receive both for the same cause; the government adjusts by subrogation and deduction (Article 12-4). If you fully settle with the other party and waive claims beyond the settlement amount, in principle you can no longer receive workers' accident benefits after the settlement, so consult the Labour Standards Inspection Office before settling. A commuting injury is covered by workers' accident insurance and cannot be treated with a health-insurance card, so if you mistakenly used health insurance, switch to workers' accident insurance. The claim procedures for workers' accident benefits are the field of a Shakai Hoken Roumushi, and negotiating the fault ratio and damages settlement is the field of a lawyer, each contracted separately as an independent business entity where the matter crosses entities.

Is a traffic accident during commuting a workers' accident?

A traffic accident during commuting can be covered by workers' accident insurance as a commuting injury. Article 7, paragraph 1, item 3 of the Workers' Accident Compensation Insurance Act makes "a worker's injury, illness, disability, or death due to commuting" a commuting injury eligible for benefits. "Commuting" here means moving, in connection with work, between home and the place of work and the like, by a reasonable route and method, excluding what has the nature of work (paragraph 2 of the same Article).

Requirement	Content	Basis
Connection with work	Movement made in connection with work (commuting to/from work, etc.)	Article 7, paragraph 2
Covered movement	Round trip between home and place of work / movement between places of work / movement between the dwelling at a single-posting location and the home (where it meets the requirements set by ordinance)	Article 7, paragraph 2, items
Route and method	By a reasonable route and method	Article 7, paragraph 2
Deviation / interruption	During a deviation or interruption from the route, and after, is in principle not commuting. But a minimum act of daily necessity done for an unavoidable reason set by ordinance is treated as commuting except during the deviation/interruption	Article 7, paragraph 3

In other words, an accident on the way while commuting by a reasonable route can be a commuting injury whether or not there is a counterparty. Note that the conclusion changes depending on whether it is during a side trip (deviation/interruption) and whether the route is reasonable. For recognizing commuting routes and movement between a dormitory and the workplace, see is a foreign worker's route between dormitory and workplace a workers' accident. This article narrows to how to use workers' accident insurance and jibaiseki when a counterparty (third party) is added by a traffic accident.

What is the third-party-action report for?

An accident caused by the action of a third party other than the parties to the workers' accident insurance relationship (the government, the employer, and the person entitled to benefits)—such as a traffic accident with a counterparty—is a "third-party-action accident." Here the injured person holds both a claim for damages against the perpetrator and a claim for workers' accident benefits. Receiving both as they are would compensate the same loss twice, so an adjustment mechanism is needed.

The starting point of that adjustment is the third-party-action report. When claiming workers' accident insurance, you file this report with the Labour Standards Inspection Office without delay. The report records the other party, the accident situation, and the status of jibaiseki and voluntary insurance, and becomes the basis on which the government subrogates against the perpetrator's side or deducts the damages received from the benefits.

Document / procedure	Who	When / where
Third-party-action report	Injured worker / bereaved family	Without delay, to the competent Labour Standards Inspection Office
Benefit claim forms (medical, leave, disability, etc.)	Injured person / bereaved (employer certifies)	To the Labour Standards Inspection Office
Copy of the settlement (if settled)	Injured person	Promptly to the Labour Bureau / Labour Standards Inspection Office

Preparing and filing the report and claim forms is the field of a Shakai Hoken Roumushi. For the flow of workers' accident procedures in general, see also where do you start with workers' accident procedures (difference from private illness/injury).

Which do you use first, jibaiseki or workers' accident insurance?

In a traffic accident, the injured side may freely choose whether to use jibaiseki (compulsory automobile liability insurance) or workers' accident insurance first. You cannot receive both for the same cause; only the amount received first is adjusted against the later benefit.

Category	Content
Jibaiseki first	Receive payment from jibaiseki first. Up to the limit paid by jibaiseki for the same cause, the workers' accident benefit is deducted
Workers' accident first	Receive the workers' accident benefit first. For the same cause, you cannot overlap with payment from jibaiseki, etc.
Subrogation (workers' accident first)	The government acquires, up to the value of the benefit paid, the injured person's claim for damages against the perpetrator (Article 12-4, paragraph 1)
Deduction (compensation first)	Where the injured person has received compensation first from the perpetrator for the same cause, the government may withhold benefits up to that value (paragraph 2 of the same Article)

Which to choose is advantageous or not depending on the case. In general, jibaiseki has a broader scope for leave-of-absence loss (leave loss is in principle fully compensated), while workers' accident insurance has benefits such as special lump-sum payments that are not adjusted against jibaiseki. Where the fault ratio is contested, how to combine the negotiation with jibaiseki/voluntary insurance and the workers' accident claim directly affects the practical gain. The negotiation of the fault ratio and the amount of damages that underlies this judgment is itself the domain of a lawyer, as legal judgment and negotiation.

If you settle first, what happens to workers' accident benefits?

This is the point to watch most in a commuting traffic accident. If a full settlement (a settlement in which no damages beyond the settlement amount will be claimed) is genuinely concluded between the injured person and the perpetrator's side, and claims beyond the settlement amount are waived, the government in principle does not pay workers' accident benefits after the settlement is concluded. This is because any benefits that should have been received in the future are treated as waived.

• Do not mistake the order: if, before claiming workers' accident insurance, you conclude a settlement of "no further claims from now" for an insufficient amount, you may lose the workers' accident benefits that would otherwise follow. A settlement should be considered only after you understand how far workers' accident insurance covers.
• Always report once you settle: once a settlement is concluded, promptly notify the Labour Bureau or the Labour Standards Inspection Office and submit a copy of the settlement.
• Separate your consultation counterparties: the settlement negotiation (agreement on fault ratio and damages) is a lawyer, and the claim procedure for workers' accident benefits is a Shakai Hoken Roumushi—the handling entities differ. For how to sort out "whom to consult," including dismissal and disputes, the way of thinking in unfair dismissal: a Shakai Hoken Roumushi or a lawyer is also helpful.

Because workers' accident benefits are adjusted or suspended depending on the content of the settlement, the order of "settle first, then think about workers' accident insurance" is dangerous. We recommend first consulting the Labour Standards Inspection Office before settling.

If you used health insurance, how do you switch?

An injury from an accident during commuting is a commuting injury—covered by workers' accident insurance—so it is not something to be treated with a health-insurance card. An injury or illness arising from work or commuting is, in principle, handled by the workers' accident insurance medical (compensation) benefit.

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Insurance mistakenly used	Response
Received treatment with a health-insurance card	In principle switch to workers' accident insurance. Contact the health-insurance insurer, repay the portion the insurer bore, and switch to a workers' accident claim (confirm the procedure with the insurer, medical institution, and Labour Standards Inspection Office)
Used health insurance for an ordinary traffic accident by a third party	The insurer subrogates the claim for damages against the perpetrator. The insured files a report of injury by a third-party action with the insurer (Article 57 of the Health Insurance Act)

If you keep receiving treatment under health insurance when it is clearly a commuting injury, a settling-up becomes necessary later and the procedure grows cumbersome. Where you used health insurance in a traffic accident with a counterparty, a report of injury by a third-party action to the insurer is also needed; confirm the switching procedure early. The administrative work of switching and of the workers' accident claim is something a Shakai Hoken Roumushi can advise on. Negotiating the fault ratio and damages with the other party is the field of a lawyer; where the matter crosses entities, each is contracted separately as an independent business entity, and there is no referral fee.

Frequently asked questions

Q. I had an accident during commuting through my own carelessness (fault). Does fault mean no workers' accident insurance?
A. Even if the worker is at fault, if it was during commuting by a reasonable route and method, it can be eligible for workers' accident benefits as a commuting injury (Article 7, paragraph 1, item 3 of the Workers' Accident Compensation Insurance Act). Workers' accident insurance is basically not a system where the presence of fault decides eligibility. However, whether it was during a deviation/interruption of the route, and how the fault ratio with the other party affects the damages amount and the subrogation/deduction, are separate questions. The judgment and negotiation of the fault ratio itself is the domain of a lawyer. Whether an individual case qualifies is determined by a qualified professional after a consultation.

Q. The perpetrator had voluntary insurance. Is it better not to use workers' accident insurance?
A. Not decided uniformly. "Jibaiseki first" (using jibaiseki/voluntary insurance first) and "workers' accident first" (using workers' accident insurance first) can be chosen by the injured side, and you cannot receive both for the same cause (Article 12-4). Workers' accident insurance has benefits such as special lump-sum payments that are not adjusted against compensation, and the method of calculating leave compensation also differs. Which is advantageous varies with the fault ratio, the amount of loss, and the length of treatment, so it is safest to compare the scope of workers' accident benefits and the outlook for the other party's compensation before claiming.

Q. A settlement with the other party's insurer is about to be reached. May I proceed before workers' accident insurance?
A. Please judge carefully. If a full settlement is genuinely concluded and claims beyond the settlement amount are waived, the government in principle does not pay workers' accident benefits after the settlement is concluded. Settling for an insufficient amount of "no further claims" risks losing workers' accident benefits that could have been received afterward. Consult the Labour Standards Inspection Office before settling, and once a settlement is concluded, submit a copy of the settlement promptly to the Labour Bureau / Labour Standards Inspection Office.

Q. After the accident, I went to the hospital using a health-insurance card for the time being. What should I do?
A. A commuting injury is covered by workers' accident insurance and is not something to be treated with a health-insurance card. If you have already used health insurance, in principle switch to workers' accident insurance. The flow is to contact the health-insurance insurer, settle up the portion the insurer bore, and switch to a workers' accident claim. Where you used health insurance in a traffic accident with a counterparty, a report of injury by a third-party action to the insurer is also needed (Article 57 of the Health Insurance Act). Confirm the specific procedure with the insurer, medical institution, and Labour Standards Inspection Office.

Basis for this article

• Workers' Accident Compensation Insurance Act (Act No. 50 of 1947), Article 7, paragraph 1, item 3 — "benefits for a worker's injury, illness, disability, or death due to commuting (... commuting injury ...)." Item 1 of the same paragraph = work injury, item 2 = multiple-workplace-factor injury (confirmed on e-Gov Law Search on 5 November 2026)
• Same Act, Article 7, paragraph 2 — commuting means moving, in connection with work, between home and the place of work, etc., by a reasonable route and method, excluding what has the nature of work (confirmed on e-Gov Law Search on 5 November 2026)
• Same Act, Article 7, paragraph 3 — during a deviation/interruption of the route and the movement after it is in principle not commuting. But where it is a minimum act of daily necessity set by ordinance done for an unavoidable reason, it is commuting except during the deviation/interruption (confirmed on e-Gov Law Search on 5 November 2026)
• Same Act, Article 12-4, paragraph 1 — where the government pays benefits when the accident was caused by the action of a third party, it acquires, up to the value of the benefit paid, the injured person's claim for damages against the third party (subrogation). Paragraph 2 — where the injured person has received damages from that third party for the same cause, the government may withhold benefits up to that value (deduction) (confirmed on e-Gov Law Search on 5 November 2026)
• Ministry of Health, Labour and Welfare / Prefectural Labour Bureau, "Guide to third-party-action accidents" and Labour Bureau guidance — in a third-party-action accident, file the third-party-action report without delay. The injured person can choose whether to receive jibaiseki or workers' accident insurance first; under jibaiseki first, the workers' accident benefit is deducted up to the jibaiseki limit for the same cause, and under workers' accident first, you cannot overlap with jibaiseki, etc., for the same cause. If a full settlement is genuinely concluded and claims beyond the settlement amount are waived, in principle no workers' accident benefits are paid after the settlement. After settling, promptly submit a copy of the settlement to the Labour Bureau / Labour Standards Inspection Office (confirmed on Ministry of Health, Labour and Welfare / Tokyo Labour Bureau guidance on 5 November 2026)
• Automobile Liability Security Act (Act No. 97 of 1955) — liability for damages when the operation of an automobile harms another's life or body, and the jibaiseki mechanism
• Health Insurance Act (Act No. 70 of 1922), Article 57 — where the insurer pays benefits for an injury or illness caused by the action of a third party, it acquires, up to that value, the insured's claim for damages against the third party. The insured files a report with the insurer for an injury by a third-party action (confirmed on 5 November 2026). An injury or illness due to work or commuting is covered by workers' accident insurance and is not eligible for treatment with a health-insurance card
• Which of jibaiseki first or workers' accident first is advantageous varies with individual circumstances such as the fault ratio, the amount of loss, and the length of treatment. The evaluation of the fault ratio and the negotiation of damages itself is the domain of a lawyer, and this article gives no uniform conclusion (unverified). Confirm the specific settling-up/switching procedure from health insurance to workers' accident insurance with the insurer, medical institution, and competent Labour Standards Inspection Office

This article is general information. Individual determinations are made by a qualified professional after a consultation, in light of individual circumstances. 四葉社会保険労務士事務所 can advise on organizing whether a commuting injury applies, the third-party-action report and the various workers' accident benefit claim procedures, structuring the claim in light of the order with jibaiseki/voluntary insurance, and organizing the switch from health insurance to workers' accident insurance. The settlement negotiation over the fault ratio and damages with the other party is the field of a lawyer; in that case, each is contracted separately as an independent business entity, and there is no referral fee. Fees are set out in the fee schedule, and frequently asked questions in the FAQ. Written by Joji Uramatsu (Shakai Hoken Roumushi, Gyoseishoshi, Registered Real Estate Transaction Specialist).