CASHLESSMEDICAL SERVICE I, the undersigned, hereby irrevocably authorize the Medical Service Providers to file a claim for and on behalf of me and/or
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2 CASHLESSMEDICAL SERVICE I, the undersigned, hereby irrevocably authorize the Medical Service Providers to file a claim for and on behalf of me and/or the Insured Patient, for the costs of medical services rendered pursuant to Mitsui Sumitomo Insurance CO.,LTD.(hereinafter MSI ) s cashless medical services. I hereby further agree to reimburse, as soon as practicable, either the Medical Service Providers or MSI at the direction of MSI, for the amount already paid by MSI in case that MSI is found not to be liable to pay such amount under the policy covering the Insured Patient. the undersigned, authorize the claimant to claim and receive the insurance benefit on my behalf in connection with the accident described herein. 2
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4 I, the undersigned, hereby irrevocably authorize Mitsui Sumitomo Insurance Co., Ltd. (hereinafter MSI ) to obtain any and all factual information related to an insurance claim(s) filed or to be filed against MSI, including but not limited to medical, physical, clinical, mental or psychological condition (hereinafter Medical Information ) of the Insured Patient from any relevant organization or individuals, including but not limited to any hospital(s), clinic(s), physician(s), medical doctor(s), therapist(s) and any other organization(s) or person(s) who will or have attended, examined, inspected or provided medical services of any kind (hereinafter Medical Service Providers ). This authorization shall be irrevocable, valid and in effect until the final settlement of insurance claims. I, the undersigned, hereby irrevocably authorize any Medical Service Providers to furnish MSI with such Medical Information as hereinabove defined, including but not limited to: 1.Medical record and/or report describing the details of medical services and/or medicines rendered 2.Medical opinion as regards the cause(s) and symptom(s) of the injury or sickness of the Insured Patient, chronological history, nature and period of the medical treatment rendered, preexisting medical, physical, mental or clinical condition and present or possible disability, if any, of the Insured Patient; and 3.Any other form of medical records, including but not limited to X-Ray, MRI or any other information recorded in optical, electronic or magnetic medium. 4
5 CASHLESSMEDICAL SERVICE I, the undersigned, hereby irrevocably authorize the Medical Service Providers to file a claim for and on behalf of me and/or the Insured Patient, for the costs of medical services rendered pursuant to Mitsui Sumitomo Insurance CO.,LTD.(hereinafter MSI ) s cashless medical services. I hereby further agree to reimburse, as soon as practicable, either the Medical Service Providers or MSI at the direction of MSI, for the amount already paid by MSI in case that MSI is found not to be liable to pay such amount under the policy covering the Insured Patient. the undersigned, authorize the claimant to claim and receive the insurance benefit on my behalf in connection with the accident described herein. 5
6 I, the undersigned, hereby irrevocably authorize Mitsui Sumitomo Insurance Co., Ltd. (hereinafter MSI ) to obtain any and all factual information related to an insurance claim(s) filed or to be filed against MSI, including but not limited to medical, physical, clinical, mental or psychological condition (hereinafter Medical Information ) of the Insured Patient from any relevant organization or individuals, including but not limited to any hospital(s), clinic(s), physician(s), medical doctor(s), therapist(s) and any other organization(s) or person(s) who will or have attended, examined, inspected or provided medical services of any kind (hereinafter Medical Service Providers ). This authorization shall be irrevocable, valid and in effect until the final settlement of insurance claims. I, the undersigned, hereby irrevocably authorize any Medical Service Providers to furnish MSI with such Medical Information as hereinabove defined, including but not limited to: 1.Medical record and/or report describing the details of medical services and/or medicines rendered 2.Medical opinion as regards the cause(s) and symptom(s) of the injury or sickness of the Insured Patient, chronological history, nature and period of the medical treatment rendered, preexisting medical, physical, mental or clinical condition and present or possible disability, if any, of the Insured Patient; and 3.Any other form of medical records, including but not limited to X-Ray, MRI or any other information recorded in optical, electronic or magnetic medium. 6
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A Contrastive Study of Japanese and Korean by Analyzing Mistranslation from Japanese into Korean Yukitoshi YUTANI Japanese, Korean, contrastive study, mistranslation, Japanese-Korean dictionary It is already
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Title 社 会 化 教 育 における 公 民 的 資 質 : 法 教 育 における 憲 法 的 価 値 原 理 ( fulltext ) Author(s) 中 平, 一 義 Citation 学 校 教 育 学 研 究 論 集 (21): 113-126 Issue Date 2010-03 URL http://hdl.handle.net/2309/107543 Publisher 東 京
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JVA REPORT 12 '12 DECEMBER NO.155 MAIN REPORTS SCIENCE FICTIONS LOVE STORY EDUCATION ANIMATION ACTION KIDS MUSICAL CONCERT HOW-TO TV SHOW Article 12 Transfer of Rights 1A A Contracting Party may provide
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