[Social Security and Law] A Case in which a Health Insurance Society's Ex Officio Decision to Remove an Insured Person's Child as a Dependent Was Held to Be Lawful

This case study examines a case where a health insurance society exercised its authority to remove an insured person's children from dependent status. The Tokyo District Court ruled that procedures for gaining or losing dependent status should be considered similar to those for insured status, and that insurers can make dependent certifications ex officio. The court also held that insurers should establish criteria for determining dependent requirements, and that ex officio removal is possible even outside the scope of the 2021 Notice No. 1 when couples are separated due to DV and there is no livelihood maintenance relationship. This judgment provides important guidance on legal interpretation regarding the acquisition and loss of dependent status.