{"text_format":"1","workbook":"xlsx","n_sheets":4,"sheets":["Polisyholder","Illness","Injury","Personal Liability Insurance"],"not_rendered":{"charts":0,"images":111,"macros":1,"external_links":0,"defined_names":3,"comments":0,"pivot_tables":0},"unopened":[],"bounds":{"document_bytes":16777216,"sheet_cells":100000,"rows_first":2000,"rows_last":500,"rows_between":2000,"halvings":0,"cell_chars":16384,"cell_head_chars":4096},"cells_cut":0,"cells_raw":0,"read":"whole","date_system":"1900"}

{"sheet":"Polisyholder","index":0,"n_rows":26,"n_cols":36,"rows_kept":26,"cut":false,"hidden":false,"merged":[[10,15,10,36],[4,11,4,22],[7,11,7,22],[3,29,3,36],[6,11,6,22],[6,29,6,36],[6,23,6,28],[5,11,5,22],[5,26,5,36],[25,4,25,17],[9,11,9,24],[11,11,11,36],[19,26,19,36],[21,26,21,36],[3,3,3,10],[23,4,24,34],[3,11,3,22],[8,11,8,21],[8,23,8,36]]}
[]
[]
[]
[null,null,null,"(1) Policyholder Number"]
[null,null,null,"(2) Date of Birth"]
[null,null,null,"(3) Name",null,null,null,"(spelling)",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"(Kana)"]
[null,null,null,"(4) Name of University"]
[null,null,null,"(5) Student Number"]
[null,null,null,"(6) E-mail Address",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"@"]
[null,null,null,"(7) Telephone Number",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"(In Japanese",null,null,null,null,null,null,null,null,null,")"]
[null,null,null,"(8) Document Mailing ",null,null,null,null,null,null,null,"Zip Code",null,null,"〒"]
[null,null,null,null," Address"]
[]
[]
[]
[]
[null,null,null,"    <When Claiming Medical Expenses>"]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"If you have received treatment for illness"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"If you have received treatment for injury"]
[]
[null,null,null,null,"*The valid period shall continue until the last day of the month in which the 60th day following the first medical examination falls.\nIn regard to the same injury or illness, this coverage is valid in the case that 180 days have passed from the last day"]
[]
[null,null,null,null,"<When Claiming Liability Insurance>"]

{"sheet":"Illness","index":1,"n_rows":28,"n_cols":34,"rows_kept":28,"cut":false,"hidden":false,"merged":[[23,1,23,15],[19,0,19,15],[20,0,20,15],[22,21,22,24],[22,25,22,26],[22,27,22,30],[27,9,27,15],[10,0,10,12],[3,0,3,15],[5,0,5,12],[6,0,6,12],[9,1,9,12],[22,0,22,15],[8,22,8,25],[8,28,8,31],[6,27,6,28],[8,26,8,27],[21,19,21,21],[21,24,21,25],[21,29,21,30],[15,20,15,32],[17,18,17,32],[19,23,19,33],[3,17,3,32],[5,14,5,32],[6,15,6,19],[6,22,6,23],[11,24,11,25],[11,18,11,19],[9,23,9,24]]}
[]
[]
[null,"<For Illness Claims>"]
["(1) Provide us with the name listed on the health insurance card"]
[]
["(2) Provide us with the name of the illness"]
["(3) Provide us with the date you first visited the hospital",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Year",null,null,null,"Month",null,null,null,null,"Day"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,"□","Treatment complete",null,null,null,null,null,null,null,"□","Currently under treatment"]
["(4)Were you hospitalized?",null,null,null,null,null,null,null,null,null,null,null,null,null,"□","None",null,"□","Yes",null,"(From",null,null,null,null,null,"to",null,null,null,null,null,")"]
[null,"Do you plan to be hospitalized in the future?",null,null,null,null,null,null,null,null,null,null,null,null,"□","None",null,"□","Yes",null,"(Around",null,null,null,null,"month later)"]
["(5) For which body part did you receive treatment?",null,null,null,null,null,null,null,null,null,null,null,null,null,"□","Head",null,"□","Face",null,"□","Eye",null,"□","Nose",null,"□","Ear",null,"□","Tooth"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,"□","Neck",null,"□","Shoulder",null,"□","Chest",null,"□","Stomach",null,"□","Back",null,"□","Hip"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,"□　","Arm(",null,null,"Right",null,"□","Left)",null,null,"□　","Foot(",null,null,"Right",null,"□","Left)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,"□","Finger",null,"(",null,"Right",null,"□","Left)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,"□","Toe",null,"(",null,"Right",null,"□","Left)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,"□","Other",null,null,null,"(",null,null,null,null,null,null,null,null,null,null,null,null,null,")"]
["(6) What were the symptoms?",null,null,null,null,null,null,null,null,null,null,null,null,null,"□","Fever",null,null,"□","Cold",null,null,"□","Pain"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,"□","Other ",null,"（",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,")"]
["(Please answer the following questions)"]
["(7) Was this the first time you were treated for this illness?",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"□","Yes",null,null,"□","No",null,"(Please answer questions (9) and (10))"]
["(8) What was the number of points in the field titled “初再診” on the receipt for your fist hospital visit?",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"□","282 or more",null,null,null,null,null,"□","Less than 282 points"]
["(9) When did you begin receiving treatment?",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"From",null,null,null,null,"year",null,null,null,"month",null,null,null,null,"day"]
["(10) Was there a period when you were fully recovered?",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"□","Yes",null,"(From",null,null,null,null,null,"to",null,null,null,null,null,")"]
[null,"* This includes periods during which treatment was suspended.",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"□","No (receiving regular treatment)"]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,"ins-claim_chiryou@tmnf.jp"]

{"sheet":"Injury","index":2,"n_rows":32,"n_cols":34,"rows_kept":32,"cut":false,"hidden":false,"merged":[[14,0,14,12],[27,1,27,15],[25,0,25,15],[26,0,26,15],[24,0,24,15],[26,21,26,24],[23,0,23,15],[17,20,17,32],[21,18,21,32],[31,9,31,15],[3,0,3,15],[5,0,5,12],[6,0,6,12],[10,0,10,12],[6,15,6,22],[13,1,13,12],[23,23,23,33],[15,24,15,25],[15,18,15,19],[19,23,19,25],[3,17,3,32],[5,14,5,32],[9,18,9,32],[10,15,10,19],[10,22,10,23],[10,26,10,27],[26,25,26,26],[26,27,26,30],[11,22,11,24],[25,19,25,21],[25,24,25,25],[12,22,12,25],[12,26,12,27],[12,28,12,31],[13,23,13,24],[25,29,25,30]]}
[]
[]
[null,"<For Injury Claims>"]
["(1) Provide us with the name listed on the health insurance card"]
[]
["(2) Provide us with the name of the injury or illness"]
["(3) What were you doing at the time of injury?",null,null,null,null,null,null,null,null,null,null,null,null,null,"□","During the regular curriculum/school event",null,null,null,null,null,null,null,"□","During travel to/from school"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,"□","During club activities",null,null,null,null,null,null,null,"□","Private (unrelated to school)"]
["(4) What was the situation?",null,null,null,null,null,null,null,null,null,null,null,null,null,"□","Fall",null,null,"□　","Collision",null,null,null,"□","Cut",null,null,"□","Crushed"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,"□","Other",null,"(",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,")"]
["(5) Provide us with the date you first visited the hospital",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Year",null,null,null,"Month",null,null,null,"Day"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,"□","Treatment complete(Until",null,null,null,null,null,null,null,null,null,")",null,"□","Under treatment"]
["(6)","Were you hospitalized?",null,null,null,null,null,null,null,null,null,null,null,null,"□","None",null,"□","Yes",null,"(From",null,null,null,null,null,"to",null,null,null,null,null,")"]
[null,"Do you plan to be hospitalized in the future?",null,null,null,null,null,null,null,null,null,null,null,null,"□","None",null,"□","Yes",null,"(Around",null,null,null,null,"month later)"]
["(7) For which body part did you receive treatment?",null,null,null,null,null,null,null,null,null,null,null,null,null,"□","Head",null,"□","Face",null,"□","Eye",null,"□","Nose",null,"□","Ear",null,"□","Tooth"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,"□","Neck",null,"□","Shoulder",null,"□","Chest",null,"□","Stomach",null,"□","Back",null,"□","Hip"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,"□　","Arm",null,"□　","Foot",null,"□","Finger",null,null,"□","Toe"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,"□","Other",null,null,null,"(",null,null,null,null,null,null,null,null,null,null,null,null,null,")"]
[null,"Please tell us whether it was on the left or right side",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"□","Left",null,"□","Right",null,"□","Unknown"]
["(8)","What were the symptoms?",null,null,null,null,null,null,null,null,null,null,null,null,"□","Cut",null,null,"□","Bruise",null,null,"□","Broken bone",null,null,"□","Dislocation"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,"□","Sprain",null,null,"□","Burn"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,"□","Other",null,"(",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,")"]
["(Please answer the following questions)"]
["(9) Was this the first time you were treated for your injury?",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"□","Yes",null,null,"□","No",null,"(Please answer questions (7) and (8))"]
["(10) What was the number of points in the field titled “初再診” on the receipt for your fist hospital visit?",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"□","282 or more",null,null,null,null,null,"□","Less than 282 points"]
["(11) When did you begin receiving treatment?",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"From",null,null,null,null,"year",null,null,null,"month",null,null,null,null,"day"]
["(12) Was there a period when you were fully recovered?",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"□","Yes",null,"(From",null,null,null,null,null,"to",null,null,null,null,null,")"]
[null,"* This includes periods during which treatment was suspended.",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"□","No (receiving regular treatment)"]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,"ins-claim_chiryou@tmnf.jp"]

{"sheet":"Personal Liability Insurance","index":3,"n_rows":28,"n_cols":36,"rows_kept":28,"cut":false,"hidden":false,"merged":[[3,30,3,34],[3,0,3,5],[4,0,5,5],[6,0,6,5],[8,0,8,5],[14,7,14,13],[13,7,13,13],[12,7,12,13],[7,7,7,10],[3,7,3,9],[3,12,3,13],[4,8,4,17],[4,21,4,34],[4,18,4,20],[3,17,3,18],[6,30,6,34],[27,10,27,17],[15,7,15,13],[5,9,5,34],[16,29,18,35],[19,28,23,35],[7,30,7,34],[7,23,7,27],[6,16,6,21],[10,11,10,34],[14,32,14,35],[6,25,6,27],[7,11,7,13],[7,14,7,18],[12,23,12,35]]}
[]
[]
[null,"<For Personal Liability Insurance>"]
["(1) Date/Time of occurrence",null,null,null,null,null,null,null,null,null,"Year",null,null,null,"Month",null,null,null,null,"Day",null,null,null,null,"Approximate time："]
["(2) Contact for the other party",null,null,null,null,null,"Name",null,null,null,null,null,null,null,null,null,null,null,"Phone"]
[null,null,null,null,null,null,"Address"]
["(3) Future contact",null,null,null,null,null,null,"Above(2)",null,null,null,null,"Other(",null,"Name",null,null,null,null,null,null,null,"Relationship",null,null,null,null,null,"Phone",null,null,null,null,null,null,")"]
[null,null,null,null,null,null,null,"Insurance Company",null,null,null,"(Company\n Name）",null,null,null,null,null,null,null,"Representative",null,null,null,null,null,null,null,null,"Phone",null,null,null,null,null,null,")"]
["(4) Type of accident",null,null,null,null,null,null,"Water leaks going to lower floors"]
[null,null,null,null,null,null,null,"Property damage to other person's property"]
[null,null,null,null,null,null,null,"Other",null,null,"(",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,")"]
[null,null,null,null,null,null,null,"Traffic accident (please check the following)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Bicycle",null,null,null,"Pedestrian",null,null,null,"*Automobiles and motorcycles are NOT covered"]
[null,null,null,null,null,null,null,"Was the insured party injured?",null,null,null,null,null,null,null,"Yes",null,null,"No"]
[null,null,null,null,null,null,null,"What was the other party’s vehicle?",null,null,null,null,null,null,null,"Automobile",null,null,null,"Motorcycle",null,null,null,"Bicycle",null,null,null,"Pedestrian",null,null,null,null,"Non-persons\n (fence, etc.)"]
[null,null,null,null,null,null,null,"Was the other party injured?",null,null,null,null,null,null,null,"Yes",null,null,"No"]
[null,null,null,null,null,null,null,"Please select the most similar type of accident.",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,3,null,"Other\n A person who can describe　the situation should do so below"]
[null,null,null,null,null,null,null,1,null,null,null,null,null,null,null,null,null,2]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,"ins-claim_baiseki@tmnf.jp"]