Research Article
Juridical Analysis of Claim Rejection of Smartlingk Insurance Program: Flexi Account Plus And Critical Illness Plus At Pt. Allianz Indonesia Insurance Medan Branch
@INPROCEEDINGS{10.4108/eai.14-4-2021.2312509, author={Alfindo Sebastian Putra Barus and Emir Syarif Fatahillah Pakpahan and Roswita Sitompul and Dewi Ervina Suryani and Suhaila Zulkifli}, title={Juridical Analysis of Claim Rejection of Smartlingk Insurance Program: Flexi Account Plus And Critical Illness Plus At Pt. Allianz Indonesia Insurance Medan Branch}, proceedings={Proceedings from the 1st International Conference on Law and Human Rights, ICLHR 2021, 14-15 April 2021, Jakarta, Indonesia}, publisher={EAI}, proceedings_a={ICLHR}, year={2021}, month={10}, keywords={insurance insurer and insured}, doi={10.4108/eai.14-4-2021.2312509} }- Alfindo Sebastian Putra Barus
Emir Syarif Fatahillah Pakpahan
Roswita Sitompul
Dewi Ervina Suryani
Suhaila Zulkifli
Year: 2021
Juridical Analysis of Claim Rejection of Smartlingk Insurance Program: Flexi Account Plus And Critical Illness Plus At Pt. Allianz Indonesia Insurance Medan Branch
ICLHR
EAI
DOI: 10.4108/eai.14-4-2021.2312509
Abstract
The legal relationship between the parties in the insurance agreement is the customer as the insured and the insurance company as the insured, the rights and obligations are set forth in the form of a policy and explain the premium. In insurance practice, not all claims submitted by the insured are accepted, while the criteria for rejection of customer claims by the Allianz company include: Completeness of claim documents; Exceeds the predetermined time; Claims are not covered by the agreement; Before the policy was purchased the disease already existed; Exceptions in filing a claim; and Breaking the law; Insurance claim dispute settlement can be carried out by the Financial Services Authority. The insurance policy contains clauses on how to resolve disputes, such as deliberation, arbitration or court. In addition, disputes can be resolved through dispute resolution institutions such as the Consumer Dispute Resolution Agency (BPSK) and the Indonesian Insurance Mediation Agency.