Insurances World

Abstract : Every action performed by humans can pose a risk. The risk depends on the
various activities or actions carried out by someone. Currently these risks can be transferred
to other parties, namely by purchasing an insurance policy. In this way one can shift
economic risk to the insurance company. Today, many types of insurance offered by
insurance companies in Indonesia. However, compensation is not always given the insurer in
accordance with the expected insured. Non-performance compensation in accordance with
the expected insured causes the insured to feel disappointed. Many things that cause this to
happen, so even though we have the following insurance, we must follow the procedures and
rules are written in the insurance policy so that the insurance that we created can help us in
dealing with the risks that occur in the future.

In this article will discuss the definition of insurance, insurance functions, basic
principles of insurance, type - the type of insurance, insurance claims are not paid, the reason
why the claim is not paid, and the expiration of the insurance. By knowing things - things
relating to such insurance, the insurance community is expected to follow so as to minimize
the risk borne in the future.

Keywords: Insurance

Indroduction

Insurance business is a mechanism that provides protection to the insured in the event
of future risks. If such risks actually occur, the insured party will receive compensation
amounting to the value of the agreement between the insurer and the insured. This protection
mechanism is needed in the business world is full of risks. Rationally, business people would
consider to reduce the risk. At the level of the family or household life, insurance is also
needed to reduce the economic problems that would be faced if there is one member of the
family who run the risk of disability or death.

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 Insurance development in Indonesia is now experiencing very rapid progress. Various
insurance companies competing to offer better insurance program for people and companies.

Meaning of Insurance

Insurance is derived from the word that means the insurance coverage. Insurance is an
agreement between the insured or the customer with the insurer or insurers. The insurer is
willing to bear some losses that may arise in the future after the insured agreed on the
payment of money called a premium. The premium is the money spent by the insured as
compensation to the insurer.

Function of Insurance
The main function of insurance is risk transfer mechanism, which transfer risk from one
party to the other party, namely the insured that the insurer. The transfer of risk is by no
means eliminates the possibility of misfortune, but the insurer to provide financial security
facilities and tranquility or peace of mind for the insured. In return, the insured is obliged to
pay premiums in a relatively small amount when compared with the potential losses that
might be natural.

Basic Principles of Insurance

The basic principles that must be met by institutions or companies engaged in the insurance
business are:
Principle of Good Faith (Utmost Good Faith)
Utmost good faith is the principle that every insured is obliged to disclose
accurate and complete information about all the important facts regarding the
coverage of an object to be insured. This principle also applies to the insurance
company, which is obliged to provide an explanation of the risks that are guaranteed
or not guaranteed to be clear and complete and all the terms and conditions of
coverage.
Principles of Insured Interest
Insurable interest is a right arising from a financial relationship to insure,
between the insured with the insurance object is insured and legally recognized. This
principle aims to prevent any chance of insured bad faith.

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 Principle of Indemnity
Indemnity is a compensation payment for the insured loss or accident, the
insurer is obligated to return to the state prior to the loss.
Principle of Subrogation
Subrogation is the right person after giving compensation to the insured and
act on behalf of the insured in filing a lawsuit against a third party who is legally
responsible for the occurrence of such loss.

Principle of Contribution
Contribution is the right person after giving full compensation to the insured to
sue the other person involved in the object insured to pay each of the losses in
proportion to the amount insured dependents.
Principle of Cause and Effect (Proximate Cause)
Proximate Cause is a settlement of compensation to the insured for losses
caused by more than one cause.

Types of Insurance
The insurance company makes insurance policy in accordance with the focus grouping and
risk for the insured. It provides a measure of uniformity in the types of risk covered by the
policy, which in turn enables insurers to anticipate potential losses and set premiums
accordingly. The most common form of insurance policy types, namely:
Life Insurance
Life insurance provides financial benefits to the person designated for the death of the
insured. A person can buy life insurance on his own life for the benefit of a third person.
Someone Individuals can even buy life insurance on the lives of others. For example, a wife
may buy life insurance that will provide benefits to him after the death of her husband.
Health Insurance
Health insurance is an insurance product that specifically deal with health problems caused
by an illness and treatment processes to bear on members of his insurance. Generally include
protecting and bear in injury, disability, illness, and death due to an accident. Health
insurance can be purchased for oneself and for others.
Vehicle Insurance

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Vehicle insurance is insurance against damage to the vehicle caused by another person
insured vehicle. Vehicle insurance can also pay for the loss of, or damage to, the insured
motor vehicle.
Home ownership and property Insurance
Homeowners insurance is to protect homeowners from the losses associated with their place
of residence, personal property insurance to protect against loss of, or damage to, certain
items of private property. These include protecting and providing relief in the event of an
accident in your home, such as fire and so forth.
Education Insurance
It is one of the most popular types of insurance today. education insurance is a smart solution
to ensure better life. for example, parents who insure children's education. the cost of the
premium to be paid by the insurance participants depending on the type of education to be
obtained later.

Insurance Claims Not Paid

Not long ago in Indonesia there is a case of public figure whose child suffered a traffic
accident. The child was later treated in hospital. The public figure as well as the father tried to
take care of insurance claims for the cost of his hospital. The insurance company claimed
insurance claims are not paid, because the child has violated traffic regulations.
Looking from the side of the Father above case is a case that is very annoying. Already
have to take care of children who enter the hospital, the father should also strive to take care
of insurance. Whereas the purpose of insuring is to fund medical care if something happens to
their children's health.
On the other hand the insurance company has the reason that insurance companies have
entered into an agreement with the father and the child in an insurance contract. In the
contract there are exceptions payments, one of which is a violation of law. Rules already clear
that violations of the law is not justified. Driving a vehicle is required to have a license. In the
case of the deadly accident the driver did not have a license given still under age, occurred at
3 am today. It is used to declare the insurance company refused to pay.

The reason why the claim is not paid:

1. Not included in clause (contractual agreement), for example: death due to an accident,
but it turns out the customer died of illness then death claims will not be paid

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 2. Included in the exceptions, for example: some types of cancers such as skin cancer,
prostate, etc. (each insurance company sets different types of cancer that can not be
claimed. Or die for committing the crime, was also included in the exceptions.
3. A disease that already exists, if the diagnosis is known that the claims filed due to
illnesses that existed before the policy applies and is not listed in the policy, then the
claim is not paid.
4. Incompletes documents. Required documents when the claim for example: medical
certificate, a letter from the customer's own claims. Lack of any document then the
claim will not be paid.
5. Still in the waiting period. Some types of claims such as critical illness, hospital
requires a waiting period (the time after the policy issue) between 30-365 days. If the
disease that claimed included in the waiting period then the claim is not paid.
6. Policy in a state of lapse. Lapse which means the policy is not active because of
unpaid premiums on due date then the insurance company will not pay claims
submitted.
7. Claims filed later than the time specified. Usually, insurance companies set a deadline
for claims between 30-60 days, the passing of time has elapsed, the claims will not be
entertained.
8. Claims submitted due to customer committing a crime. For example: hospitalizations
for mass beaten while stealing.
9. Crime insurance, for example: accidentally cut his own finger in order to obtain
reimbursement. Or heirs who commit crimes against the insured given the magnitude
of the money claim to be obtained.
10. Being out of the contract area. For example: in a written contract all the events that
occurred in Indonesia, but in fact there are events outside of Indonesia, the claim will
be rejected.

Insurance Expiration

There are three things that cause the insurance agreement ends, are as follows :

1. Because Occurs Evenemen

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 In life insurance, the only evenemen that a burden is the death of the insured
person. Against this evenemen held life insurance between the insured and the insurer.
If within the period agreed upon death of the insured event occurs, the insurer is
obliged to pay compensation to connoisseurs designated by the insured or to his heir.
Since the insurer repay the compensation payment, since it is also a life insurance
ends.

Why life insurance expired since the repayment of welfare money, not since
the death of the insured (occurring evenemen). According to the law the agreement,
an agreement made by the parties to come to an end when each party's achievements
have been met. Because life insurance is an agreement, then it ends the life insurance
money to pay off compensation from the insurer as a result and the death of the
insured. In other words, life insurance expired since occurred evenemen followed by a
repayment claim.

2. Because Term Ends

In the life insurance is not always to be borne by the insurer evenemen it

happens even to the expiration of the period of insurance. If the applicable time period
expired without insurance it happen evenemen, niaka burden of risk the insurer ended.
However, the agreement specified that the insurer will refund the money to the
insured sejumtah until a period when the insurance runs out does not occur evenemen.
In other words, life insurance ends since the applicable time period runs out insurance
followed by pengembalan sum of money to the insured.

3. Because Insurance Cancelled

Life insurance can end because of cancellation before the expiry date. The
cancellation can occur because the insured does not continue to pay the premium in
accordance with the agreement or because of the insured's own request. Cancellation
of life insurance premiums can occur before or after the start paid premiums are paid
according to the time period. If the cancellation before the premium is paid, there is

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 no problem. However, if the cancellation after the premium is paid once or several
times a payment (monthly), Because life insurance is based on the agreement, then the
solution depends also on an agreement the parties listed in the policy.

Conclusion
Insurance is derived from the word that means the insurance coverage. Insurance is an
agreement between the insured or the customer with the insurer or insurers. The main
function of insurance is risk transfer mechanism, which transfer risk from one party to the
other party, namely the insured that the insurer. There are six basic principles that must be
met by institutions or companies engaged in the insurance business, such as Principle of
Good Faith, Principle of Insured Interest, Principle of Indemnity, Principle of Subrogation,
Principle of Contribution, and Principle of Cause and Effect. The insurance company makes
insurance policy in accordance with the focus grouping and risk for the insured. The most
common form of insurance policy types, namely life insurance, health insurance, vehicle
insurance, home ownership and property insurance, and also education insurance.
Not long ago in Indonesia there is a case of public figure whose child suffered a
traffic accident. The public figure as well as the father tried to take care of insurance claims
for the cost of his hospital. The insurance company claimed insurance claims are not paid,
because the child has violated traffic regulations. So there are the reason why the claim is
not paid, among others not included in contractual agreement, included in exception, a
disease that already exist, incompletes document, still in the waiting period, policy in a state
of lapse, claims filed later than the time specified, claims submitted due to customer
commiting a crime, crime insurance, and last being out of the contract area. There are also
three things that cause the insurance agreement ends, as follows occurs evenemen, term ends,
and insurance cancelled.