Tanggung jawab non litigasi perusahaan asuransi jiwa terhadap penyelesaian sengketa atas klausula perjanjian pengecualian polis dalam perspektif keadilan bermartabat

Simanjuntak, Ucandi (2024) Tanggung jawab non litigasi perusahaan asuransi jiwa terhadap penyelesaian sengketa atas klausula perjanjian pengecualian polis dalam perspektif keadilan bermartabat. Masters thesis, Universitas Pelita Harapan.

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Abstract

Negara Indonesia mengakui keberadaan tanggung jawab penuh terhadap seluruh rakyat Indonesia sebagai amanah konstitusi Undang-Undang Dasar 1945 sebagaimana pasal 28I ayat (4) UUD 1945 mengatakan, bahwa “perlindungan, pemajuan, penegakan, dan pemenuhan hak asasi manusia adalah tanggung jawab negara, terutama pemerintah. Klausula perjanjian pengecualian polis asuransi jiwa terhadap penolakan klaim yang tertuang dalam pasal 7 ayat (15) pada buku polis asuransi jiwa berbunyi “Asuransi Tambahan PRUprime healthcare plus tidak berlaku untuk setiap Perawatan dan/atau pengobatan yang timbul sehubungan dengan atau yang diakibatkan oleh kelainan bawaan, cacat lahir, kelainan/ keterlambatan perkembangan atau penyakit keturunan (hereditary disease) baik yang diketahui ataupun tidak diketahui tertanggung sebelum pengajuan klaim. Penulis ingin menganalisis bagaimana implementasi penyelesaian sengketa non litigasi dalam penyelesaian masalah untuk mencari keadilan bermartabat bagi nasabah dan bagaimana tanggung jawab perusahaan asuransi jiwa terhadap penyelesaian sengketa non litigasi perspektif keadilan bermartabat. Pendekatan yang digunakan dalam penelitian ini adalah pendekatan yuridis normative dan yuridis empiris secara kualitatif dan menyajikan data sekunder dan data primer sebagai pendukung data sekunder. Hasil penelitian yang diperoleh penulis adalah implementasi penyelesaian sengketa non litigasi dalam penyelesaian masalah untuk mencari keadilan bermartabat bagi nasabah sudah tertulis secara eksplisit dalam Ketentuan umum polis asuransi jiwa PT Prudential Life Assurance butir 17 terkait Penyelesaian Sengketa mengatakan bahwa : apabila timbul persengketaan antara Kami dengan Pihak yang berkepentingan atas Polis yang tidak dapat diselesaikan melalui musyawarah, maka persengketaan tersebut harus diselesaikan di Pengadilan Negeri di dalam wilayah Republik Indonesia yang berwenang. Tanggung Jawab perusahaan asuransi jiwa terhadap penyelesaian sengketa non litigasi perspektif keadilan bermartabat adalah dengan menerima permohonan nasabah, mengkajinya serta memberikan jawaban guna penyeselaian masalah sesuai pasal 30 (1) huruf a Undang-Undang Nomor 21 Tahun 2011 tentang OJK. / The Indonesian state recognizes the existence of full responsibility towards all Indonesian people as a constitutional mandate of the 1945 Constitution as Article 28I paragraph (4) of the 1945 Constitution states, that "the protection, promotion, enforcement and fulfillment of human rights is the responsibility of the state, especially the government . The life insurance policy exclusion agreement clause regarding claim rejection as stated in article 7 paragraph (15) in the life insurance policy book reads "PRUprime healthcare plus additional insurance does not apply to any treatment and/or medication that arises in connection with or is caused by congenital abnormalities, birth defects, developmental abnormalities/delays or hereditary diseases, whether known or unknown to the insured before submitting the claim. The author wants to analyze how non-litigation dispute resolution is implemented in resolving problems to seek dignified justice for customers and how life insurance companies are responsible for non-litigation dispute resolution from a dignified justice perspective. The approach used in this research is a qualitative normative juridical and empirical juridical approach and presents secondary data and primary data as supporting secondary data. The results of the research obtained by the author are that the implementation of non-litigation dispute resolution in resolving problems to seek dignified justice for customers has been written explicitly in the general provisions of the PT Prudential Life Assurance life insurance policy point 17 regarding Dispute Resolution which states that: if a dispute arises between us and the party concerned. If you have an interest in a policy that cannot be resolved through deliberation, the dispute must be resolved in the competent District Court within the territory of the Republic of Indonesia. The responsibility of life insurance companies for non-litigation dispute resolution from a dignified justice perspective is to receive customer requests, review them and provide answers to resolve problems in accordance with article 30 (1) letter a of Law Number 21 of 2011 concerning OJK.

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