The Life Insurance Agreement serves as the primary contractual document between an insurance provider and a policyholder in Indonesia, operating under the framework of Law No. 40 of 2014 on Insurance and OJK regulations. This document is essential when establishing a life insurance policy, whether for individual or group coverage, and contains detailed provisions for insurance benefits, premium payments, beneficiary designations, and claims procedures. It's designed to protect both the insurer's and policyholder's interests while ensuring compliance with Indonesian insurance regulations, including mandatory disclosures, cooling-off periods, and consumer protection requirements. The agreement typically includes options for additional coverage through riders and may incorporate investment components for certain policy types.
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1. Parties: Identification of the insurance company and the policyholder
2. Background: Context of the agreement and general purpose of the life insurance policy
3. Definitions: Definitions of key terms used throughout the agreement including but not limited to 'sum insured', 'premium', 'beneficiary', 'policy period'
4. Policy Coverage: Detailed description of the life insurance coverage, including death benefit and any additional benefits
5. Premium Payment Terms: Premium amount, payment frequency, grace period, and consequences of non-payment
6. Beneficiary Designation: Process for naming and changing beneficiaries, and rules regarding benefit distribution
7. Claims Procedure: Process for filing claims, required documentation, and timeline for claim settlement
8. Exclusions: Specific circumstances under which the policy will not pay out benefits
9. Policy Term and Renewal: Duration of the policy, conditions for renewal, and termination provisions
10. Rights and Obligations: Detailed responsibilities and rights of both the insurer and policyholder
11. Governing Law: Specification of Indonesian law as governing law and relevant jurisdictional matters
12. Dispute Resolution: Procedures for handling disputes, including mediation and legal proceedings
1. Policy Loans: Terms and conditions for taking loans against the policy value, applicable for policies with cash value component
2. Investment Component: Details of investment structure and returns for unit-linked policies
3. Surrender Values: Terms for early policy surrender and associated values, applicable for policies with cash value
4. Riders: Additional coverage options that can be attached to the basic policy
5. Premium Holiday: Conditions under which premium payments can be temporarily suspended, applicable for policies with accumulated value
6. Cooling-off Period: Terms of the free-look period during which the policy can be cancelled without penalty
1. Schedule 1 - Premium Schedule: Detailed breakdown of premium payments, including payment dates and amounts
2. Schedule 2 - Benefit Schedule: Comprehensive list of benefits and corresponding sum assured amounts
3. Schedule 3 - Medical Requirements: List of required medical examinations and health declarations
4. Schedule 4 - Beneficiary Details: Full details of named beneficiaries and their respective benefit proportions
5. Appendix A - Claims Documentation: Complete list of documents required for different types of claims
6. Appendix B - Policy Illustration: Illustrative values showing potential policy performance over time
7. Appendix C - Risk Disclosure: Detailed disclosure of all risks associated with the policy as required by OJK regulations
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