Abstract

Establishing a national economy that can grow suatainably and stable, requires the financial service sectors conducting its business in a well organized, fair, transparent and accountable manner, and be able to protect the consumer’s and public’s interests.Transparency, fairness, reliability, confidentiality, security of consumer’s data and/or information, fast, simple complaint handling and affordable dispute resolution cost become the principles of consumers protection in the financial services sector.The common motive to conduct an insurance fraud is economical reason, that is for obtaining a financial benefit/advantage. Broadly, a fraud in insurance can be classified into 3 (three) main dimensions: dimension of the subject i.e the fraudsters; dimension of time, ie. the time during the process of underwriting and the process of claim; dimension of behaviour that is opportunistic act (soft fraud) or planned fraud (hard fraud). The insurance consumer’s awareness concerning the financial services sector activities is needed, so that the insurance financial services sector can be conducted in a well organized, fair, transparent and accountable manner. Keywords: Insurance Fraud, Insurance Consumer’s Protection

Highlights

  • affordable dispute resolution cost become the principles of consumers protection in the financial services sector

  • that is for obtaining a financial benefit

  • Peraturan Otoritas Jasa Keuangan No 28/Peraturan OJK (POJK).05/2015 tentang Pembubaran, Likuidasi, dan Kepailitan Perusahaan Asuransi, Perusahaan Asuransi Syariah, Perusahaan Asuransi, dan Perusahaan Reasuransi Syariah

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Summary

Ketut Sendra

Menstabilkan ekonomi nasional dan bertumbuhan secara berkelanjutan dan stabil, mewajibkan sektor jasa keuangan menjalankan usahanya secara terorganisir, adil, transparan dan akuntabel serta dapat melindungi kepentingan konsumen dan masyarakat. Transparansi, keadilan, kehandalan, kerahasiaan, keamanan data dan informasi konsumen, penanganan keluhan yang cepat dan sederhana, dan biaya penyelesaian sengketa yang terjangkau menjadi prinsip perlindungan konsumen di sektor jasa keuangan. Motif umum untuk melakukan penipuan asuransi adalah alasan ekonomis yaitu untuk mendapatkan keuntungan secara finansial. Kecurangan dalam asuransi dapat dikelompokkan menjadi 3 (tiga) dimensi utama: dimensi subjek yaitu penipu; dimensi waktu, yaitu waktu selama proses underwriting dan proses klaim; dimensi perilaku yaitu tindakan oportunistik (soft fraud) atau penipuan yang direncanakan (hard fraud). Kesadaran konsumen asuransi mengenai kegiatan sektor jasa keuangan sangat dibutuhkan, sehingga sektor jasa keuangan asuransi dapat dilakukan dengan cara yang terorganisir, adil, transparan dan akuntabel

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