Insurance Agreement Research Articles

WANPRESTASI PEMBAYARAN KLAIM ASURANSI JIWA AKIBAT KELALAIAN PENYERAHAN BERKAS OLEH MITRA PENANGGUNG SEBAGAI KOLEKTOR PENGAJUAN KLAIM (Studi Kasus Sertifikat Asuransi Polis Nomor 15.001673)


 
 
 At this time many banks are incentive to lure consumer credit to consumers. In general, consumer loan interest rate is higher than productive credit, even there is a fixed rate. It seems that the fixed rate makes it easy to organize family finances, paying only monthly installments of the same amount, but if carefully calculated, the interest is much higher. Consumer Loan Protection with Insurance Policy Certificate 15.001673 is a life insurance product that guarantees repayment of the remaining amount of Loans and / or monthly loan installment of the Customer as Participant (Insured) to the Policyholder in case the Participant (the Insured) has a death risk or total temporary disability / Or total permanent disability. Although it is clear about the rights and obligations in the insurance agreement but the reality is very different because it turns out the insurer does not fulfill its obligations in the event of claim submission from the insured. Rejection of insurance claims may be made by the insurer under the pretext of submitting the file beyond the specified time limit. Issues to be studied further is how validation of denial of life insurance claim made by Jasindo in accordance with the insurance policy and existing legislation and whether Partner Error is can be classified as Wanprestasi payment of Insurance Claim for late in submission of policy file No: 15.001673. In conducting research, this research is normative law research that is research having object of study about rule or rule. The objective is to determine the validity of the refusal of insurance claims made by Jasindo in accordance with the existing insurance policies and regulations and to find out the Default Payment of Insurance Claims due to Delayed Submission by Marketing Party as Collector Submission of Claim on Insurance Certificate Number 15.001673
 
 

ANALISIS PENERAPAN TEORI OBJEKTIVITAS DALAM ASURANASI KAPAL ANTARA PT. BRINGIN SEJAHTERA ARTAMAKMUR DAN PT. DJAKARTA LLOYD (STUDI PUTUSAN NO.423/PDT.G/2011/ PN.JKT.PST.)

In the insurance agreement, of course, there is an insurance object where the insurance object must be notified in detail by the insured to the insurer if it will not be threatened by the cancellation of the agreement. This is supported by one of the theories developed in insurance business, namely the theory of objectivity supported by article 251 KUHD This research is a study of the application of the theory of objectivity to Decree Number 423 / Pdt.G / 2011 / PN.Jkt.Pst because of the claim from PT. Djakarta Lloyd from the insurance object in the form of MV Jatiwangi PB 400 vessel that has been insured to PT Asuransi Bringin Sejahtra Artamakmur (PT BSAM), but the insurance company rejects the claim on the grounds that the ship was damaged at the time of signing the insurance policy. So that the problem arises how to apply the theory of objectivity to the rejection of insurance claims made by (PT BSAM)? is the application of the theory of objectivity in Indonesian insurance law correct? The research method used is a normative juridical research method. Data from the study shows that based on Article 251 KUHD and the theory of objectivity is a description of the honesty of insurance participants with the threat of cancellation of insurance if the insured party is proven not to have good intentions. Based on the definition of objectivity theory and Article 251 KUHD the author wants to discuss how it applies to ship insurance

PHP64 - ALLOWABILITY OF OUTCOMES-BASED RISK-SHARING SCHEMES IN RUSSIA WITHIN CURRENT LEGISLATIVE HURDLES

There is strict and robust regulation of drug provision in Russia which can be a visible hurdle for outcomes-based risk-sharing schemes (OBRSS) introduction. The objective of our qualitative research is to find legal basis for OBRSS within current regulation. Data sources included legislative documents of different level authorities (e.g. civil code, federal laws, government decrees, orders and official letters), juridical comments, actual routine practice of drug procurement, and expert opinion which was collected during consultations with experienced legist in the field of drug procurement. We searched in centralized legislative databases “Garant” and “ConsultantPlus”. Possible schemes were presented as consecutive block-schemes, which were discussed with experts. During the research and discussion series we realized that key hurdle for OBRSS introduction is that drugs must be purchased only using robust competitive procedure of auction. Considering this we developed next schemes which were aligned with current legislation and routine practice. within one contract with drug supplier where health outcomes (HOs) are considered as unexpected deferred conditions (unknown will it happened or not, civil code, article 157). It can include compensation or proportional decrease of contract total price. All specific outcomes and contract terms limits have to be clearly stated in initial contract. within several consecutive purchases of the drug where HOs are considered as a basis for review of starting terms for the next auction. This option implies preliminary local act with detailed description of the scheme. This option is most risky for the industry pricing. within separate agreements. HOs compensation agreement (or HOs risk insurance agreement) with third party (e.g. industry) can be separated from supply contract with drug supplier auction winner. We found at least three possible options for OBRSS introduction in Russia wich can help to overcome legislative hurdle.

PELANGGARAN PRINSIP ITIKAD BAIK DALAM PERJANJIAN ASURANSI PADA P.T. ASURANSI JIWASRAYA CABANG PADANG

This study uses empirical juridical method where research with a view to legal provisions in practice. This study concerns the basic factors underlying the onset of any breach of the principle of utmost good faith in the insurance agreement as well as how the settlement and legal consequences of the breach of the principle of utmost good faith in the contract of insurance. The author uses the qualitative data analysis to make an assessment of data that authors get on the field with the help of literatures related research. Based on the research that earned the author the P.T. Asuransi Jiwasraya (Persero) Padang Branch that the factors underlying the violation of the principle of utmost good faith can be caused by internal factors (the insurer) is an insurance agent and risk selectors (underwriter) and external factors i.e. insured parties. Violation of the dishonest agents caused the insurer gives a description of the products offered to the prospective insured because only the pursuit of targets and commissions, vice versa the insured provides false information when responding to a question from the insurer. Completion of the offence principle of utmost good faith this is done first by deliberation, if agreement was not reached will proceed through court proceedings. As a result of legal violations of principle of utmost good faith is the insurance agreement void or in other words the insurer has no duty to indemnify if the claims of the insured object.

Осуществление страховых выплат в случае смерти потерпевшего по договорам обязательного страхования гражданской ответственности в сфере транспорта

Осуществление страховых выплат в случае смерти потерпевшего по договорам обязательного страхования гражданской ответственности в сфере транспорта

A study on the consent of the insured in life insurance for third person’s death

타인의 생명의 보험과 관련하여 종전 ‘보험계약에는 피보험자의 동의’를, ‘보험 계약체결시에는그타인의서면에의한동의’를받도록상법제731조를개정하였다. 그이유는‘보험계약성립후의분쟁과도덕적위험을방지하기위함’에있다고한다. 이와관련하여 한편에서는 개정 조문의 해석론이 다른 한편에서는 조문의 각 요소(조문 전체와 동의 시점과 방법 및 피보험자의 동의)에 대한 법리적 검토가 요구된다. 타인의 사망의 보험계약에 피보험자의 동의를 받도록 한 규정은 피보험자의 인격권 침해나 공서양속의 침해가 없더라도 그대로 적용되는 강행규정이다. 보험계약자는 보험계약 체결 전에 동의를 받아야 한다. 이 동의는 준법률행위이다. 종전단지‘보험계약에동의’를받도록한것을‘보험계약체결시’로변경하였음에도종전과 같은 주장, 즉 추인이 가능하다는 논리는 입법론적인 방법론으로는 주장할 수 있지만 현행법의 해석론으로는 무리다. ‘서면에 의한 동의’를 받도록 하였음에도 불구하고 이 규정이 강행성을 갖지 않는다는 주장이 있지만, 입법론적 논의가 아닌 한 무리한 논리 전개이다. 보험계약과관련한당사자의지위겸병또는변경과관련하여어느형태에서건피보험자의 동의는필요하다. 보험계약자가피보험자의지위를겸병하는경우동의가있어야하는지와동의가반드시서면에의한동의를요하는지문제된다. 제3자가보험계약자의동의를얻어계약을체결하고 보험사고가 발생하면이에따른경제적 효과를노릴수 있다는점에서강행규정인제731조에대한탈법행위로무효이다. 피보험자를보험수익자로변경할때에는보험계약자는피보험자의동의를받아야한다. 그것은피보험자가동의를하게된주된이유가자기, 자기가 사망한 후 자기의 상속인이 아니라 특정한 보험수익자의 이익을 위함이기 때문이다.Before the 1991 Commercial Code revision the insurance contract should be subject to the consent of the insured person. According to the amended new provision in 1991, the insurance contract was required the written concent of the insured person on one the hand, and this concent shall be reached before the signing of insurance contract on the other hand. The purpose of this provision is to prevent moral hazard, insurance companies and policyholders and beneficiaries conflict of interest between each other. In this regard it is necessary to examine the legal character of this provision above all. And it is required the legal review about each element of the provisions, namely the insured person s consent and when and how. This provision applies even if the infringement of the moral rights of the insured person or infringe public order and morals. In this sense this provision is mandatory provisions. The concent of the insured person is a necessary element for the beneficiaries, even if it is not the requirement of insurance contract. Namely the concent of the insured is not a requirement of conclusion of a contract, insurance companies do not pay the insurance amount to beneficiaries without the consent of the insured, hence the concent of the insured is characterized a quasi-legal act. Therefore the insured person have to indicate his concent for the conclusion of insurance contract for his death to policyholders. That before signing the insurance contract shall receive the insured s written consent means that the insured person must be indicated agreement to policyholders. Holding both status or change of status with regard to the parties with respect to the insurance agreement the insured in case of any type are needed. The problem is that the policyholder does not necessarily require the consent in writing and that the agreement should agree to both insurer and/ or policyholder, if the insured person s status. It might be occured manipulation of the provision of Article 731, when the policyholder entered into an agreement with the consent of the insured and change the insured for his own interest. The main reason insured person to agrees with the contract, is not only for himself or for his own heirs but also for the interest of another persons.

STAN CYWILNOPRAWNEJ OCHRONY KONSUMENTA USŁUG UBEZPIECZENIOWYCH W POLSCE

Protection of Personal Data of Consumers of Insurance Services in PolandSummaryThe article analyses the regulations o f Polish civil law, which were introduced to protect a consumer of insurance services who, as a weaker party of a insurance agreement needs such protection. It presents main changes of the insurance law in this respect, introduced on M ay 01, 2004 as a part of the process of adapting Polish legal system to the EU legislation. Amongst other things, the author discusses the following issues: legal definition of a „consumer”, scope o f legal measures on protection of the insured, legal character of the general terms and conditions of the insurance agreements issued by insurance companies and forbidden contractual clauses. The author also suggests changes to these laws in order to improve them and make them more precise.

KAJIAN YURIDIS PERLINDUNGAN HUKUM TERTANGGUNG PADA PERJANJIAN ASURANSI KENDARAAN BERMOTOR DI PT. ASURANSI RAMAYANA TBK. JAKARTA

The legal protection for the insured in an insurance agreement with PT Asuransi Ramayana Tbk exists while being observed generally by insurance law for the fulfillment of rights and obligations of both the insured and the insurer. In case of force majeur (unsure occurance) which causes loss; then based on Indonesian Standard Insurance Policy for Motor Vehicle Chapter 1 Article 1 and Article 2, the insured deserves to get the indemnity due to theft, and also get the solution for the dispute through a mediator under Article 54 Chapter XI 40 of 2014 concerning insurance about the protection of Insurance Policy holders, the Insured or the participant. The refusal of legal validity of the claim by PT. Asuransi Ramayana Tbk is not appropriate and does not have any correlation with the case of theft occurred because in Mr. Mery Sam Arvianto’s case, the insurance agreement with the insurance policy number 18.0212.14.001512 must covers All Risk / Comprehensive ( collateral damage to a part or the whole car because of falling objects, fire, collision, traffic accidents, theft or collision), and the insured should receive compensation, based on Chapter 1 Article 1 paragraph 1.3 Indonesian Standard Policy for motor vehicle insurance governing the guarantee, including guarantee from theft. Key Words: The legal protection for the insured in an insurance agreement.

Reducation of volatility yield and prices in corn production using revenue insurance

Revenue insurance represents a new risk management tool in agriculture, based on the difference between the guaranteed and actual revenue of the entire farm or some production. Most commonly, crops that have a significant share in the structure of planting or significant yield are insured with the application of this tool. Mercantile corn is the most important field crop in Serbia, and climatic conditions and price changes have a huge impact on its production. As one of the aspects of struggle with volatility of revenues there is a possibility to insure the corn revenue, by concluding the insurance agreement. However, the revenue insurance is very slightly applied in the world, while in our country in recent years is in its infancy. This paper analyzes the economic and legal aspects of the insurance model in order to determine the basic mechanisms of its functioning, as well as the conditions that must be fulfilled so that conclusion of the agreement would have an economic justification for both parties (farmers and financial institutions). It also examines the normative framework for the conclusion of this agreement and stresses the differences relative to the classic insurance contract.

THE DESIGN OF AN OPTIMAL RETROSPECTIVE RATING PLAN

AbstractA retrospective rating plan, whose insurance premium depends upon an insured's actual loss during the policy period, is a special insurance agreement widely used in liability insurance. In this paper, the design of an optimal retrospective rating plan is analyzed from the perspective of the insured who seeks to minimize its risk exposure in the sense of convex order. In order to reduce the moral hazard, we assume that both the insured and the insurer are obligated to pay more for a larger realization of the loss. Under the further assumptions that the minimum premium is zero, the maximum premium is proportional to the expected indemnity, and the basic premium is the only free parameter in the formula for retrospective premium given by Meyers (2004) and that the basic premium is determined in such a way that the expected retrospective premium equates to the expected indemnity with a positive safety loading, we formally establish the relationship that the insured will suffer more risk for a larger loss conversion factor or a higher maximum premium. These findings suggest that the insured prefers an insurance policy with the expected value premium principle, which is a special retrospective premium principle with zero loss conversion factor. In addition, we show that any admissible retrospective rating plan is dominated by a stop-loss insurance policy. Finally, the optimal retention of a stop-loss insurance is derived numerically under the criterion of minimizing the risk-adjusted value of the insured's liability where the liability valuation is carried out using the cost-of-capital approach based on the conditional value at risk.

The Essential Conditions for the Validity of the Contract of Carriage

Abstract At the conclusion of the transport contract for goods or people, the carrier shall make available to the consignor or the passenger his exclusive and special service to travel in space with a suitable means of transport, different from other previous or subsequent transport services. Thus, the transport activity is entirely distinct and independent from the civil or economic transactions concerning the goods transported, which run between the consignor and the recipient, or, taking another example, from the insurance agreement during the transport of goods or persons, imposed by law. At the same time, transport is a service of public interest, which obliges the transport operator to publish permanently his transport offer with all the information needed to access it. This is the source of the organized and uniform periodicity of the carrying trade, performed as a constant preoccupation in order to obtain profit. But, because of the multitude and diversity of displacement interests of the transport beneficiaries, sometimes the transport operator is forced to arrange that the transport of goods or people contracting should be carried out through another carrier. Therefore, whenever the transporter is substituted by another transport operator for total or partial execution of its duty, the latter will be considered part of the transport contract, taking over all obligations of the contracting operator directly with the beneficiary of his service.

The Design of an Optimal Retrospective Rating Plan

A retrospective rating plan, whose insurance premium depends upon an insured's actual loss during the policy period, is a special insurance agreement widely used in liability insurance. In this paper, the design of an optimal retrospective rating plan is analyzed from the perspective of the insured who seeks to minimize its risk exposure in the sense of convex order. In order to reduce the moral hazard, we assume that both the insured and the insurer are obligated to pay more for a larger realization of the loss. Under the further assumptions that the minimum premium is zero, the maximum premium is proportional to the expected indemnity, and the basic premium is the only free parameter in the formula for retrospective premium given by Meyers (2004) and that the basic premium is determined in such a way that the expected retrospective premium equates to the expected indemnity with a positive safety loading, we formally establish the relationship that the insured will suffer more risk for a larger loss conversion factor or a higher maximum premium. These findings suggest that the insured prefers an insurance policy with the expected value premium principle, which is a special retrospective premium principle with zero loss conversion factor. In addition, we show that any admissible retrospective rating plan is dominated by a stop-loss insurance policy. Finally, the optimal retention of a stop-loss insurance is derived numerically under the criterion of minimizing the risk-adjusted value of the insured's liability where the liability valuation is carried out using the cost-of-capital approach based on the conditional value at risk.

MENCIPTAKAN ITIKAD BAIK YANG BERKEADILAN DALAM KONTRAK ASURANSI JIWA

An insured who bind themselves to the insurer to protect his life by taking life insurance, of course, will conduct the closing of the contract of insurance agreements. To close this insurance contract the insured is deemed very essential to peruse the terms and conditions and the rights and obligations that will he get. In many cases it is turned to be extremely detrimental to the insured party when related to the contract of insurance. This is due to a lack of good faith on the part of the insurer to pay insurance claim filed by the insured or beneficiary. Instead, the insured is required to execute an agreement in good faith even at the beginning of the insurance contract the insured has been burdened insurance for acting in good faith.Keywords: contract, good faith, life insurance.

Risk-sharing networks and farsighted stability

Evidence suggests that in developing countries, agents rely on mutual insurance agreements to deal with income or expenditure shocks. This paper analyzes which risk-sharing networks can be sustained in the long run when individuals are farsighted, in the sense that they are able to forecast how other agents would react to their choice of insurance partners. In particular, we study whether the farsightedness of the agents leads to a reduction of the tension between stability and efficiency that arises when individuals are myopic. We find that for extreme values of the cost of establishing a mutual insurance agreement, myopic and farsighted agents form the same risk-sharing networks. For small costs, farsighted agents form efficient networks while myopic agents don’t.

Fronting insurance and its impact on the development of insurance in Serbia

General globalisation has set new challenges in all segments of the society for both the state and insurers. Globalisation brings with it the opening and deregulation of the insurance market. However, there are still numerous countries with the laws that prevent foreign insurers from operating directly at their markets. Aiming at overcoming the above-mentioned barriers with their global property insurance programmes, the companies are directed to services of local insurers holding permits for insurance operations issued by the competent supervision authorities of the country in which the property is located. Fronting insurance is the agreement concluded between the companies acting as the insurer for the insured parties, but the main portion of up to 100% of risk is transferred onto third persons, namely one or several reinsurers. The insurer from abroad is entitled to insure directly the property of companies in the countries that liberalised insurance operations. However, a large number of countries protect their insurance markets and property insurance in these countries requires the insurer to hold the licence of the competent supervision authority, namely it has to be registered for conducting of insurance operations. In such cases, the insurer from abroad has to co-operate with local insurers, namely licensed insurers in the relevant country. Local insurers conclude the agreement with the insurer from abroad on implementation of a global insurance programme, which makes the insurer from abroad the insurance leader, and local insurers become fronting insurers. Local insurer concludes the insurance policy with the insured party, but the largest portion of risk or even the entire risk is transferred onto the insurance leader as its re-insurer, while it is paid appropriate commission for its part of work. The insurance conditions of local insurers are most oft en more restrictive in the scope of coverage compared to insurance conditions under which a global insurance programme was compiled. Th erefore, in such situations the master policy covers the diff erence in coverage between the above-mentioned conditions. Local policies always have to be in compliance with local legislation and that is why the re-insurer and insurer integrate the DIC clauses in the insurance agreements in order to cover the diff erence in conditions. The above-mentioned clause regulates the issues when local insurance conditions are more limited compared to those provided by master policy, which means that such diff erence shall be covered from the master policy. The DIL clause on diff erence in limits regulates the issues related to cases when the limit that is set based on a local insurance policy is exhausted and the diff erence between the local policy limit and master policy limit shall be covered from the master policy. Due to legal limitations, Serbia introduces the retrocessionaire in fronting insurance since local insurers have the obligation to insure the risk exceeding the retention at domestic reinsurers, who in turn may insure abroad the surplus risk that exceeds the retention. The impact of fronting insurance on insurance in Serbia may be analysed through the impact this insurance has on the insured parties, insurers, reinsurers, as well as effects of fronting insurance on the overall insurance activities. The effects that fronting insurance has may be classifi ed as positive and negative. The analysis of all the arguments points to the conclusion that fronting insurance has a positive impact on the development of insurance in Serbia through the transfer of know-how and experiences of foreign insurers, development of new insurance programmes, promoting of competition and enhancing of the quality of insurance services.

‘England owes something to these people’: the Anglo-Irish Unemployment Insurance agreement, 1946

On 19 December 1946, the Irish President, Seán T. O'Kelly, signed the Unemployment Insurance Act into law. This innocuous-sounding piece of legislation has received very little attention from historians, but was of great importance to one section of post-war Irish society. Under its terms, Dublin and London entered into a special scheme whereby Irish men and women who had served with the British forces during the Second World War were allowed to claim British unemployment insurance payments, while still resident in the twenty-six counties of independent Ireland. Coming at a time of unemployment and economic slump in Ireland, this was of crucial importance to many exservicemen. This article will explore the background, negotiation and implementation of the unemployment insurance agreement, and will speculate on the reasons why the Taoiseach, Éamon de Valera, agreed to it. It will also examine the British side of the scheme and explore London's motives, both concrete and notional.

Keabsahan Perjanjian Asuransi Melalui Telemarketing Ditinjau dari Undang-Undang Nomor 11 Tahun 2008

ABSTRACT: Insurance is an agreement between two or more parties that the payer binds inself to the paid by receiving premi for compensating the paid because of loss, damage or miss he benefit or the law responsibility of third party that might burdened the pid because of something that is not exactly happens or to compensate due to the death or life the paid as mentioned in Article 1 verse 1 of the Act Number 2, 1992. However, in its implementation the product is also sold by telemarketing through electronic media based on the Act Number 11, 2008 regarding Information and Electronic Transaction that an cause different views on when the validity of the agreement through the media. The Validity of Insurance Agreement Through Telemarketing Based on The Act Number 11, 2008

Law and Psychiatry. Doing Forensic Work, II

Forensic practice fees, billing, and collection procedures are quite different from those in general psychiatry. Most forensic practices have far fewer "clients," and individual bills are usually larger. Collections are usually better (and less frequently discounted) in forensic practice, and resolving billing disputes is far more straightforward. Medicare, Medicaid, other insurance coverage, provider networks and agreements, procedure codes, and diagnosis-related groups (DRGs) are all largely irrelevant in forensic work (although sometimes important to direct clinical services in correctional psychiatry or forensic treatment clinics). An understanding of the practicalities and ethics of charging and billing for forensic services greatly simplifies practice management.

Uberrima Fides, Foucault and the Security of Uncertainty

Uberrima Fides is a legal doctrine that governs insurance contracts and expects all parties to the insurance agreement to act in good faith by declaring all material facts relative to a policy. The doctrine originated in England in 1766 with the case Carter v Boehm ruled by Lord Mansfield. Ever since, it has become, with some differences in interpretation, a cornerstone of insurance relationships around the world. The role that trust plays within it, however, is not simple and should not be taken for granted. While it is expected that an idea of trust represents an order of truth, trust in itself is the outcome of a complex negotiation of moral orders. Semiotically, trust operates here not as a Kantian category for the understanding but as a signifier of an order of truth that upholds the possibility for insurance relationships. Trust, as sign, operates as a condition of possibility for the performance of insurance. In this article, a Foucaultian approach is employed to problematise the idea of trust and its role in insurance relationships. The case of mis-selling of insurance policies in the United Kingdom since the 1980s, which has given rise to numerous legal rulings, is used as the empirical site for the problematisation.

KONSEP KEADILAN DAN SISTEM TANGGUNG JAWAB KEPERDATAAN DALAM HUKUM UDARA

The research studies and analyzes the settlement of the indemnification to passengers due to flight accident. The scope of the research involves the obligation of the airlines company, aircraft producer, and insurance company in settling the indemnification to passengers who die, are injured, or disabled due to flight accident in Indonesia using liability theory. This research uses normative law method with qualitative approach which is explanatory and evaluative in form to find the solution to a problem by applying descriptive analysis. The result of the research concludes that, first, the indemnification to the passengers who die, are injured, or disabled due to flight accident is based on the principles of absolute liability. Second, the indemnification from insurance company to the passengers as the first party insurance is paid as the amount of the indemnification incurred as stated in the insurance agreement, based on the premium paid.