Carry out what is promised but not in accordance with the agreement

Oct 13, 2025 by magicalceylontours.com 67 views

Juridical Review: The Act of Defaulting Claim Payments in the Insurance Policy Agreement Conducted by PT. Sequis Life Life Insurance (Medan District Court Decision Study No. 574/Pdt.G/2019/PN.Mdn)

Introduction

In everyday life, humans are often faced with various uncertainties, one of which is an unexpected risk. This risk can result in significant financial losses. To overcome this problem, insurance comes as a solution that offers protection and minimizes financial impacts when the risk occurs. Insurance functions by diverting risks from individuals to insurance companies through agreements stipulated in the insurance policy. However, it often occurs that the implementation of the agreement does not go as expected, which raises a dispute between the policyholder and the insurance company. In Indonesia, some insurance companies are still facing problems in terms of compliance with agreements, which can be seen from the many complaints of policyholders regarding difficulties in submitting claims or even rejection of claims for unclear reasons.

The Importance of Insurance Policy Agreements in Indonesia

The insurance policy agreement is regulated in positive law in Indonesia, especially in the Civil Code (Kuhperdata). In this agreement, there are clear rights and obligations between the policyholder and the insurance company. However, reality in the field often shows the non-compliance of insurance companies in fulfilling its obligations, especially when there is a claim submission. The insurance policy agreement is a crucial document that outlines the terms and conditions of the insurance policy, including the rights and obligations of both parties. It is essential for policyholders to understand their rights and obligations under the agreement to avoid any disputes or misunderstandings.

Types of Default in Insurance Policy Agreements

There are four types of default that can occur in the contract, namely:

Do not do what is agreed: This type of default occurs when the insurance company fails to fulfill its obligations as stated in the agreement.
Carry out what is promised but not in accordance with the agreement: This type of default occurs when the insurance company performs its obligations but does not do so in accordance with the agreement.
Do what promised but with delay: This type of default occurs when the insurance company fails to fulfill its obligations in a timely manner.
Doing something that is prohibited by the agreement: This type of default occurs when the insurance company performs an action that is prohibited by the agreement.

Legal Protection for Policy Holders

Policyholders who are disadvantaged due to default have the right to obtain legal protection. In the judicial process, policyholders can file a lawsuit against insurance companies that are considered to be default. In the decision of the Medan District Court No. 574/Pdt.G/2019/PN.Mdn, PT Asuransi Jiwa Sequis Life is found guilty of default for not fulfilling its obligations to pay claims submitted by the policyholder. This decision reflects the importance of legal protection for insurance consumers in Indonesia.

Judge's Consideration in the Case of Default

In the decision, the judge considered that the action of PT Asuransi Jiwa Sequis Life that did not pay claims was a form of default in accordance with Article 1243 of the Civil Code. The judge emphasized that the insurance company must fulfill the agreed obligations in the policy agreement. As a consequence of the default, the judge decided that the company pay compensation arising from his actions and bear the cost of the case. This decision is important not only for individual cases but also as a precedent for similar cases in the future.

Conclusion

In carrying out the insurance policy agreement, both the policyholder and the insurance company must understand and meet their respective obligations. Understanding or non-compliance can cause default, which in turn will trigger disputes that can lead to legal proceedings. It is essential for policyholders to find out their rights and take legal steps if needed, as well as for insurance companies to behave transparently and professionally in fulfilling claims. Through effective law enforcement, it is expected that the rights of policyholders can be maintained and the relationship between insurance companies and the community can increase.

Recommendations

Based on the study, the following recommendations are made:

Insurance companies must comply with the agreed obligations: Insurance companies must fulfill their obligations as stated in the agreement to avoid any disputes or misunderstandings.
Policyholders must understand their rights and obligations: Policyholders must understand their rights and obligations under the agreement to avoid any disputes or misunderstandings.
Effective law enforcement is essential: Effective law enforcement is essential to maintain the rights of policyholders and increase the relationship between insurance companies and the community.
Transparency and professionalism are essential: Insurance companies must behave transparently and professionally in fulfilling claims to maintain the trust of policyholders.

Limitations of the Study

This study has several limitations, including:

Limited scope: The study only focuses on the case of PT Asuransi Jiwa Sequis Life and does not cover other insurance companies in Indonesia.
Limited data: The study only uses the decision of the Medan District Court No. 574/Pdt.G/2019/PN.Mdn as the primary data source.
Limited analysis: The study only analyzes the decision of the Medan District Court No. 574/Pdt.G/2019/PN.Mdn and does not conduct a comprehensive analysis of the insurance policy agreement in Indonesia.

Future Research Directions

Future research directions include:

Conducting a comprehensive analysis of the insurance policy agreement in Indonesia: Future research should conduct a comprehensive analysis of the insurance policy agreement in Indonesia to identify the strengths and weaknesses of the agreement.
Analyzing the impact of the decision of the Medan District Court No. 574/Pdt.G/2019/PN.Mdn: Future research should analyze the impact of the decision of the Medan District Court No. 574/Pdt.G/2019/PN.Mdn on the insurance industry in Indonesia.
Identifying the best practices for insurance companies in Indonesia: Future research should identify the best practices for insurance companies in Indonesia to maintain the trust of policyholders and increase the relationship between insurance companies and the community.
Frequently Asked Questions (FAQs) about Juridical Review: The Act of Defaulting Claim Payments in the Insurance Policy Agreement Conducted by PT. Sequis Life Life Insurance

Q: What is the purpose of the juridical review of the act of defaulting claim payments in the insurance policy agreement conducted by PT. Sequis Life Life Insurance?

A: The purpose of the juridical review is to analyze the decision of the Medan District Court No. 574/Pdt.G/2019/PN.Mdn and to identify the key issues and findings related to the act of defaulting claim payments in the insurance policy agreement conducted by PT. Sequis Life Life Insurance.

Q: What are the key issues related to the act of defaulting claim payments in the insurance policy agreement conducted by PT. Sequis Life Life Insurance?

A: The key issues related to the act of defaulting claim payments in the insurance policy agreement conducted by PT. Sequis Life Life Insurance include:

Non-compliance with the agreed obligations: PT. Sequis Life Life Insurance failed to fulfill its obligations to pay claims submitted by the policyholder.
Default in accordance with Article 1243 of the Civil Code: The judge considered that the action of PT. Sequis Life Life Insurance that did not pay claims was a form of default in accordance with Article 1243 of the Civil Code.
Compensation arising from the actions of PT. Sequis Life Life Insurance: The judge decided that PT. Sequis Life Life Insurance pay compensation arising from its actions and bear the cost of the case.

Q: What are the implications of the decision of the Medan District Court No. 574/Pdt.G/2019/PN.Mdn?

A: The implications of the decision of the Medan District Court No. 574/Pdt.G/2019/PN.Mdn include:

Importance of legal protection for insurance consumers: The decision reflects the importance of legal protection for insurance consumers in Indonesia.
Precedent for similar cases: The decision is important not only for individual cases but also as a precedent for similar cases in the future.
Increased transparency and professionalism: The decision emphasizes the need for insurance companies to behave transparently and professionally in fulfilling claims.

Q: What are the recommendations for insurance companies in Indonesia?

A: The recommendations for insurance companies in Indonesia include:

Compliance with the agreed obligations: Insurance companies must fulfill their obligations as stated in the agreement to avoid any disputes or misunderstandings.
Transparency and professionalism: Insurance companies must behave transparently and professionally in fulfilling claims to maintain the trust of policyholders.
Effective law enforcement: Effective law enforcement is essential to maintain the rights of policyholders and increase the relationship between insurance companies and the community.

Q: What are the limitations of the study?

A: The limitations of the study include:

Limited scope: The study only focuses on the case of PT. Sequis Life Life Insurance and does not cover other insurance companies in Indonesia.
Limited data: The study only uses the decision of the Medan District Court No. 574/Pdt.G/2019/PN.Mdn as the primary data source.
Limited analysis: The study only analyzes the decision of the Medan District Court No. 574/Pdt.G/2019/PN.Mdn and does not conduct a comprehensive analysis of the insurance policy agreement in Indonesia.

Q: What are the future research directions?

A: The future research directions include:

Conducting a comprehensive analysis of the insurance policy agreement in Indonesia: Future research should conduct a comprehensive analysis of the insurance policy agreement in Indonesia to identify the strengths and weaknesses of the agreement.
Analyzing the impact of the decision of the Medan District Court No. 574/Pdt.G/2019/PN.Mdn: Future research should analyze the impact of the decision of the Medan District Court No. 574/Pdt.G/2019/PN.Mdn on the insurance industry in Indonesia.
Identifying the best practices for insurance companies in Indonesia: Future research should identify the best practices for insurance companies in Indonesia to maintain the trust of policyholders and increase the relationship between insurance companies and the community.