This Contractual Obligation (Insurance) document serves as the primary agreement between an insurance provider and policyholder in Indonesia, structured in accordance with Law No. 40 of 2014 on Insurance and related OJK regulations. It is used when establishing new insurance coverage or renewing existing policies, containing essential elements such as risk coverage, premium calculations, claims procedures, and party obligations. The document must be drafted in Indonesian language (with optional translation) and requires specific provisions mandated by Indonesian insurance regulations. It's particularly important for risk management and compliance purposes, as it needs to balance commercial interests with regulatory requirements while providing clear and transparent terms for all parties involved. The document is designed to be adaptable for various types of insurance products while maintaining compliance with Indonesian insurance law framework.
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1. Parties: Identification of the insurer and the policyholder/insured party, including complete legal names and addresses
2. Background: Context of the insurance agreement and brief description of the insurance coverage being provided
3. Definitions: Detailed definitions of key terms used throughout the contract, including insurance-specific terminology
4. Scope of Coverage: Detailed description of what risks are covered under the policy and any territorial limits
5. Premium and Payment Terms: Premium amount, payment schedule, and consequences of non-payment
6. Duration and Renewal: Policy period, effective date, expiration date, and renewal terms
7. Exclusions: Specific risks, circumstances, or losses that are not covered under the policy
8. Claims Procedure: Step-by-step process for filing claims, required documentation, and timeframes
9. Obligations of the Insured: Policyholder's duties regarding disclosure, risk mitigation, and claim reporting
10. Obligations of the Insurer: Insurer's responsibilities regarding coverage, claims processing, and payment
11. Termination Provisions: Circumstances under which the policy can be terminated by either party and the consequences
12. Dispute Resolution: Procedures for handling disputes, including jurisdiction and applicable law
13. General Provisions: Standard contractual clauses including notices, amendments, and entire agreement provisions
1. Co-Insurance Provisions: Required when multiple insurers share the risk, detailing the proportion of coverage by each insurer
2. Reinsurance Arrangements: Included when specific reinsurance details need to be disclosed to the policyholder
3. Beneficiary Provisions: Required for life insurance policies, detailing beneficiary designation and change procedures
4. Investment Components: Required for unit-linked or investment-linked insurance products
5. Grace Period Provisions: Included for policies with premium payment flexibility options
6. Rehabilitation Clause: Optional section for reinstating lapsed policies
7. Profit Sharing: Required for participating policies where policyholder is entitled to share in profits
8. Territory Extension: Included when coverage extends beyond Indonesia
1. Schedule of Benefits: Detailed breakdown of coverage amounts, sub-limits, and specific benefits
2. Schedule of Premiums: Detailed premium calculation, including any loadings or discounts
3. Schedule of Exclusions: Comprehensive list of excluded risks and circumstances
4. Claims Documentation Requirements: Detailed list of documents required for different types of claims
5. Schedule of Insured Property/Assets: For property insurance, detailed list of covered assets and their values
6. Schedule of Endorsements: List of all endorsements modifying the base policy
7. Schedule of Important Timeframes: List of key dates and deadlines for various policy-related actions
8. Risk Disclosure Statement: Mandatory disclosure of risks as required by OJK regulations
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