Legal Analysis of the OJK's Role in Rejecting Insurance Policy Claims by Customers

Abstract

Insurance is an institution that functions to mitigate various risks that may occur in the
future. Therefore, insurance plays a crucial role in providing protection to policyholders.
One of the challenges that frequently arise in insurance practice is the rejection of claims
submitted by customers to insurance companies, which are usually accompanied by
various reasons from the company. In this case, the existence of the Financial Services
Authority (OJK) is very helpful for customers in resolving issues related to claim
rejections. Based on Law Number 21 of 2011 concerning the Financial Services
Authority, this institution not only serves as a facilitator of consumer protection and
mediation, but also plays an active role in legal defense for customers. The OJK's role in
resolving disputes over insurance claims rejected by insurance companies includes
acting as a mediator in the deliberation process to reach a consensus between the
customer and the insurance company, as well as acting as a supervisor to ensure the
outcome of the agreement. However, in carrying out its functions, the OJK faces a
number of non-legal obstacles, both internal and external. This research uses literature
review and legal analysis to help provide results in addressing this issue. Some of these
obstacles include the lack of clarity in customer complaints, incomplete supporting
documents, and minimal information that can be obtained.