Kepastian Hukum terhadap Pembayaran Klaim Asuransi Unit Link yang Mengalami Gagal Bayar

Abstract

Unit-linked insurance agreements combine life insurance products with investments, offering dual benefits for policyholders. However, cases of claim defaults in unit-linked insurance frequently occur due to legal uncertainties involving transparency, corporate governance, and the policyholders' understanding of the terms and conditions of the policy. This study aims to analyze the legal certainty regarding the payment of claims in unit-linked insurance, including the insurance company's responsibility to provide protection to policyholders. The research method used is a normative-juridical approach, involving an analysis of relevant legislation, such as Law Number 40 of 2014 on Insurance and several regulations from the Financial Services Authority (OJK), as well as a review of related cases. The study finds that the primary causes of claim defaults include insufficient transparency regarding investment risks, ambiguous clauses in the policy, and weaknesses in regulatory oversight. Furthermore, the limited understanding of policyholders about the mechanisms of unit-linked products worsens the situation. OJK plays a critical role in ensuring transparency, solvency, and policyholder protection. Moral hazards and fraud often occur in the insurance sector, involving both customers and agents. The study concludes by highlighting the importance of strengthening legal certainty through more effective supervision by OJK, improving transparency within insurance companies, and educating the public about their rights and obligations in unit-linked insurance. The implementation of these measures is expected to prevent claim defaults and enhance protection for policyholders. The establishment of the Policy Guarantee Program, as regulated by Law No. 4 of 2023 on Financial Sector Development and Strengthening (P2SK), aims to protect policyholders of insurance companies that are liquidated or have their licenses revoked, provide compensation for approved claims, and increase public trust in the insurance industry.