Polis Lapse Sebagai Alasan Penolakan Klaim Asuransi Jiwa Oleh Perusahaan Asuransi (Studi Putusan Nomor 252/Pdt/2019/PT.DKI)

Abstract

The development of the life insurance industry in Indonesia has shown a growing public interest; however, it is often accompanied by conflicts over claim rejections, one of which is due to delayed premium payments that result in policy lapses. This thesis aims to identify the factors causing policy lapses in life insurance agreements, to examine the legal consequences of a lapsed policy concerning the rights of policyholders, and to analyze the legal considerations of the Panel of Judges regarding the use of policy lapse as a reason for rejecting life insurance claims by the insurance company, as reflected in Decision Number 252/Pdt/2019/PT.DKI. The research method employed is normative legal research using a statutory approach and a case approach. Secondary data were collected from primary legal materials (laws and regulations, court decisions, standard insurance policies) and secondary legal materials (books, journals, and scholarly articles). The data were analyzed qualitatively with conclusions drawn deductively. Based on the discussion, the main factors contributing to a lapsed insurance policy include the policyholder's noncompliance in making timely premium payments, insufficient investment value, and unstable financial conditions. Additionally, internal factors such as the lack of notification regarding premium due dates and external factors such as the negligence of the insured in fulfilling their contributions also play a role. The legal consequence of a lapsed policy is the termination of the life insurance contract, resulting in the loss of the policyholder’s right to insurance benefits and the rejection of claims by the insurance company. In Decision Number 252/Pdt/2019/PT.DKI, the panel of judges upheld the rejection of a claim by PT. Asuransi Jiwa Manulife Indonesia on the grounds of a lapsed policy. The court’s consideration was based on the policy provision which stated that notifying the policyholder of the premium due date is a service, not an obligation of the company, and that the policyholder remains responsible for paying the premiums as scheduled. This decision emphasizes the importance of policyholders’ compliance with premium payment obligations and underscores the principle of pacta sunt servanda in insurance contracts.