Pelindungan Hukum terhadap Pemegang Polis Akibat Pelanggaran Prinsip Utmost Good Faith yang Dilakukan oleh Perusahaan Asuransi dalam Penutupan Polis Asuransi Jiwa (Studi Putusan Nomor 135/Pdt.G/2022/PN Jkt.Sel)

Abstract

Insurance companies that violate the utmost good faith principle, resulting in financial losses to policyholders, may be held liable if the policyholder can prove that such actions caused harm. This study aims to examine the urgency of applying the utmost good faith principle, the legal liability of insurance companies for its violation, and the legal protection available to policyholders affected by such breaches in life insurance policies, with a focus on Decision No. 135/Pdt.G/2022/PN Jkt.Sel. This research adopts a normative juridical approach with a descriptive nature, utilizing statutory and case law analysis, Secondary data sources were used, with data collected through literature review and document analysis. Data analysis was conducted qualitatively using deductive reasoning. The urgency of implementing the utmost good faith principle in life insurance policy issuance is regulated under Article 31(2) of the Insurance Law, which mandates that insurance companies provide clear explanations regarding the products offered, including all risks, applicable costs, and other essential information such as the exclusion of benefits, to prospective and existing policyholders. This transparency is crucial in preventing future legal disputes. Regarding legal liability, insurance companies that violate the utmost good faith principle in life insurance policy issuance must compensate policyholders or insured individuals, ensuring legal certainty as stipulated in Article 1365 of the Indonesian Civil Code (KUHPerdata). In Decision No. 135/Pdt.G/2022/PN Jkt.Sel, the court ruled that the insurer's removal of the Berkah Healthsafe benefit constituted an unlawful act. Consequently, the defendant was ordered to reimburse the plaintiff for medical treatment and surgery expenses totaling IDR 67,632,158 and to cover court fees amounting to IDR 520,000.