Penerapan Prinsip Itikad Baik (Utmost Good Faith) dalam Hal Kewajiban Pemberitahuan Riwayat Kesehatan yang Menyebabkan Ditolaknya Pembayaran Klaim Asuransi Jiwa Nasabah (Studi Putusan Badan Penyelesaian Sengketa Konsumen Kabupaten Sukabumi Nomor: 010/G/BPSK.KABSI/X/2021)

Abstract

The application of utmost good faith principle requires a clarity regarding the condition of the policy maker in accordance with the actual facts stated the insurance agreement. However, there are still violations committed by the policy maker regarding the actual facts of his medical history. One of the case examples is found in the Decision of the Consumer Dispute Resolution Agency of Sukabumi Regency No: 010/G/BPSK KABSI/X/2021. The problems of this research are as follows: how about the application of utmost good faith principle in the event of medical history notification obligation in the insurance contract, how about the limitation of liability for the insurance company in the event of a violation of utmost good faith principle committed by the policy maker in the insurance agreement, how about the analysis of the authority of the Colasumer Dispute Resolution Agency (BPSK) of Sukabumi Regency against the rejection of payment of life insurance claims which belongs to the customer of PT BNI Life Insurance who has died (A Study of Consumer Dispute Resolution Agency of Sukabumi Regency Decision No: 010/G/BPSK KABSI/X/2021) This research employed normative juridical approach which is a descriptive method. Primary data were obtained from secondary data collected by literature study (library research) and interviews. They were analyzed by using qualitative data

analysis. The research result indicates that there has been a violation in terms of the application of utmost good faith principle committed by the policy maker which causes his heirs could not receive the insurance claims. According to Article 249 and Article 276 of the Criminal Code as well as the regulations stipulated in the Insurance Policy No. BLPM9172089237 (General Provision) Article 2 Paragraph (4), the insurance company may limit its responsibility in paying insurance claims to the beneficiary or heirs this is in the analysis of the authority of BPSK of Sukabumi Regency against the case of payment rejection of life insurance claims is that BPSK does not have the authority to handle the case regarding this insurance claim. This is in accordance with the Jurisprudence of the Supreme Court of the Republic of

Indonesia Rulings No. 757/Pdt.Sus-BPSK/2016, No. 472 K/Pdt Sus-BPSK/2014, and

No. 572 K/Pdt.Sus-BPSK/2014