Claim Missing Document
Check
Articles

Found 1 Documents
Search

The Effectiveness of Regulating Pre-Existing Conditions in Life Insurance Policies as a Risk-Mitigation Mechanism for Insurance Companies in Indonesia: Efektivitas Pengaturan Pre-Existing Condition dalam Polis Asuransi Jiwa Sebagai Mekanisme Mitigasi Risiko Perusahaan Asuransi di Indonesia Awuy, Euginia Nataniela; Gunadi, Ariawan
Indonesian Journal of Law and Economics Review Vol. 21 No. 1 (2026): February
Publisher : Universitas Muhammadiyah Sidoarjo

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21070/ijler.v21i1.1408

Abstract

Background: Life insurance plays a crucial role in balancing financial protection and risk management, where pre-existing condition clauses function to maintain fairness between premium payments and actual risks borne by insurers. Specific Background: In Indonesia, the implementation of these clauses often triggers disputes due to inconsistent interpretations, lack of regulatory standardization, and low public literacy regarding insurance contracts. Knowledge Gap: Despite their importance, limited studies examine how effectively these clauses mitigate risk while maintaining legal certainty amid regulatory ambiguity and practical challenges in underwriting and proof. Aim: This study evaluates the effectiveness of pre-existing condition clauses as a risk-mitigation mechanism for Indonesian life insurance companies. Results: Findings show that these clauses prevent adverse selection, strengthen utmost good faith, and support accurate underwriting, though effectiveness is hindered by unclear definitions, uneven documentation, agent miscommunication, and difficulties in proving prior illnesses. Novelty: This research integrates legal, technical, and consumer-protection perspectives to identify systemic weaknesses that reduce clause enforceability. Implications: Strengthening regulatory standards, improving transparency, and enhancing underwriting systems are essential to reduce disputes and reinforce legal certainty in life insurance governance. Highlights: Evaluates how pre-existing condition clauses function as a core risk-mitigation tool in Indonesian life insurance. Highlights legal and practical challenges, including regulatory gaps, proof difficulties, and low insurance literacy. Recommends strengthening regulation, transparency, and underwriting systems to reduce disputes and enhance legal certainty. Keywords: Pre-Existing Condition, Life Insurance, Risk Mitigation, Legal Certainty, Underwriting