Clinical Practices and Hospital Management
Vol. 1 No. 2 (2025): Clinical Practices and Hospital Management

Behind the Hospital–Insurance Deal: Untangling Indonesia’s Legal Maze

Zahry Vandawati Chumaida (Universitas Airlangga Fakultas Hukum)
Mochamad Kevin Romadhona (Faculty of Social and Political Sciences, Universitas Airlangga)
Bambang Sugeng Ariadi Subagyono (Faculty of Law, Universitas Airlangga)
Alaa Basil Baqer Alfadhel (Faculty of Law, Universiti Kebangsaan Malaysia)



Article Info

Publish Date
21 Dec 2025

Abstract

This study examines the legal framework governing cooperation agreements between hospitals and health insurance companies in Indonesia. These agreements play an essential role in regulating the provision and financing of healthcare services for insured patients, yet they often operate within a fragmented and inconsistently applied regulatory environment. Using a juridical-normative approach, the research analyzes relevant legislation, contractual principles, and doctrinal interpretations to understand the legal nature, structure, and implementation challenges of such agreements. The findings reveal significant regulatory gaps and a lack of harmonization between health-sector and insurance-sector rules, which contribute to legal uncertainty and inconsistent contractual practices. The study also identifies administrative burdens, information asymmetry, and weak dispute-resolution mechanisms as major obstacles in the implementation of these agreements. Based on these findings, the research proposes several improvements, including regulatory standardization, enhanced institutional coordination, more efficient dispute settlement procedures, and stronger transparency and consumer protection measures. Overall, the study contributes to a deeper understanding of the legal dynamics of hospital–insurance cooperation and offers recommendations for strengthening legal certainty, contractual fairness, and the effectiveness of healthcare financing in Indonesia.

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Journal Info

Abbrev

CPHM

Publisher

Subject

Description

The journal encourages submissions from scholar-practitioners and professionals who contribute to the fields of Medical Innovations and Technologies, Clinical Practices and Patient Care, Healthcare Management and Policy, Ethical Issues in Healthcare, and Healthcare Informatics and Telemedicine, as ...