| Title | ANALISIS PENYEBAB PENOLAKAN KLAIM REIMBURSEMENT PADA PROGRAM ASURANSI KESEHATAN KUMPULAN PT ASURANSI RELIANCE INDONESIA TAHUN 2011 |
|---|---|
| Author | Romdaniyah |
| Abstract | This study aims to analyze the cause of the rejection of claims reimbursement Reliance Insurance Indonesia Company in 2011. To get the analysis of the cause of rejection of the writer tries to make a qualitative descriptive study using secondary data from the system database Claims Department with research sample is all file reimbursement claims were denied payment. The results showed that the amount of reimbursement claim denials reached 11.65% of the total claims received by administrative staff Reliance Insurance Indonesia for 5388 and rejected the file with an increasing trend from 9.60% in January to 16.20% in December 2011. There are several things that cause rejection of reimbursement claims, which were the exception / exclusion, fraud, and the over limit and the provisions of the policy. From the results of the study, concluded that the denial of claims due to the biggest reimbursement over limit that is equal to 48.83% of the total rejection of claims reimbursement. In the second claim denials due to the public policy exception, amounting to 29.91% of the total rejection of claims reimbursement. Furthermore, for the third order is a denial of a claim arising from fraud as much as 18.35% of the total rejection of claims reimbursement. And the fourth is caused by the provisions of the policy as much as 2.91% of the total rejection of claims reimbursement. From the description above, in order to reduce the rejection of reimbursement claims are rejected is conducting ongoing socialization of each company to the understanding of health insurance products collection Reliance Insurance Indonesia Company and claim procedures to be followed to the participants of the contract / policy should be made clear and understood by all parties that the participants really understood about the condition of the policy. Kata kunci : Penolakan Klaim, Reimbursement |
Repository Admin | 09 Aug 2021
The purpose of this study is to know the partial and simultaneous influence of corporate image and employee performance to the satisfaction of the insured. The population in this study are customers o...
Repository Admin | 19 Aug 2021
Munculnya SKKNI menjelaskan bahwa industri broker asuransi memiliki skema bagi pekerja mengenai tugas dan kewajiban yang harus dilakukan dalam upaya
memenuhi kebutuhan pekerja untuk menjawab pertumbu...
Admin | 03 Aug 2021
Penelitian ini bertujuan untuk mengetahui hubungan hasil investasi dan beban
operasional dengan laba bersih perusahaan asuransi syariah umum. Metode yang
digunakan dalam penelitian ini adalah kuanti...
Admin | 01 Jul 2021
Fraud has been serious problem in henlth insuramce, this is because it can lead to higher in health insurance premiumms and prolong the claints process. Technological changes und the loopholes in the...
Admin | 16 Aug 2021
Admin | 23 Jun 2021
The background of this research is to find out the process of claiming for
educational scholarship partner products in the branch office of AJB
BUMIPUTERA 1912 Explained by the claims section, in ad...
Admin | 03 Aug 2021
Penelitian ini diberi judul “Pengaruh Total Keseluruhan pendapatan premi dan Beban klaim terhadap underwriting result pada PT Asuransi QBE Pool Indonesia periode 2013-2017. Penelitian ini dilakukan di...
Repository Admin | 09 Aug 2021
Penelitian ini bertujuan untuk menguji secara empiris pengaruh kualitas sumber daya manusia (SDM) dan gaya kepemimpinan terhadap kinerja karyawan. Dalam penelitian ini, peneliti mengkaji kinerja karya...
Repository Admin | 27 Sep 2021
Admin | 23 Aug 2021
Penelitian ini bertujuan untuk menganalisis penerapan manajemen risiko terhadap
piutang tak tertagih bengkel rekanan. Manajemen risiko yang dimaksud adalah
menghitung frekuensi dan besaran dari keru...
Repository Admin | 31 Aug 2021
TUJUAN PENELITIAN, Ialah untuk mengetahui adakah hubungannya dari Sistem Kompensasi dengan Kinerja Karyawan PT. Bosowa Asuransi. Kedua, untuk mengetahui seberapa besar hubungan dari Sistem Kompensasi...
Admin | 03 Aug 2021
Penelitian ini berjudul Hubungan Deposito dan Efek dengan Hasil Investasi
Perusahaan Asuransi Umum Go Publik di Indonesia, penelitian ini bertujuan untuk
mengetahui hubungan Deposito dan Efek dengan...
Repository Admin | 25 Nov 2021
Admin | 26 Nov 2021
Underwriting is the process of identification, evaluation of health, physical and
financial risks that exist in prospective insured or insured. To determine whether
the risk is acceptable or decline...
Repository Admin | 31 Aug 2021
Penyelenggaraan jaminan sosial bagi seluruh rakyat Indonesia
diamanatkan dalam Undang-Undang Dasar (UUD) Tahun 1945 Pasal 28 H dan Undang-Undang Nomor 36 Tahun 2009 tentang Kesehatan. Kedua Undang-Un...
Repository Admin | 02 Sep 2021
Proses kegiatan asuransi tidaklah seperti yang dibayangkan kebanyakan orang. Premi yang masuk ke perusahaan asuransi masih akan dibayarkan kembali ke perusahaan reasuransi sebagai penanggung ulang. Pe...
Admin | 24 Jun 2021
The purpose of this research is to analysis the influence of promotion and quality of
service to the decision purchase of insurance products at PT BRIngin Life Syaria
Insurance. The analysis tools u...
Repository Admin | 30 Jun 2021
"Every insurance company must have a distribution channel in selling its products to the buyers. Lots of distribution channels are used by insurance companies, One of the most common distribution chan...
Putri Melati Kresna Dewi | 15 Jun 2021
Everyone who do not have financial capacity, buying a house in eash is an obstacle. One alternative is funding from banks tike housing loan. In order to avoid the occurrence of bad credit the bank pro...
Admin | 12 Aug 2021
Penelitian ini bertujuan untuk mengetahui pengaruh pendapatan underwriting dan
beban underwriting terhadap hasil underwriting. Penelitian dilakukan terhadap
perusahaan reasuransi PT Reasuransi Nasio...