| 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 |
Admin | 19 Aug 2021
Bisnis asuransi di Indonesia merupakan sebuah bisnis yang memiliki potensi besar di masa yang
akan mendatang, namun semakin bertambahnya keluhan pelanggan yang diterima oleh perusahaan
asuransi, mak...
Admin | 25 Aug 2021
The research is described the analysis in PT Bosowa Asuransi for increase the premium income property insurance. The researchers conducted a study in PT Bosowa Insurance, Global Tower 2rd Floor, Jl. J...
Admin | 19 Aug 2021
Tujuan dari penelitian ini adalah untuk mengetahui bagaimana proses perpanjangan
polis asuransi kesehatan kumpulan dilakukan di Unit Bisnis Syariah PT. Asuransi
Bintang Tbk, pada produk Asuransi Kes...
Admin | 23 Aug 2021
penelitian ini berjudul "Implementasi Manajemen Hubungan Pelanggan di PT Asuransi
Central Asia Cabang Latumenten". Penelitian ini bertujuan untuk mendeskripsikan
pihak - pihak yang terkait dalam pel...
Repository Admin | 04 Aug 2021
Penelitian ini dilakukan untuk mencari tahu hubungan antara Faktor Manusia dan Faktor Teknis dengan Risiko Kecelakaan Pesawat Komersial. Data primer diperoleh dari penyebaran kuisioner melalui google...
Admin | 19 Aug 2021
Admin | 24 Aug 2021
Admin | 23 Aug 2021
The purpose of this study was to determine the existence of the application
of risk management in the Bajaj Pool Sunter-North Jakarta. Data analysis method
used is interviews through 3 (three) sourc...
Admin | 10 Aug 2021
This study is to answered the problem that how much the premium income
and claim as partialy and simultaneously have influence toward underwriting
result.
The purpose of this study is to obtain the...
Repository Admin | 09 Aug 2021
Tujuan dari penelitian ini untuk mengetahui faktor kepuasan pelanggan saat mengajukan klaim di PT Asuransi Allianz Indonesia Serta mengetahui pengaruh dari kualitas pelayanan bengkel dan prosedur pena...
Admin | 09 Aug 2021
This thesis examines the income and expenses of insurance business to net income which are converted in the form of underwriting ratio, loss ratio, and return on assets so this rescarch title is the I...
Repository Admin | 16 Jun 2021
Surety Bond is an innovative product that is offered by the insurance company as a takeover attempt the potential risk of loss that may be experienced by one of the parties, generally the owner of the...
Repository Admin | 21 Jun 2021
Money Insurance or Money Insurance is an insurance product that guarantees money from various risks that result in a loss during storage and in the shipping process. There are several processes in clo...
Repository Admin | 25 Aug 2021
Penelitian ini dilakukan dengan tujuan untuk menganalisis pengaruh pendapatan premi bruto dan beban klaim bruto terhadap hasil underwriting perusahaan reasuransi di Indonesia tahun 2007-2016. Data yan...
Admin | 25 Aug 2021
The objective of this research is to get influence or not influence between tabarru
'earnings income to underwriting result, shariah facultative fire reinsurance claim
expense to underwriting result...
Repository Admin | 31 Jan 2024
Kemampuan dasar yang perlu dimiliki oleh masyarakat pada era industri 4.0 adalah kemampuan dalam menggunakan komputer. Salah satu perangkat lunak komputer yang digunakan dalam berbagai bidang adalah M...
Admin | 24 Jun 2021
This research was conducted with the aim to find out the effect training and
implementation SOP on service quality in the operation division of PT Asuransi
Jiwa Nasional.The research method used is...
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...
Repository Admin | 01 Apr 2021
Risk is an uncertainty that can cause a loss. The risk of an accident will always be there. Accident is an unfortunate incident that happens unexpectedly and unintentionally, typically resulting in da...