| 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 | 01 Apr 2021
There are so many risks that may occur for everything that happen even in our daily activities. For food and beverage industries, the risks may occur in every process from the beginning until the prod...
Repository Admin | 01 Apr 2021
Penelitian ini bertujuan untuk mengetahui hubungan kualitas pelayanan dan penyelesaian klaim dengan kepuasan nasabah asuransi kendaraan bermotor di PT. Asuransi Wahana Tata SO Rasuna. Populasi dalam p...
Repository Admin | 01 Apr 2021
Repository Admin | 22 Apr 2021
Repository Admin | 01 Apr 2021
Penelitian ini bertujuan untuk mengetahui pengaruh strategi pemasaran dan komunikasi terhadap meningkatkan penjualan produk. Penelitian dilakukan pada perusahaan PT. Asuransi Jasa Indonesia (Persero)....
Repository Admin | 01 Apr 2021
Administrator | 05 Mar 2021
The background of this study is to determine the service process of insurance agents at PT Asuransi Jiwa Central Asia Raya. What is done by the agency care specialist division. In addition, it will ex...
Repository Admin | 01 Apr 2021
Repository Admin | 01 Apr 2021
Risk Management is a set of processes or methods in carrying out the process of identifying, measuring, monitoring and controlling risks. The application of risk management is expected to provide more...
Repository Admin | 01 Apr 2021
Repository Admin | 23 Mar 2021
Penelitian ini bertujuan untuk mengetahui dan menguji adanya pengaruh dari status kepesertaan JKN (BPJS Kesehatan) dan tingkat pendapatan terhadap minat masyarakat dalam membeli produk asuransi keseha...
Administrator | 15 Mar 2021
The purpose of this study is to determine the difference in single net premiums based on Indonesian Mortality Table IV and De Moivre's Legal Mortality Table, and to find out a more efficient Mortality...
Repository Admin | 01 Sep 2021
Repository Admin | 01 Apr 2021
Program dana pensiun adalah program yang dibuat untuk menjamin risiko para pekerja di masa tuanya. Dalam mengelola dana pensiun, dapat dilakukan dengan metode perhitungan aktuaria. Program pendanaan p...
Repository Admin | 01 Apr 2021
Penelitian ini bertujuan untuk mengetahui pengaruh persepsi dan tingkat pendapatan terhadap minat beli khususnya. Metode yang digunakan dalam penelitian ini adalah kuantitatif, hasil dan kesimpulan pe...
Admin | 03 Aug 2021
Penelitian ini bertujuan untuk mengetahui hubungan persepsi risiko dan tingkat
pendapatan dengan minat beli produk asuransi umum pada generasi milenial di
Jakarta. Populasi dalam penelitian ini adal...
Repository Admin | 23 Mar 2021
Penelitian ini bertujuan untuk mengetahui hubungan persepsi dan pendapatan masyarakat dengan keputusan pembelian asuransi kendaraan Bermotor pada masyarakat di RW:07 Serua Indah Tangerang Selatan. Pop...
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 | 01 Apr 2021
Risk Management is a set of processes or methods in carrying out the process of identifying, measuring, monitoring and controlling risks. The application of risk management is expected to provide more...
Repository Admin | 12 Apr 2023
Peran aktuaris dan ilmu aktuaria dalam industri jasa keuangan sangat penting. Aktuaris memiliki peran sentral dalam menghitung, memprediksi dan mengelola risiko yang dapat terjadi dimasa depan dari ke...