The Nature of the Legal Responsibility of Insurance Companies in Increasing Individual Claims in the Southern Sulawesi Region | [Pakistan Journal of Life and Social Sciences • 2025]

Author(s):

1. Mariany M Lintjewas: Doctoral of Law Universitas Muslim Indonesia

2. Sufirman Rahman: Universitas Muslim Indonesia

3. Kamal Hidjaz: Universitas Muslim Indonesia

4. Ilham Abbas: Universitas Muslim Indonesia

Abstract:

This study aims to explore, analyze, and uncover the legal responsibilities of insurance companies in safeguarding customer rights based on the principle of good faith. It also seeks to determine whether the responsibilities of insurance companies align with statutory regulations and to identify the factors influencing the implementation of individual claims services in insurance companies within the South Sulawesi region. The research adopts a legal framework, combining empirical and normative legal research methods. Conducted in Makassar City, South Sulawesi, the study focuses on branch offices of PT. BNILife Insurance, PT. Axa Mandiri, PT. Jasindo General Insurance, FWD Insurance, BPJS Health, and PT. Ramayana Insurance. Data sources include primary and secondary legal materials, with a sample size of 50 respondents. Data collection methods comprise observation, interviews, questionnaires, and documentation, while the data analysis employs qualitative techniques, including the interpretation of operational definitions. The findings reveal that the legal responsibilities of insurance companies in protecting customer rights are rooted in the principle of good faith, emphasizing adherence to policy agreements to ensure protection, claim settlements, and benefits. The implementation of these responsibilities in accordance with statutory regulations obligates insurance companies to guarantee protection, defend customers, provide compensation, and address disputes, including any harmful actions by insurance agents. Factors influencing individual claims services in South Sulawesi include the expectation (das sollen) that claims payments are realized, supported by digital, transparent, and accountable systems. However, practical implementation (das sein) remains less effective due to issues such as the legal framework, organizational structures, facilities, infrastructure, and legal culture. The study underscores the need for insurance companies to enhance claims services by aligning responsibilities with policy agreements and human values, guided by Pancasila, Law No. 40 of 2014 on Insurance, the Civil Code (KUHPer), the Commercial Code (KUHD), and other relevant laws.

Page(s): 1470-1481

DOI: 10.57239/PJLSS-2025-23.1.00114

Published: Journal: Pakistan Journal of Life and Social Sciences, Volume: 23, Issue: 1, Year: 2025

Keywords:

Legal responsibilities of Insurance companies claims services Good faith Statutory regulations Analysis

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