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Generali Membayar Rp608,2 Miliar pada Semester I/2024, Hampir 80% dari Klaim Asuransi Kesehatan Diproses

PT Asuransi Jiwa Generali Indonesia (Generali Indonesia) has reported a total payout of Rp608.2 billion in claims during the first half of 2024. These insurance claims cover cases of death, critical illness, and health for over 140,000 claimants. This represents a 13% increase in claim payouts compared to the previous period, with 78% of the total claims being related to health.

Vivin Arbianti Gautama, the Chief Marketing Officer of Generali Indonesia, highlighted that the rise in medical inflation has led to an increase in the prices of medications and medical services, resulting in higher claim amounts. She emphasized that the company’s commitment to paying out claims is a testament to Generali Indonesia’s dedication to supporting its policyholders, especially during challenging times. This commitment reflects one of Generali’s core values, „Deliver on The Promise,“ where the company fulfills its promises to policyholders by paying out claims in accordance with policy terms.

Despite the high volume of claims, Vivin expressed optimism in the collaborative efforts between regulators and various stakeholders to address the issue of rising medical inflation. By working together, they aim to control medical inflation, minimize increases in health insurance claims, and maintain the financial performance of the insurance industry.

According to the Indonesian Life Insurance Association (AAJI), the life insurance industry has seen a significant increase in health insurance claims in the first half of 2024. Health insurance claims reached Rp11.83 trillion, marking a 26% increase compared to the same period in the previous year. Individual health insurance claims saw a substantial 29.3% year-on-year increase to Rp7.62 trillion, while group health insurance claims also rose by 20.3% to Rp4.21 trillion.

Freddy Thamrin, Chair of the Literacy & Consumer Protection Division at AAJI, noted that the escalating health insurance claims have resulted in a health insurance claims-to-premium income ratio of 105.7%. This indicates that the amount paid out in claims by the life insurance industry exceeds the premiums received, posing significant financial pressure on insurance companies.

Freddy attributed the high health insurance claims to the continuous rise in medical inflation, posing a major challenge for the life insurance industry. However, he assured that the industry has strategic measures in place to address this trend. AAJI is committed to ensuring that policyholders receive the best quality healthcare services tailored to their needs by collaborating closely with regulators, the Ministry of Health, and healthcare providers.

In total, the life insurance industry disbursed Rp77.67 trillion in claims during January-June 2024, benefiting over 9.82 million life insurance policyholders. While the overall trend shows a decrease in total claims payouts, driven by lower surrender and death claims, health insurance claims continue to rise in the first half of 2024.

In conclusion, the surge in health insurance claims in Indonesia underscores the importance of addressing medical inflation and finding sustainable solutions to balance the interests of the insurance industry and the healthcare sector. By fostering collaboration and implementing strategic measures, the industry can navigate the challenges posed by rising health insurance claims and ensure the continued financial stability of insurance companies.

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