Policy holders are required to report and complete claim submission documents completely and correctly no later than 90 (ninety) calendar days from the date the insured risk occurs to the Insurer.
Beyond the period specified above, the insurer has the right to reject the claim submitted and the insurer is free from the obligation to pay benefits/losses guaranteed in the policy and the coverage is declared ended.

Death Claim Documents:

Policy (this document can be sent in original form or a copy either in printed or softcopy form)
Original Death Claim submission form;
Photocopy of Family Card or legal proof that the Heir is a family member or someone who has been appointed by the Insured;
Original/legalized death certificate from the local authority;
Doctor’s certificate form for death claims, provided by the Insurer and filled in by the treating doctor and/or medical resume;
Original/legalized certificate from the police or official report from the police if the death is unnatural and/or caused by an accident;
Original/legalized death certificate from the Indonesian Embassy (if the Insured dies abroad);
Other supporting documents.

Individual Claim Guide – Non-Cash / Cashless Claims (Provider)

Cashless within the provider network area.

Individual Claims Guide – Reimbursement Claims

Submission of Medical Treatment Claims must be submitted no later than 60 (Sixty) Calendar Days from the End Date of treatment.
Claim submission documents must be completed and received no later than 90 (Ninety) Calendar Days from the End Date of Treatment.
If the claim submission exceeds the time period specified above, the claim submitted will be rejected.
Insurance benefits will be paid after all Claim Documents are received completely and correctly and have fulfilled all the terms and conditions stipulated in the Policy.
If a Claim submission is found that is not in accordance with the actual situation, the Insurer has the right not to pay the Insurance Benefits, or if the Insurer has already paid the Insurance Benefits before the Insurer knows about the untruth, then the Insurer has the right to charge back the Insurance Benefits to the Policy Holder or Insured, and/or terminate the Policy.
The documents that must be completed by the Policy Holder or Insured are as follows:
1. Claim submission form (available at Provider Hospital or MNC Life Website);
2. Photocopy of the Insured’s original proof of insurance participation (Policy/Certificate/Participant Card);
3. Photocopy of valid identity card of the Insured and/or Policy Holder (KTP/SIM/Passport/Student Card);
4. Doctor’s certificate or medical resume;
5. Original/legalized receipt of maintenance costs along with all details;
6. Photocopy of prescription from Doctor;
7. Photocopies of all supporting examination results during treatment (laboratory, x-ray, ultrasound, etc.).
The Insurer has the right to request information and/or other supporting documents related to medical treatment costs from the Policy Holder or Insured or medical service provider.

Payment of claims:

All reimbursements for benefits will be carried out within 14 (fourteen) working days from the time the documents are received and meet the requirements.

Group Claim Guide – Non-Cash Facilities
1. Participants come to the MNC Life insurance partner hospital or clinic.
2. Participants show their insurance card and participant identity card.
3. Partner hospitals register and contact the Third Party Administration (TPA) for communications regarding health service guarantees.
4. Participants receive health services according to medical indications and doctor’s recommendations.
5. Partner hospitals complete documents in accordance with guarantee procedures.
6. TPA will inform the guarantee decision to partner hospital officers.
7. If the participant requires hospitalization, the TPA will issue an Inpatient Guarantee Letter.
Group Claims Guide – Reimbursement Claims
1. Participants must submit a claim in writing within 30 (thirty) calendar days from the date of the last treatment by the Participant, by attaching the required claim submission documents in full.
2. Claims submitted beyond this time period may be rejected by the Insurer.
3. In the event that the claim submission documents are incomplete, the claim is deemed not to have been submitted, and will be returned to be completed by the Participant. Returned claim documents must be completed and received by the Insurer within 30 (thirty) calendar days from the date the written notification is delivered to the Participant.
4. Resubmission of claims beyond the time period may be rejected by the Insurer.

Required claim documents:

Medical Resume from the treating Doctor or Hospital or Clinic.
Original Receipt from a Doctor or Hospital or Clinic, with sufficient stamps stating:

Participant’s name, name of the treating doctor, diagnosis of disease, date of treatment, details of treatment costs, name stamp and signature of the treating doctor.

Original Receipt from the Pharmacy, which is accompanied by a copy of the prescription for the medicines given, the prescription number, and the name of the prescribing Doctor, which in certain quantities must be sufficiently stamped.
Original Receipt containing details of the name of the Diagnostic Support Examination.
A copy of the results of the Diagnostic Support Examination, and a Cover Letter from the Doctor for the Diagnostic Support Examination.
Cover Letter from a General Practitioner or Specialist Doctor if further examinations need to be carried out.

The documents required to submit a Death Compensation Claim are:

Claim Submission Letter from the Policy Holder;
Participant Card;
Photocopy of Participant’s Identity Card;
Photocopy of Family Card;
Certificate of Death or Death Letter from the Authorized Agency;
Doctor’s Certificate regarding the causes of death of the Participant;
Police Certificate in the event that the Participant dies unnaturally or due to an accident;
Death Certificate from the Embassy of the Republic of Indonesia (KBRI) or Consulate General (Konjen) if you died abroad.

Payment of claims:

If approved by the Insurer, the Claim will be paid according to the Insurer’s approval no later than 14 (fourteen) working days from the time the complete documents are received.

Package	Sum Insured (UP)	Life Benefits	Premiums according to payment method
Package	Sum Insured (UP)	Life Benefits	Annually	Semi-Annually	Quarterly	Monthly
1	Rp 50 Million	Rp 115 Million	Rp 3 Million	Rp 1.56 Million	Rp 810 Thousand	Rp 300 Thousand
2	Rp 100 Million	Rp 3 Million	Rp 5 Million	Rp 2.6 Million	Rp 1.35 Million	Rp 500 Thousand
3	Rp 225 Million	Rp 6.75 Million	Rp 10 Million	Rp 5.2 Million	Rp 2.7 Million	Rp 1 Million
4	Rp 500 Million	Rp 15 Million	Rp 20 Million	Rp 10.4 Million	Rp 5.4 Million	Rp 2 Million

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