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Group Insurance Form

Group Insurance Form Template for Indonesia

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Key Requirements PROMPT example:

Group Insurance Form

"I need a Group Insurance Form for my tech company with 500 employees in Jakarta, covering health and life insurance with international coverage options, to be effective from March 1, 2025, with special provisions for remote workers."

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Document background
The Group Insurance Form serves as a foundational document in the Indonesian insurance market, designed to facilitate group insurance arrangements between insurance providers and organizations. This document type emerged from the need to provide standardized yet customizable insurance coverage for groups such as employees, association members, or other collective entities. The form must comply with Indonesian insurance regulations, particularly Law No. 40 of 2014 on Insurance and various OJK regulations governing group insurance policies. It is structured to accommodate the complex nature of group insurance arrangements, including member eligibility, premium calculations, claims procedures, and policy administration. The document requires careful consideration of both the organization's needs and regulatory compliance, making it a crucial tool in Indonesia's insurance industry.
Suggested Sections

1. Parties: Identification of the insurance company, group policyholder (organization), and the category of insured members

2. Background: Context of the group insurance arrangement and purpose of the agreement

3. Definitions: Key terms used throughout the form including technical insurance terms, group-specific definitions, and regulatory terms

4. Scope of Coverage: Detailed description of insurance coverage, including risks covered and excluded

5. Eligibility Requirements: Criteria for group members to be eligible for coverage

6. Premium Calculation and Payment: Premium structure, calculation method, payment schedule, and consequences of non-payment

7. Policy Period and Renewal: Duration of coverage, renewal terms, and conditions for policy continuation

8. Claims Procedure: Process for filing claims, required documentation, and timeline for claim settlement

9. Rights and Obligations: Detailed responsibilities of all parties - insurer, policyholder, and insured members

10. Termination Provisions: Conditions and procedures for policy termination by either party

11. Dispute Resolution: Procedures for handling disputes, including jurisdiction and applicable law

Optional Sections

1. Grace Period Provisions: Include when offering flexible payment terms for premium payment

2. Conversion Privilege: Include when offering option to convert to individual policy upon leaving the group

3. Profit Sharing Agreement: Include when the policy includes profit-sharing arrangements with the group policyholder

4. International Coverage: Include when coverage extends beyond Indonesian territory

5. Rehabilitation Clause: Include when offering options for reinstating lapsed policies

6. Premium Adjustment Mechanism: Include when premium rates are subject to periodic review and adjustment

Suggested Schedules

1. Schedule A - Benefits Schedule: Detailed breakdown of coverage amounts, limits, and sublimits for each type of benefit

2. Schedule B - Premium Rates: Detailed premium rates and calculations based on member categories

3. Schedule C - Excluded Conditions: Comprehensive list of exclusions and limitations

4. Appendix 1 - Claim Forms: Standard forms required for claim submission

5. Appendix 2 - Member Registration Format: Template for registering new group members

6. Appendix 3 - Medical Underwriting Requirements: Medical examination and underwriting criteria if applicable

Authors

Alex Denne

Head of Growth (Open Source Law) @ tiktok成人版 | 3 x UCL-Certified in Contract Law & Drafting | 4+ Years Managing 1M+ Legal Documents | Serial Founder & Legal AI Author

alex.den.21@genieai.co
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Relevant Industries

Corporate and Business Services

Healthcare

Education

Manufacturing

Financial Services

Professional Services

Non-Profit Organizations

Retail

Technology

Construction

Hospitality

Transportation and Logistics

Relevant Teams

Human Resources

Legal

Finance

Risk Management

Compliance

Employee Benefits

Insurance Operations

Claims Processing

Corporate Administration

Policy Management

Relevant Roles

Human Resources Director

Benefits Manager

Risk Manager

Insurance Broker

Compliance Officer

Legal Counsel

Chief Financial Officer

HR Operations Manager

Employee Benefits Coordinator

Insurance Underwriter

Claims Manager

Contract Administrator

Corporate Secretary

Finance Manager

Industries







Teams

Employer, Employee, Start Date, Job Title, Department, Location, Probationary Period, Notice Period, Salary, Overtime, Vacation Pay, Statutory Holidays, Benefits, Bonus, Expenses, Working Hours, Rest Breaks, 聽Leaves of Absence, Confidentiality, Intellectual Property, Non-Solicitation, Non-Competition, Code of Conduct, Termination, 聽Severance Pay, Governing Law, Entire Agreemen

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