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Insurance Authorization Letter Template for Indonesia

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Key Requirements PROMPT example:

Insurance Authorization Letter

"I need an Insurance Authorization Letter that allows my sister to manage my health insurance claims and policy adjustments while I'm working abroad from January 2025 to December 2025, including authority to access medical records and process claims with my Indonesian insurance provider."

Document background
The Insurance Authorization Letter is a crucial document in Indonesian insurance practice that facilitates the delegation of authority in insurance-related matters. It becomes necessary when an individual or entity needs to authorize another party to act on their behalf in insurance transactions, claims processing, or policy management. The document must conform to Indonesian legal requirements, particularly those set forth by the Financial Services Authority (OJK) and Law No. 40 of 2014 on Insurance. This authorization letter typically includes comprehensive details about the parties involved, specific powers granted, temporal limitations, and any conditions or restrictions on the authority. It serves as a protective measure for all parties involved, ensuring clear documentation of the authorized powers while meeting regulatory compliance requirements in Indonesia's insurance sector.
Suggested Sections

1. Letter Date and Reference Number: Current date and unique reference number for tracking purposes

2. Recipient Details: Complete name and address of the insurance company or institution

3. Subject Line: Clear indication that this is an Insurance Authorization Letter

4. Authorizer's Details: Full name, address, and identification details of the person granting authorization

5. Authorized Party's Details: Full name, address, and identification details of the person or entity being authorized

6. Scope of Authorization: Specific insurance-related actions and decisions the authorized party can make

7. Duration of Authority: Time period for which the authorization is valid

8. Policy Details: Relevant insurance policy numbers and types covered by this authorization

9. Declaration of Sound Mind: Statement that the authorizer is of sound mind and giving authorization freely

10. Signature Block: Space for authorizer's signature, date, and witness signatures

Optional Sections

1. Medical Information Access: Authorization for access to medical records and information, used when the insurance involves health coverage

2. Financial Authority Limits: Specific monetary limits on the authorized party's decision-making power, used when financial restrictions are needed

3. Emergency Contact Information: Additional contact details for urgent situations, included when dealing with health or life insurance

4. Revocation Clause: Specific terms for how the authorization can be revoked, included when the authorizer wants explicit revocation terms

5. Language Declaration: Statement about the governing language if the letter is bilingual, used when multiple language versions are provided

Suggested Schedules

1. Identity Documents: Copies of official identification documents of both authorizer and authorized party

2. Insurance Policy Details: List of relevant insurance policy numbers and types covered by the authorization

3. Medical History Summary: Summary of relevant medical history if required for health insurance purposes

4. Witness Information: Details and identification documents of witnesses to the authorization

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

Relevant legal definitions

























Clauses




















Relevant Industries

Insurance

Healthcare

Financial Services

Banking

Corporate Services

Real Estate

Manufacturing

Transportation

Retail

Construction

Maritime

Aviation

Relevant Teams

Legal

Compliance

Risk Management

Insurance Operations

Claims Processing

Customer Service

Documentation

Administrative Support

Human Resources

Corporate Secretariat

Policy Management

Relevant Roles

Insurance Agent

Claims Manager

Risk Manager

Compliance Officer

Legal Counsel

Insurance Broker

Policy Administrator

Corporate Secretary

Human Resources Manager

Finance Director

Operations Manager

Administrative Assistant

Document Controller

Insurance Underwriter

Customer Service Representative

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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