How health insurance works the latest and most complete | ClueWorks

Originally Posted by ClueWorks – Remote Worker International

Health insurance is one of the financial products that are already quite familiar in the ears of the people of International. In 2018 alone, the Central Statistics Agency (bps) recorded that of the 262 million Internationaln population, as many as 208 million of them, equivalent to 79.4%, had been protected by health insurance.

Insurance is a service in the financial services sector with the aim of taking risks by the insurance company (insurer) from the customer (insured). The risk resulting in financial loss is closed by using the premium pool paid by the customer.

How Does Health Insurance Work?

In simple terms, the way health insurance works is described in the chain of work of insurance companies that starts from creating insurance products. In general, insurance products are created depending on current or previous conditions.

To update the benefits offered through new products, insurance companies often do a number of opinion gathering and listening to the needs of customers.

Opinion collection is done to find out the expectations of the desired insurance product. If it is felt that something must be updated, the insurance company will update its products.

How Insurance Works In General

1. Offering insurance products that suit your needs

The distribution channels of insurance companies are diverse. Insurance companies generally offer the types of insurance they have by relying on insurance agents, telemarketing, bancassurance, to insurance brokers.

The insurance company will offer as well as introduce the types of insurance to its customers according to their needs. In order not to be rejected by prospective customers while offering products, insurance companies ideally recognize the targeted customers in advance.

2. Making An Insurance Policy Agreement

If the prospective customer is interested and has understood the insurance products offered, the insurance company will provide an insurance filing form as a condition for making an insurance policy agreement.

The insurance customer is the owner of the policy (as well as the insured or beneficiary) and the insurance company acts as the insurer (insurer).

In short, an insurance policy is a contract between the insurer and the insured which determines the claims that the insurer must pay to the insured by law.

The content of the insurance policy agreement is the obligation of the insurer to pay financial compensation or insurance benefits with the prerequisite that the insured has paid the premium.

If you are still difficult to understand the entire contents of the insurance policy, at least four points of the insurance policy below can be understood well.

a. Data Policy

It contains the name of the policyholder, the name of the insured or beneficiary or heir, the amount of the premium, to the amount of coverage. Policy Data is basic information.

b. Insurance Benefits

Lists the protection benefits received in the event of a risk. If the type of insurance at the same time provides investment benefits, there are investment benefits obtained when you die. If we want to add benefits or riders to the type of insurance, the insurance policy will detail the additional risks covered.

c. Exceptions

This is important to know so that insurance customers really know and understand what is not included in the insurance policy risk coverage. For example, conditions, diseases, and causes of death that are not covered.

d. Claim Submission

In the insurance policy will be written the procedure for filing a claim, including with the conditions that must be included. It is important that you pay attention to the deadline for filing a claim in the insurance policy.

3. Paying Insurance Premiums

Paying insurance premiums is the obligation of every policyholder. This is so that the policyholder can receive insurance benefits in accordance with the initial agreement between the policyholder and the insurance service provider company.

The schedule of premium payments will also be determined by the insurance company. The amount of premiums set by insurance companies is also based on several factors, namely:

  • Age
  • Insurance benefits obtained
  • Coverage coverage
  • Additional benefits (if there is a request from the customer)
  • Pre-existing condition of policyholder
  • Lifestyle
  • Working environment
  • Hobbies

4. Accepting and disbursing Insurance Claims

Before accepting an insurance claim you must first be eligible to make a claim. One of the main conditions for filing a claim is the active period of the premium. You cannot make a claim if your premium is inactive.

Usually, in the process of insurance claims from customers, the insurance company will conduct an examination of the events that occurred.

The examination is carried out after the administration of the insured has been completed. Examination of the events that occur is usually done by verifying to the authorities, relevant agencies such as hospitals, families, to relatives around.

This is done to ensure that the benefits received are on target. The insured who submits a claim will get two answers, namely the claim approved or the claim rejected.

Come On, Register The Company Immediately!

For those of you who are still confused, contact Safe right now! Why should Safe? Increase business, easy purchasing, easy administration of benefits, higher employee engagement and various other benefits you can get!

You can also download the application at Google Play dan App Store. PT. Insurtech Technologies International has also been officially registered in the Ministry of communication and information, so you don’t have to worry or doubt anymore!

Read also health insurance benefits dan how to make health insurance to increase your understanding of health insurance. Not only that, there are many other informative articles that you can find in ClueWorks Blog, you know!

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