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Area Description Notes

1 Insurance Company
2 Health insurance type
3 Coverage area Indonesia
4 Insured gender
5 Insured age of entry Minimum
6 Maximum
7 Policy holder age Minimum
8 Maximum
9 Period of coverage
10 Period of premium payment
11 Payment Terms (Year)
12 Payment Terms (Semester)
13 Payment Terms (Quarter)
14 Payment Terms (Month)
15 Change of payment term
Currency
16 Payment Method (Credit Card)
17 Payment Method (Bank Transfer)
18 Payment Method (Autodebet)
19 Payment Method (Others)
20 Premium
21 Minimum & Maximum Sum Insured Minimum
22 Maximum
23 Promotion / discount Paid Annual
24 How to Activate Policy?
25 Policy in Soft-copy?
26 Additional cost Printing
27 Stamp
28 Underwriting process
29 How many policies can the insured have?
30
Waiting period (after activated)
31 Customer is covered while he hasnt
Grace period (After the due date) renewed the policy)
32 Customer can be refunded 100% after
Free looked period (After policy received) policy issued
33
Return of premium

34
Insurance coverage
35

37 Surrender / premium redemption (from paid premium)


38 Premium Calculation
39 Claim method (Cashless)
40 Claim method (Reimbursement)
41 Claim procedure
42 Claim document
43 Claim sent to?
44 Claim notes
45 Deactivation Reasons
46
47
48
49

51
Exclusions
52 Cancellation 14 days after the policy is received
53 Cancellation fee
54 Downgrade
55 Upgrade
56 Downgrade Procedure
57 Upgrade Procedure
58 Change of policy holder
59 Heirs
60 Change of Heir
61 Change of Heir or policy holder procedure
UoM Chubb - Extra Cashback Protection
Chubb Life
Life

Year 6
Year 55
Year 17
Year 55
Year 10
Year 5
No
No
No
YES
Tidak bisa
Rupiah
Yes
Yes
Yes
Yes
Rp Based on table
Rp 25,000,000
Rp 500,000,000
-
Refer to How to Issue SOP
Yes
Rp 0
Rp 0
2) Guaranteed
Unit 1
- Kecelakaan : Tidak ada masa tunggu
Days - Sakit : 2 tahun

Days 3 bulan

Days 30 hari
100% amount paid if the insured is still alive until the end of the
coverage period

1. In the 1st year, Sum Insured is paid 100% for die due to an
accident, and since the second year will be paid for die of any kind.
2. An additional 100% of the Sum Insured for death due to an
accident when the insured travels by Public Transportation.
Hanya berlaku di akhir tahun ke 10, polis selesai
Refer to premium table
NO
YES
Refer to SOP "How to claim"
Refer to SOP "How to claim"
Refer to SOP "How to claim"
Refer to SOP "How to claim"
1. End of coverage, namely at the end of the coverage date
2. Redemption of policy (if any)
3. The Insured dies
4. All insurance benefits have been paid
5. Premiums are not paid in the Free Period
- Bunuh diri sebelum 2 tahun
- Terorisme
- Dihukum mati oleh pengadilan
- Melakukan kegiatan berbahaya yang melanggar hukum
TBD
50,000 free look
Tidak bisa
Tidak bisa
N/A
N/A
Bisa
Bisa
Bisa
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