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Ketentuan Umum Professional Group Health

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Ketentuan Umum Professional Group Health KETENTUAN UMUM PROFESSIONAL GROUP HEALTH PASAL 1 DEFINISI Definisi yang digunakan dalam Polis ini harus diartikan sebagaimana uraian berikut ini: 1. Addendum adalah Ketentuan yang menambah dan mengubah ketentuan yang tercantum dalam Polis dan merupakan bagian yang tidak terpisahkan dari Polis. 2. Anggota adalah Seseorang yang memiliki hubungan kerja dan/atau formal dengan Pemegang Polis. 3. Beban Sendiri adalah Selisih atau kelebihan pembayaran yang dibayarkan BRI LIFEkepada rumah sakit, klinik, apotek, optik atau pihak ketiga dengan jumlah yang seharusnya menjadi kewajiban Pemegang Polis dan Peserta sesuai dengan ketentuan Polis ini. 4. Biaya-biaya adalah Biaya-biaya yang dibebankan kepada Pemegang Polis yang berhubungan dengan Polis dan perubahannya. 5. BRI Life adalah PT. Asuransi Jiwa BRI Life yang bertindak sebagai penangung. 6. Daftar Peserta adalah Daftar Peserta diterbitkan oleh BRI LIFE yang berisikan nomor Peserta, nama, jenis kelamin, tanggal lahir, manfaat asuransi dan informasi lainnya (jika ada). 7. Data Polis adalah Suatu dokumen yang merupakan satu kesatuan yang tidak dapat dipisahkan dari Polis yang memuat data dan informasi umum mengenai Pemegang Polis dan pertanggungannya. 8. Ekstra Premi adalah Premi untuk Peserta dengan tingkat risiko lebih tinggi dan/atau riwayat kesehatan di bawah standar. 9. Endorsement adalah Dokumen yang berisikan catatan perubahan data Peserta yang disetujui dan ditandatangani oleh pejabat BRI Life yang berwenang dan merupakan bagian yang tidak terpisahkan dari Polis. 10. Ketentuan Umum adalah Ketentuan yang menjelaskan mengenai Asuransi Kumpulan secara umum dan merupakan bagian yang tidak terpisahkan dari Polis. 11. Ketentuan Khusus adalah Ketentuan yang menjelaskan mengenai program Asuransi Kumpulan yang diperjanjikan dan merupakan bagian yang tidak terpisahkan dari Polis. 12. Manfaat Asuransi adalah Sejumlah uang yang dibayarkan oleh BRI LIFE kepada Pemegang Polis sesuai dengan perjanjian setelah semua syarat-syarat untuk menerima pembayaran dipenuhi. 13. Masa Asuransi adalah Masa berlakunya Polis Asuransi Kumpulan. V01.09.19 Ketentuan Umum Polis Professional Group Health 1 14. Program Asuransi adalah Bentuk dan tingkatan manfaat Asuransi yang diperjanjikan. 15. Pemegang Polis adalah Perusahaan, organisasi, atau badan hukum yang mengadakan perjanjian Asuransi Kumpulan dengan BRI Life. 16. Peserta adalah Anggota dan/atau Tanggungan yang memenuhi syarat untuk dipertanggungkan yang telah didaftarkan oleh Pemegang Polis dan disetujui oleh BRI Life. 17. Peserta Tambah adalah Peserta yang kepesertaannya dimulai setelah Polis berlaku. 18. Polis adalah Surat Perjanjian beserta dokumen dan/atau perubahannya yang memuat perjanjian Asuransi Kumpulan antara Pemegang Polis dan BRI Life sebagai Penanggung. 19. Premi adalah Sejumlah uang yang ditetapkan oleh BRI LIFE, tercantum dalam Polis dan disetujui oleh Pemegang Polis, untuk dibayarkan kepada BRI LIFE sesuai yang diperjanjikan. 20. Pengembalian Premi adalah sejumlah uang yang dikembalikan oleh BRI Life kepada Pemegang Polis dikarenakan peserta keluar dalam masa asuransi, dengan cara perhitungan yang telah ditentukan. 21. Premi Tambahan adalah Premi yang berkaitan dengan Peserta Tambah. 22. Provider adalah Institusi atau Lembaga yang berupa Rumah Sakit, Rumah Bersalin, Klinik, Praktek Dokter, Apotek atau Laboratorium yang memiliki izin resmi untuk melakukan pelayanan kesehatan atau pengobatan yang memiliki kerjasama dengan BRI LIFE atau dengan TPA yang ditunjuk BRI LIFE. 23. Surat Permohonan Asuransi Kumpulan (SPAK) adalah Formulir pengajuan tertulis dari Calon Pemegang Polis sebagai dasar perjanjian Polis. 24. Tanggungan adalah Anggota keluarga inti yang sah secara hukum. 25. Tabel Manfaat adalah Lampiran penjelasan manfaat Asuransi dan penggolongan kelas yang merupakan suatu bagian yang tidak terpisahkan dari Polis ini. 26. Tanggal Efektif adalah Tanggal mulai berlakunya Polis yang tercantum dalam Data Polis atau Addendum jika telah dilakukan perubahan. 27. Tanggal Berakhir adalah Tanggal berakhirnya Polis yang tercantum dalam Data Polis atau Addendum jika telah dilakukan perubahan. 28. Tenggang Waktu adalah Masa dimana Pemegang Polis memiliki kesempatan untuk melunasi kewajiban premi serta tidak mempunyai hak untuk mengajukan klaim. V01.09.19 Ketentuan Umum Polis Professional Group Health 2 PASAL 2 DASAR PERTANGGUNGAN (1) Semua keterangan, pernyataan serta penjelasan dalam SPAK, pembayaran premi, serta data dan/atau keterangan lain yang diberikan secara tertulis oleh calon Pemegang Polis, merupakan dasar diterbitkannya Polis ini. (2) Apabila kemudian ternyata bahwa pernyataan, keterangan, atau penjelasan yang dimaksud dalam Ayat (1) Pasal ini tidak benar atau kurang lengkap dan mempengaruhi risiko yang ditanggung, sedangkan Polis sudah berlaku, BRI LIFE berhak sepenuhnya membatalkan perjanjian ini. (3) Dalam hal kesalahan yang dimaksud Ayat (2) Pasal ini ternyata dibuat dengan tidak sengaja dan menurut pertimbangan BRI LIFE tidak mempengaruhi risiko yang ditanggung, perjanjian ini dapat berlaku terus setelah dilakukan penyesuaian dengan keadaan yang sebenarnya. (4) Apabila ternyata terjadi kesalahan pengolahan data yang diberikan Pemegang Polis dan/atau kesalahan pengolahan data oleh BRI LIFE maka diperlukan suatu penyesuaian tanpa membatalkan Polis ini. Penyesuaian yang mengakibatkan kelebihan/kekurangan Polis akan diberlakukan sebagaimana berikut ini: a. Jika ada kelebihan Premi maka BRI LIFE berkewajiban mengembalikan kelebihan Premi tanpa bunga; b. Jika ada kekurangan Premi maka Pemegang Polis berkewajiban membayar kekurangan Premi tanpa bunga. (5) Syarat-syarat dalam Polis ini tidak dapat dibatalkan, diubah ataupun diganti oleh siapapun, kecuali diminta secara tertulis oleh Pemegang Polis dan disetujui oleh BRI LIFE dan telah tercatat dalam Addendum atau Endorsement. (6) Polis ini disusun dan dicetak dalam Bahasa Indonesia yang merupakan bahasa kontrak, meskipun mungkin didapatkan terjemahan dalam bahasa lainnya. PASAL 3 MASA ASURANSI (1) Polis ini mulai berlaku sejak tanggal efektif pukul 00.00 waktu standar Indonesia di alamat Kantor Pusat BRI LIFE dan Premi telah lunas. (2) Polis ini dinyatakan habis masa berlakunya sampai dengan tanggal berakhir, pukul 00.00 waktu standar Indonesia di alamat Kantor Pusat BRI LIFE dan apabila tidak dinyatakan oleh BRI LIFE untuk diperpanjang. V01.09.19 Ketentuan Umum Polis Professional Group Health 3 PASAL 4 PERPANJANGAN POLIS (1) Sebelum jatuh tempo perpanjangan Polis : a. Pemegang Polis dan BRI LIFE mempunyai hak untuk tidak memperpanjang Polis; b. Pemegang Polis dapat mengajukan perubahan Manfaat Asuransi. Perubahan manfaat dapat dilakukan apabila BRI LIFE menyetujuinya; c. BRI LIFE berhak menentukan Premi perpanjangan Polis; d. Setiap perubahan ketentuan-ketentuan dalam Polis yang ditetapkan oleh BRI LIFE akan diberlakukan pada saat perpanjangan Polis. (2) Polis dapat diperpanjang untuk periode berikutnya atas persetujuan BRI LIFE dan baru berlaku efektif apabila Premi perpanjangan telah dibayar lunas. (3) Perhitungan Premi perpanjangan akan ditentukan berdasarkan jumlah Peserta, distribusi Peserta, usia Peserta, riwayat klaim, tingkat inflasi dan kondisi Peserta terakhir. (4) BRI LIFE berhak menentukan dan menawarkan besaran ekstra premi untuk peserta dengan tingkat risiko lebih tinggi dan/atau riwayat kesehatan di bawah standar. (5) Apabila masa berlaku Polis disetujui untuk diperpanjang maka BRI LIFE akan menerbitkan Addendum yang mengatur perpanjangan Polis. PASAL 5 KEPESERTAAN (1) Peserta yang dapat diikutsertakan pada awal tanggal efektif Polis adalah: a. Peserta memiliki hubungan kerja dan/atau formal dengan pemegang polis; b. Peserta yang telah memenuhi syarat untuk dipertanggungkan, sesuai dengan ketentuan yang tercantum dalam Ketentuan Khusus untuk setiap Program Asuransi; c. Peserta yang tidak dalam keadaan sakit dan sedang dirawat di rumah sakit; d. Telah didaftarkan secara tertulis oleh Pemegang Polis. (2) Peserta Tambah wajib didaftarkan secara tertulis oleh Pemegang Polis kepada BRI LIFE serta memenuhi ketentuan Ayat (1) butir a, b dan c Pasal ini dan berlaku sejak tanggal didaftarkan. (3) BRI LIFE dapat menerima Peserta Tambah pada masa pertanggungan berjalan dengan ketentuan premi peserta tambah dibayarkan secara proporsional dengan manfaat sesuai yang tercantum dalam Tabel Manfaat. (4) Usia Peserta saat perpanjangan Polis tidak melebihi usia yang diatur dalam Ketentuan Khusus setiap Program Asuransi yang diambil. (5) Apabila Peserta dalam keadaan sakit dan sedang dirawat di rumah sakit maka berlakunya pertanggungan adalah tanggal di mana Peserta telah pulang dari perawatan di rumah sakit dan dinyatakan sembuh dari penyakit yang dideritanya. V01.09.19 Ketentuan Umum Polis Professional Group Health 4 PASAL 6 BERAKHIR DAN BATALNYA PERTANGGUNGAN Berakhirnya Polis (1) Pertanggungan Polis berakhir apabila: a. Masa berlaku Polis berakhir; atau b. Polis tidak memenuhi syarat minimum Peserta dan/atau Premi sesuai dengan yang telah ditetapkan BRI LIFE untuk masing-masing jenis pertanggungan. Ketentuan jumlah minimum Peserta akan diatur dalam Ketentuan Khusus atau Addendum. Pembatalan Polis (2) Pertanggungan Polis dinyatakan batal dalam hal-hal sebagai berikut: a. Pembatalan oleh Pemegang Polis: i. Polis ini dapat dibatalkan oleh Pemegang Polis dengan memberitahukan secara tertulis kepada BRI LIFE dalam waktu 30 (tiga puluh) hari kalender sebelum tanggal pembatalan; ii. Setelah BRI LIFE dan Pemegang Polis sepakat atas pembatalan tersebut, Pemegang Polis berhak memperoleh pengembalian
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