Most people think that making an insurance claim can be very complicated. Does this happen at PT Tokio Marine Life Insurance Indonesia?

Insurance is a contract which sets out the rights and obligations of Policyholder and Insurer. Insured is entitled to make a claim and follows through claim procedures as stipulated by Insurer. As long as all claim requirements have been fulfilled and information provided on claim form are accurate and true, we will assess the claim within the timeframe as set out in the Policy. 

Why do I have to pay Premium in time?

For your policy benefit continuation,  you should make Premium payment before the Grace Period. Failure to make Premium payment in time will make your Policy being lapsed unless your policy is a cash value policy or Unit-Linked Policy.

In the case of cash value Policy , if the cash value greater than the unpaid Premium, your Policy status will change to Automatic Policy Loan (APL) and the coverage continues. APL will charge interest at a rate to be determined by PT Tokio Marine Life Insurance Indonesia. 

In the case of Unit-Linked Policy, as long as your investment value is sufficient to Cost of Insurance and monthly administration fee, your Policy remains inforce and coverage will continue. Failure to make payment will reduce the investment value accordingly.  

Why have I not received notification letter nor informed about my Premium payment due date?

We send Premium Due Date Notification Letter 1 (one) month prior to due date as well information through short message service (SMS). If you have changed your current address or mobile phone number, please contact us for data update.  

I have paid my premium to my insurance agent but PT Tokio Marine Life Insurance Indonesia has never received any payment. 

We thank you for your Premium payment. As stated in Policy terms, all Premium payments must be made to PT Tokio Marine Life Insurance Indonesia and will be deemed paid on the date of receipt and recorded in our account in amount set out in the Policy. To avoid any unwanted occurrence, please make direct payment to PT Tokio Marine Life Insurance Indonesia bank account.

My policy is lapsed due to the late payment. How do I recover my policy?

Lapsed Policy can be reinstated no later than 2 (two) years from the lapsed Policy date, by completing the provided form. Unpaid Premium during policy lapse must be settled. Provisions regarding reinstatement Policy depend on each product, some products may not be reactivated when it lapsed. 

How do I purchase a life insurance product?

Our marketing consultant will reach you and explain which product that meets your needs. After that you need to complete the Life Insurance Application Form (SPAJ) containing your personal information, medical history, and other information. Based on the information provided in the SPAJ, underwriting process will begin. Once your insurance application is approved, we will issue the Policy. Please make sure you provided all information required on SPAJ completely and accurately as they are parts of the Policy.

I lost my policy document, can I get the new one?

We issue the Policy only once, however, we can issue a duplicate. To get a duplicate Policy please follow the following instructions:

1. Enclose the Report of Lost Policy from the Police as reported by Policyholder.
2. Policyholder shall complete and sign Report of Lost Policy Form and Duplicate Policy Application Form over IDR10.000 stamp duty.
3. Enclose a photocopy of Policyholder’s Identity Card (KTP/SIM/Passport).
4. Pay administrative cost (if any).

What should I do if I change my address? 

If you change address please inform us in writing by filling in Policy Minor Alteration Application Form. Please contact our Customer Service to get this form.

How to make a death claim?

In the case of Individual Insurance Business, the following requirements apply to Death Claim:

1. Complete Death Claim provided by PT Tokio Marine Life Insurance Indonesia.
2. Original Policy.
3. Enclose a photocopy of Beneficiary’s valid ID Card.
4. Enclose a photocopy of document certifying the relationship of Beneficiary with the Insured such as Family Card or Birth Certificate.
5. Statement Letter of Beneficiary or letter of authorization of Beneficiary if more than one Beneficiaries area authorized by competent authority.
6. Certified version of Death Certificate from competent authority.
7. Medical resume completed by the latest doctor in charge (if the Insured passed away at Hospital or Clinic/Medical Center).
8. A death certificate from competent authorities and legalized at least by consulate general of the Republic of Indonesia if the Insured passed away abroad.
9. Statement from competent authority stating that the Insured passed away if the insured missed in a disaster.
10. PT Tokio Marine Life Insurance Indonesia reserves the right to request other information and/or document and/or evidence deemed necessary to process the claim.
11. Death Claim documents above must be submitted within 90 (ninety) days of the Insured’s death.

What should I do if I change my Beneficiary? 

The following requirements apply for change of Beneficiary:

1. Complete the Policy Minor Alteration Application Form.
2. Enclose a photocopy of valid ID card of Policyholder (KTP/SIM/Passport).
3. Enclose family card/birth certificate/marriage certificate/other documents stating relationship between the Insured and prospective Beneficiary.
4. Pay administrative cost (if any).

I have never received billing statement so I do not have to pay any accrued interest if APL occurs.

As stated in Policy terms, either sending Premium billing statement to your billing address or other manner of delivery as chosen by Policyholder will not release your obligation to pay Premium fully. Costs incurred related to preferred payment methods shall be paid by policyholder. We apologize for this inconvenience but we cannot exempt you from paying the interest.  

Can I apply for a Policy loan?

Policy loan is available for cash value Policy (non unit-linked). As long as the Policy is still active (inforce) and there are no unpaid Premiums, Policy Loan can be granted based on the terms and conditions of the Policy. The maximum amount of loan is 80% (eighty percent) of Cash Value, and loan interest is to be determined by PT Tokio Marine Life Insurance Indonesia.

What is unit-linked product?

Unit-linked insurance offers two benefits, namely, protection and investment benefits. Your Premium payment will be allocated partly to pay for your protection and partly to investment instrument in the form of unitlinked.

Policyholder reserves the right to allocate investment funds provided by Insurer. There is no guarantee as to investment performance which depends on respective risks and investment condition.  

Who will assess and determine unit price? 

Custodian Bank will assess and determine the unit price because Custodian Bank is responsible for investment administration.  

What is custodian bank?

Custodian Bank is an entity that provides custodian services of Securities and other assets relating to Securities and other services including receiving dividends, interest, and other entitlement, settle securities transactions, and representing account holders who become its customers.  

What should I do if I want to increase my investment balance (top-up)? 

The following Requirements apply to Investment Top Up:

1. Unit Link Transaction Application Form
2. Enclose a photocopy of Policyholder’s valid ID Card (KTP / SIM / Passport)
3. Minimum Top Up amount is IDR1.000.000.  

What are the procedures if I want to withdraw a sum of fund from my investment balance?

The following requirements apply to Withdrawal:

1. Complete Unit Link Transaction Application Form
2. Enclose a photocopy of Policyholder’s valid ID Card (KTP / SIM / Passport)
3. Minimum withdrawal is IDR1.000.000.
4. Minimum funds remaining for each type of investment is RP 2.000.000.

What are the procedures if I want to switch the fund to other investment type?

The following requirements apply to Fund Transfer (Switching):

1. Complete Unit Link Transaction Application Form
2. Enclose a photocopy of Policyholder’s valid ID Card (KTP / SIM / Passport)
3. Minimum fund switched is IDR1.000.000.
4. No transfer fee is charged for 2 fund transfers made in one year. Thereafter, a transfer fee amounting to IDR100.000 will be charged

Will I receive investment report regularly?

Investment Report will be sent on each policy anniversary (annually), however, you can ask Investment Report at any time by contacting our Customer Service.

What are the procedures for making inpatient claim (Reimbursement)? 

In the case of Individual Insurance Business, follow the following processes in order to make a claim for Inpatient and Surgery (Reimbursement) :

1. Complete the Inpatient and Surgery Claim Form as provided by PT Tokio Marine Life Insurance Indonesia.
2. Enclose the original receipt of Hospital bill and/or Operation bill including payment items in details. The original receipt must be signed by authorized officer of relevant Hospital and stamped by the Hospital. In case of inpatient care is performed abroad, please enclose tax invoice.
3. Enclose the results of supplementary examination and details of medications during hospitalization.
4. Enclose document detailing actions taken during hospitalized.
5. Enclose Attending Physician's Statement, Medical Resume from treating physician during hospitalization.
6. In the case of inpatient care is performed abroad, please enclose Medical Record issued by relevant Hospital.
7. PT Tokio Marine Life Insurance Indonesia reserves the right to request any other information and/or document and/or evidences deemed necessary to process the claim. 
8. All claim documents must be submitted to PT Tokio Marine Life Insurance Indonesia not later than 30 (thirty) days of discharge date.

How do I make a Claim?

1. Policy Holder / Beneficiary fill out respective Claim Form and enclosing the supporting documents.

2. Tokio Marine Life Claim Form and supporting documents for each type of claim can is avaliable in the Claim Form menu.

3. The claim documents can be submitted to Tokio Marine Life Head Office or Sales Office.

4. The claim will be processed if the claim form and all supporting documents completely received by Tokio Marine Life.

How is the procedure of Hospitalized at  Domestic Hospital Provider 

1. The insured comes to the Hospital and shows an insurance card.

2. The Hospital confirmed to the Third Party Administration (TPA) which appointed by TMLI, namely Across Asia Assist (AAA). 

3. The doctor who performs the examination fill out completely the health data form and send it to TPA.

4. If the initial diagnosis meets the provisions of the Policy, then  AAA issues an initial Guarantee Letter. 

5. AAA will do monitoring during Hospitalization.

6. The hospital send final Diagnosis and billing to AAA when the hospitalization is finish. 

7. AAA will verify the final diagnosis.

8. If the final diagnosis meets the provisions of the Policy, then  AAA issues a Final Guarantee Letter. 

9. AAA will provide final guarantee calculations to the hospital.

10. If all fees are included in the insurance guarantee, then no excess are paid by the Insured.

How is the procedure of Hospitalized at  Overseas Hospital Provider 

1. The Policyholder must do pre-authorizition of planning for the hospitalization to AAA at least 3 (three) days prior the departure.

2. Documents required for pre-authorization are photocopies of ID cards, passports, doctor's appointment and medical data.

3. AAA will verify the submitted health data.

4. If the initial Diagnosis meets the provisions of the Policy, then  AAA issues an Initial Guarantee Letter.

5. AAA will coordinate with the Hospital Provider.

6. The insured comes to the Hospital and shows the Initial Guarantee Letter and pays the deposit.

7. AAA will do monitoring during Hospitalization. 

8. The hospital send final Diagnosis and Billing to AAA when the hospitalization is finish.

9. AAA will verify the final diagnosis.

10. If the final diagnosis meets the provisions of the Policy, then AAA issues a Final Guarantee Letter. 

11. AAA will provide final guarantee calculations to the Hospital.

12. If all fees are included in the insurance guarantee, then no excess are paid by the Insured.

What is Medisclick and how do I access it?

Medisclick is an application provided by Asia Across Assist (AAA) to facilitate the Insured in hospitalization process. 

The benefits of Medisclick are: 

1. To get information the nearest  Hospital Provider.

2. To do admission in the Hospital Provider.

3. Easy access in communication with AAA.

4. To monitor hospitalization guarantee status.

5. Information of Insurance Benefits.

The Medisclick application is available in Android and iphone (iOS) version that can be downloaded on the Google Play Store or Apple App Store. 

Medisclick application ussage click here.