JAKARTA, KOMPAS.com - PT MSIG Life Insurance Indonesia Tbk (MSIG Life) mengatakan, salah satu faktor yang membuat klaim kesehatan industri asuransi meningkat adalah adanya biaya tambahan berlebih (over charging) yang dikenakan rumah sakit.
CEO dan Presiden Direktur MSIG Life Wianto Chen mengatakan, hal tersebut juga dapat terjadi karena ada manfaat asuransi yang memiliki batas limit terlampau tinggi.
Sebagai ilustrasi, sebuah produk asuransi bisa memiliki manfaat total hingga Rp 35 miliar. Sedangkan, klaim yang diberikan misalnya ada dikisaran Rp 35 juta.
"Kadang-kadang ada kecenderungan menambah sesuatu yang tidak penting, sehingga klaimnya naik, jadi over treatment," kata dia dalam konferensi pers, Selasa (6/2/2024).
Ia menambahkan, di negara maju ada yang disebut deductible atau ekses asuransi. Hal ini membuat pemegang polis harus ikut membayar sebagian jumlah klaim yang disepakati saat mengajukan klaim.
"Kalau di Indonesia, tidak, karena kompetisinya tidak ada deductible, semuanya los, jadi kamu tidak peduli di-charge berapa, asuransi yang bayar," imbuh dia.
Wianto menjelaskan, klaim yang terus-terusan tumbuh dapat berpengaruh pada peningkatan premi nasabah.
"Untuk deal dengan rumah sakit terkait dengan over treatment sudah ada pembicaraan antara asosiasi dengan Otoritas Jasa Keuangan (OJK), dan terkait juga dengan Kementerian Kesehatan," imbuh dia.
Selain itu, Wianto mengungkapkan faktor lain yang menjadi pendorong adalah adanya inflasi kesehatan di Indonesia. Pasalnya, semua biaya rumah sakit seperti obat dan perawatan naik.
Ia mencatat, peningkatan klaim asuransi kesehatan mencapai 34 persen secara tahunan. Hal tersebut terutama didorong oleh klaim asuransi kesehatan individu.
Padahal, klaim produk asuransi kumpulan atau karyawan justru turun.
Sebelumnya, riset Mercer Marsh Benefits (MMB) dalam Health Trends 2023 menyebut, Medical Trend Rate atau biaya kesehatan di Indonesia diproyeksikan meningkat hingga 13,6 persen di 2023.
Lebih lanjut, Wianto mengungkapkan ke depan industri asuransi akan menerapkan pertukaran data antara anggota Asosiasi Asuransi Jiwa Indonesia (AAJI).
Hal itu bertujuan agar setiap perusahaan dapat memitigasi risiko fraud atau kecurangan dari nasabah. Hal itu lantaran, hal ini juga berpengaruh pada peningkatan klaim asuransi kesehatan.
"Karena kita ada banyak sekali orang yang klaimnya luar biasa. Sehinga kalau ada data ini kita tahu, nasabah tersebut apakah nasabah yang layak asuransi atau tidak," terang dia.
Sebagai informasi, AAJI melaporkan klaim asuransi kesehatan mencapai Rp 15,24 triliun pada kuartal III-2023.
Angka tersebut tumbuh 32,9 persen secara tahunan dibandingkan periode yang sama tahun lalu senilai Rp 11,47 triliun.
Pada tahun sebelumnya, klaim kesehatan tumbuh 35,1 persen secara tahunan.
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Pilihan Untukmu
`); var wSpecStop = createElementFromHTML(`
Konten disembunyikan. Muat ulang halaman untuk perbarui rekomendasi.
`); reactionPopup.querySelector('.buttonShare').setAttribute('data-title', item.title); reactionPopup.querySelector('.buttonShare').setAttribute('data-url', itemUrl); reactionPopup.querySelector('.buttonShare').setAttribute('data-campaign', 'AIML_Widget_Desktop'); let userFeedback = new UserFeedback(resultObj.engine['tracker_algsrc'], itemUrl + tracker_params, jxRecHelper, index); reactionPopup.querySelector('.buttonBookmark').addEventListener('click', function() { do_bookmark(itemUrl, index, userFeedback); }); reactionPopup.querySelector('.buttonShare').addEventListener('click', function() { userFeedback.event('share'); }); reactionPopup.querySelector('.buttonNotInterest').addEventListener('click', function() { if (getCookie('kmps_usrid')) { hideThisArt(this); userFeedback.event('not-interested'); } else { const parentAction = this.parentElement.parentElement.parentElement if (!!parentAction) { let indexElement = parentAction.getAttribute('data-index') if (indexElement != 'undefined') { localStorage.setItem('reaction_not_interest_temp', JSON.stringify({ urlpage: items[indexElement].url })) } } window.location.href = "" + btoa(window.location.href); } }); /** * trigger action "userFeedback" that user not interest item before, when not interest without login */ if (getCookie('kmps_usrid') && localStorage.getItem('reaction_not_interest_temp')) { const tempUrlNotInterest = JSON.parse(localStorage.getItem('reaction_not_interest_temp')) if (itemUrl == tempUrlNotInterest.urlpage) { userFeedback.event('not-interested'); localStorage.removeItem('reaction_not_interest_temp'); } } wSpecStop.querySelector('.wSpec-stop-undo').addEventListener('click', function() { showThisArt(this); userFeedback.event('un-not-interested'); }); recItem.appendChild(buttonOption); recItem.appendChild(reactionPopup); recItem.appendChild(wSpecStop); } var recItemWrapperA = createElement('a', null, null, null); recItemWrapperA.setAttribute('href', itemUrl + tracker_params); var titleDiv = createElement('h4', null, null, [cssClasses.title]); var titleTextNode = document.createTextNode(item.title); if (item.itemType == 'video') { var iconVideo = createElement('div', null, null, ['icoInline', 'icoVideo']); iconVideo.style.marginRight = '5px'; titleDiv.appendChild(iconVideo); } titleDiv.appendChild(titleTextNode); var sourceDiv = null; if (item.hasOwnProperty('method')) { sourceDiv = createElement('div', null, null, [cssClasses.source], resultObj.engine['type'] + ' . ' + item.method.toUpperCase()); } else { var sourceDiv = createElement('div', null, null, [cssClasses.source], resultObj.engine['type']); } var textWrapper = createElement('div', null, null, [cssClasses.text_wrapper]); textWrapper.appendChild(categoryDiv); textWrapper.appendChild(titleDiv); textWrapper.appendChild(sourceDiv); recItemWrapper.appendChild(imgWrapper); recItemWrapper.appendChild(textWrapper); recItemWrapperA.appendChild(recItemWrapper); recItem.appendChild(recItemWrapperA); widgetWrapper.appendChild(recItem); // hook up the click handler for this item // recItem.onclick = handleClick.bind(null, jxRecHelper, itemUrl + tracker_params, index); recItemWrapperA.onclick = handleClick.bind(null, jxRecHelper, itemUrl + tracker_params, index); }); } // end while var endDate = new Date(); var loadtime = (endDate.getTime() - startDate.getTime()); trackEventGa('AIML Article Recommendation', 'Content Loaded', 'algsrc='+algsrc+',site=MONEY,device=desktop,loadtime=' + loadtime) let domain = window.location.hostname; if(domain=='){ var url=window.location.href.split("/"); domain=url[2]+'/'+url[3] } let user_subs_type = "Gues"; let subs_type = ""; let is_lgn = 0; let engine = algsrc; if(getCookie('kmps_usrid')){is_lgn=1}; let time_load = loadtime; resolve(); /*** * JXRECSDK NOTES 3 of 5 - * pass all the info about the items to the rec helper * each one is an object: ALL MANDATORY * div * id * pos */ jxRecHelper.items(widgetItemArr); /*** * JXRECSDK NOTES 4 of 5 - * Call the ready() of the helper object when the recommendation * results have been populated to the widget * (This will register the action=ready event) */ if (resultObj.engine['type'] == 'api-1') { jxRecHelper.ready(resultObj.options.algo + ":" + resultObj.options.version); } else { jxRecHelper.ready(resultObj.engine['type']); } } else { jxRecHelper.error(204); console.error("Error: no recommendation items"); return; } } catch (err) { jxRecHelper.error(901); console.log(err.stack); let domain = window.location.hostname; if(domain=='){ var url=window.location.href.split("/"); domain=url[2]+'/'+url[3] } let user_subs_type = "Gues"; let subs_type = "" let is_lgn = 0; let engine = algsrc; if(getCookie('kmps_usrid')){is_lgn=1}; let endDate = new Date(); let time_load = (endDate.getTime() - startDate.getTime()); } }); } const _jxRecSdkURL = ' var startDate = new Date(); class OneWidget { constructor() { //this is also the one we will pass to the JX rec helper object when //we instantiate it: //In this implementation most of these come from the options obj //on the publisher page. this._options = { accountid: '9262bf2590d558736cac4fff7978fcb1', pageurl: ' widget_id: '1000183-6xWeiWZFIM', type: 'pages', container: 'rekomendasi-konten-pilihan-untukmu-aiml', keywords: content_tags, title: title, customid: "26", count: 14, }; this._containerId = this._options.container; this._container = document.getElementById(this._containerId); this._engines = [{"url":"https:\/\/recommendation.kgdata.dev\/rec\/kompascom\/api\/v2\/recommendation\/item","method":"POST","pageurl":"https:\/\/money.kompas.com\/read\/2024\/02\/06\/184326026\/over-treatment-rumah-sakit-jadi-sorotan-tajam-perusahaan-asuransi","system":"kg","type":"api-2","tracker_params":"?source=widgetML&engine=C","tracker_algsrc":"C","count":14,"page_status":"read","excludeitemids":["20240206184326026"],"multiFormat":true}]; } kickOff() { startDate = new Date(); const rand = Math.floor(Math.random() * 1000); /*const randSystem = Math.floor(Math.random() * 3); this._engine = this._engines[randSystem] if (location.hostname.indexOf('lestari') != -1) { this._engine = this._engines[1] }*/ this._engine = this._engines[0]; this._options.system = this._engine['system'] trackEventGa('AIML Article Recommendation', 'Widget load', 'algsrc=' + this._engine['tracker_algsrc'] + ',site=MONEY,device=desktop') let promJXSDK = fetchJSFileP(_jxRecSdkURL); let thisObj = this; // first we wait on the JX REC SDK to be loaded and initialized let recHelperObj = null; let recResults = null; promJXSDK .then(function() { /*** * JXRECSDK NOTES 1 of 5 - INSTANTIATION OF A JX REC HELPER OBJECT * Call this AFTER JX REC SDK is loaded but BEFORE you call your REC * backend. * * param: MANDATORY options object * options object must at a minimal have * accountid: get from jixie * widgetid: get from jixie * container: DIV ID of the destination div to house the widget * (for jixie widget this is just the options object passed from the page) * * (This will also register the action=load event) */ recHelperObj = jxRecMgr.createJxRecHelper(thisObj._options); let basicInfo = thisObj._options; basicInfo.engine = thisObj._engine if (basicInfo.engine.type == 'api-1') { var options = { count: basicInfo['count'], adpositions: "", keywords: basicInfo['keywords'], title: basicInfo['title'], date_published: "2024-02-06", pagecategory: "MONEY", algo: "mixed" }; if(getCookie('kmps_usrid')){ var kg = { pagetype:basicInfo.engine.page_status, uid:getCookie('kmps_usrid'), ukid:getCookie('kmp_uid') } if(basicInfo.engine.page_status=='read'){ kg['excludeitemids'] = basicInfo.engine.excludeitemids; kg['multiFormat'] = true; } options['additional'] = { kg:kg }; } return recHelperObj.getJxRecommendations(options); } else { return fetchRecommendationsP(basicInfo, recHelperObj.getJxUserInfo()); } }) .then(function(resp) { if (thisObj._engine.type == 'api-3') { recResults = new Object recResults.items = resp.docs.result; } else { recResults = resp; } recResults.engine = thisObj._engine; if (!resp || !recResults.items || recResults.items.length == 0) { /*** * JXRECSDK NOTES 2 of 5 - * Call the error() function on the recHelper when either an error * has occured in the fetching or there are no recommended items * * (This will register the action=error event) */ recHelperObj.error(204); throw "no recommendation results"; } }) .then(function() { // everything is ready (recommendation results, css): document.getElementById("rekomendasi-konten-pilihan-untukmu-aiml").classList.remove("-loading"); document.querySelector('.wSpec-list').remove(); createDisplay(rand, thisObj._container, recResults, recHelperObj) .then(function() { toggleDropdown(); //observe lozad lozad('.lozad', { load: function(el) { el.src = el.dataset.src; el.onload = function() { el.classList.add('fade') } } }).observe() }) }) .catch(function(error) { console.log(`Unable to create recommendations widget ${error.stack} ${error.message}`); }); } } var limit_gtm_ready = 1; function check_gtm_ready() { if ('ga' in window) { // create a new instance of our widget based on the options const newW = new OneWidget(); newW.kickOff(); } else { const timeout_gtm_ready = setTimeout(check_gtm_ready, 500) limit_gtm_ready += 1; if (limit_gtm_ready > 10) { clearTimeout(timeout_gtm_ready); const newW = new OneWidget(); newW.kickOff(); } } } check_gtm_ready() document.querySelector('.wSpec-secret').addEventListener('click', function(e) { e.preventDefault(); let wSl = document.querySelectorAll('.wSpec-source'); if (wSl.length > 0) { for (let i = 0; i < wSl.length; i++) { wSl[i].classList.toggle('show') } } }) function trackEventGa(category, action, label) { if ("ga" in window) { ga(function() { tracker = ga.getAll()[0]; if (tracker) { tracker.send("event", category, action, label); console.log('track event ', category, action, label) } }) } } function formBody(obj) { let formBody = []; for (var property in obj) { let encodedKey = encodeURIComponent(property); let encodedValue = encodeURIComponent(obj[property]); formBody.push(encodedKey + "=" + encodedValue); } return formBody.join("&"); } function getCookie(name) { var name = name + '='; var cookies = decodeURIComponent(document.cookie).split(';'); for (var i = 0; i < cookies.length; i++) { var c = cookies[i]; while (c.charAt(0) == ' ') { c = c.substring(1); } if (c.indexOf(name) == 0) { return c.substring(name.length, c.length); } } } function get_guid(url) { const videoPath = url.match(/\/watch\/(\d+)/); if (videoPath) { return `video.${videoPath[1]}`; } let arrayUrl = url.split('/'); let readPath = arrayUrl.indexOf('read'); if (arrayUrl[readPath + 1] == 'xml') { readPath += 1; } let year = arrayUrl[readPath + 1]; let month = arrayUrl[readPath + 2]; let date = arrayUrl[readPath + 3]; let id = arrayUrl[readPath + 4]; let guid = `.xml.${year}.${month}.${date}.${id}`; return guid; } function toggleDropdown() { let tdd = document.querySelectorAll('[data-dropdown]') if (!!tdd) { tdd.forEach((el) => { el.addEventListener('click', function() { el.parentElement.classList.toggle('-active') let saved = el.parentElement.getAttribute('data-saved') let kmps_usrid = getCookie('kmps_usrid'); if (kmps_usrid && !saved && el.parentElement.classList.contains('-active')) { let url = el.parentElement.getAttribute('data-url'); let guid = get_guid(url); check_bookmark( kmps_usrid, guid ).then(function(resp) { if (resp.hasOwnProperty('total_data')) { if (resp.total_data > 0) { el.parentElement.querySelector('.buttonBookmark').classList.add('-active'); el.parentElement.querySelector('.buttonBookmark').innerHTML = 'Hapus dari tersimpan'; el.parentElement.setAttribute('data-saved', 'true'); } else { el.parentElement.setAttribute('data-saved', 'false'); } } }) } }) document.addEventListener("click", function(e) { // console.log(e.target) if (el.contains(e.target)) { // console.log(tdd) } else { el.parentElement.classList.remove('-active') } }); }); } } function check_bookmark(kmps_usrid, guid) { let url = ` return new Promise(function(resolve, reject) { var xmlhttp = new XMLHttpRequest(); xmlhttp.onreadystatechange = function() { if (this.readyState == 4 && this.status == 200) { resolve(JSON.parse(this.responseText)) } }; xmlhttp.open("GET", url, true); xmlhttp.send(); }); } function do_bookmark(pageurl, pos, userFeedback) { const wSpecItem = document.querySelector(`.wSpec-item[data-index="${pos}"]`); const btnBookmark = wSpecItem.querySelector('.buttonBookmark'); const kmps_usrid = getCookie('kmps_usrid'); const guid = get_guid(pageurl); const type = pageurl.match(/\/watch\/(\d+)/) ? 'video' : 'article'; if (kmps_usrid) { if (btnBookmark.classList.contains('-active')) { set_unbookmark({ guid: guid, kmps_usrid: kmps_usrid, type: type }).then(function(resp) { btnBookmark.classList.remove('-active'); btnBookmark.innerHTML = 'Simpan artikel'; reactionToast('Artikel berhasil dihapus dari list yang disimpan'); userFeedback.event('un-save'); }).catch(function(resp) { // message: "Data doesn't exists" if (resp.hasOwnProperty('message') && resp.message.includes('exist')) { btnBookmark.classList.remove('-active'); btnBookmark.innerHTML = 'Simpan artikel'; reactionToast('Artikel berhasil dihapus dari list yang disimpan'); } }) } else { const user_bookmark_url = ""; set_bookmark({ guid: guid, kmps_usrid: kmps_usrid, type: type, publisher: 'kompas', platform: 'desktop' }).then(function(resp) { btnBookmark.classList.add('-active'); btnBookmark.innerHTML = 'Hapus dari tersimpan'; reactionToast('Artikel berhasil disimpan', user_bookmark_url); userFeedback.event('save'); }).catch(function(resp) { // message: "Data already exist" if (resp.hasOwnProperty('message') && resp.message.includes('exist')) { btnBookmark.classList.add('-active'); btnBookmark.innerHTML = 'Hapus dari tersimpan'; reactionToast('Artikel berhasil disimpan', user_bookmark_url); } }) } } else { const login_url = "" + btoa(window.location.href); window.location.href = login_url; } } function set_bookmark(data) { const url = ""; return new Promise(function(resolve, reject) { const xmlhttp = new XMLHttpRequest(); xmlhttp.onreadystatechange = function() { if (this.readyState == 4 && this.status == 201) { resolve(JSON.parse(this.responseText)); } else if (this.readyState == 4 && this.status == 400) { reject(JSON.parse(this.responseText)); } }; xmlhttp.open("POST", url, true); xmlhttp.setRequestHeader("Content-Type", "application/x-www-form-urlencoded;charset=UTF-8"); xmlhttp.send(formBody(data)); }); } function set_unbookmark(data) { const url = ""; return new Promise(function(resolve, reject) { const xmlhttp = new XMLHttpRequest(); xmlhttp.onreadystatechange = function() { if (this.readyState == 4 && this.status == 200) { resolve(JSON.parse(this.responseText)); } else if (this.readyState == 4 && this.status == 400) { reject(JSON.parse(this.responseText)); } }; xmlhttp.open("POST", url, true); xmlhttp.setRequestHeader("Content-Type", "application/x-www-form-urlencoded;charset=UTF-8"); xmlhttp.send(formBody(data)); }); } class UserFeedback { constructor(engine, pageurl, jxRecHelper, pos) { this.engine = engine; this.pageurl = pageurl; this.jxRecHelper = jxRecHelper; this.pos = pos; } event(feedback) { if (this.engine == 'C') { const xmlhttp = new XMLHttpRequest(); let params = { domain: 'kompas.com', ce_userid: getCookie('kmps_usrid'), ce_sessionid: getCookie('ukid'), ce_pageurl: this.pageurl, engine: 'C', ce_feedback: feedback } xmlhttp.open("GET", ' + formatParams(params)); xmlhttp.send(); } else if (this.engine == 'V') { if (feedback == 'share') { this.jxRecHelper.shared(this.pos); } else if (feedback == 'save') { this.jxRecHelper.bookmarked(this.pos); } else if (feedback == 'not-interested') { this.jxRecHelper.hidden(this.pos); } else if (feedback == 'un-not-interested') { this.jxRecHelper.unhidden(this.pos); } } } } function formatParams(params) { return "?" + Object .keys(params) .map(function(key) { return key + "=" + encodeURIComponent(params[key]) }) .join("&") } document.addEventListener("click", function(e){ let dx = document.querySelectorAll('[data-dropdown]') if(dx) { dx.forEach(function(el){ if(el.contains(e.target)) { el.parentElement.classList.toggle('-active') } else { el.parentElement.classList.remove('-active') } }) } })
