The Insurance Release Form is a critical document in Indonesian insurance practice, used when finalizing insurance claim settlements. It serves as a formal conclusion to the claims process, protecting both the insurer and insured parties under Indonesian law. The document must comply with Law No. 40 of 2014 on Insurance and relevant OJK regulations, including specific consumer protection requirements and disclosure obligations. This form is typically used after a claim has been settled and both parties have agreed to terms, documenting the release of the insurance company from future liabilities related to the specific claim while ensuring all mandatory legal protections for the insured party are maintained. The document includes essential details about the claim, settlement amount, and specific terms of the release, all structured to meet Indonesian legal requirements and industry standards.
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1. Parties: Identification of all parties involved - the insurer, insured, and any other relevant parties such as beneficiaries or claimants
2. Background: Context of the insurance claim, including policy details, incident description, and claim reference numbers
3. Definitions: Key terms used in the release form, ensuring clarity and preventing misinterpretation
4. Release Statement: Clear statement of the release being given, including the scope of claims being released
5. Settlement Amount: Details of any payment or consideration being provided in exchange for the release
6. Acknowledgment: Confirmation that the releasing party understands the implications of signing the release
7. Representations and Warranties: Statements confirming the authority to sign and the binding nature of the release
8. Governing Law: Explicit statement that Indonesian law governs the release
9. Execution: Signature blocks and formal execution requirements
1. Partial Release Provisions: Used when only certain claims are being released while others are reserved
2. Multiple Beneficiaries: Required when the release involves multiple beneficiaries or claimants
3. Translation Declaration: Required when the release form is provided in multiple languages
4. Witness Statement: Optional additional verification of signature, recommended for high-value claims
5. Medical Information Release: Required when the claim involves medical records or health information
6. Future Claims Waiver: Optional section explicitly waiving future claims related to the same incident
1. Schedule A - Claim Details: Detailed description of the claim(s) being released, including dates, policy numbers, and incident details
2. Schedule B - Settlement Calculation: Breakdown of how the settlement amount was calculated, if applicable
3. Schedule C - Related Documents: List of all relevant documents such as policy documents, claim forms, and supporting evidence
4. Appendix 1 - OJK Required Disclosures: Standard disclosures required by Indonesian Financial Services Authority
5. Appendix 2 - Supporting Documentation: Copies of relevant supporting documents such as medical reports or damage assessments
Relevant legal definitions
Clauses
Relevant Industries
Insurance
Banking & Financial Services
Healthcare
Construction
Manufacturing
Transportation & Logistics
Real Estate
Retail
Professional Services
Maritime & Shipping
Relevant Teams
Legal
Claims Processing
Risk Management
Compliance
Customer Service
Policy Administration
Underwriting
Document Management
Corporate Affairs
Quality Assurance
Relevant Roles
Insurance Claims Manager
Risk Management Officer
Legal Counsel
Compliance Officer
Claims Adjuster
Insurance Underwriter
Policy Administration Manager
Customer Relations Manager
Insurance Broker
Corporate Secretary
Risk Assessment Officer
Settlement Officer
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