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Pengertian klaim asuransi adalah permintaan resmi yang ditujukan kepada perusahaan asuransi terkait perlindungan finansial atau ganti rugi dari pihak tertanggung sesuai dengan kontrak perjanjian yang telah disepakati antara tertanggug dengan perusahaan penyedia jasa asuransi.

Sebelum klaim asuransi disetujui biasanya perusahaan akan meninjau validitasnya sebelum permintaan disetujui. Perlindungan asuransi yang akan diberikan dapat berupa asuransi jiwa, properti, kesehatan dan lain sebagainya sesuai dengan program asuransi yang di ikuti. Terdapat banyak jenis program asuransi diantaranya adalah kematian, kehilangan, kerusakan atau sakit, di mana melibatkan pembayaran premi secara teratur dalam jangka waktu tertentu sesuai dengan yang telah ditentukan sebagai ganti polis untuk mendapatkan perlindungan dari program asuransi yang diikuti.

Sebelum mengikuti program asuransi dan mengajukan klaim terhadap asuransi anda perlu memperhatikan beberapa hal berikut ini.

Klaim sesuai dengan yang tertera dalam polis

Resiko yang dijamin dan yang tidak dijamin
Barang yang dijamin dan yang tidak dijamin
Hal hal lain

Hal lain yang juga perlu untuk anda perhatikan adalah

Polis masih berlaku ( inforce)
Polis tidak dalam masa tunggu masa mulai berlakunya
Klaim termasuk dalam pertanggungan

Saat anda melakukan klaim terdapat 3 tahapan yang harus anda lalui tiga tahapan dalam klaim asuransi antara lain : notification, investigation, dan submission.

Notification

Batas waktu pelaporan klaim sesuai dengan ketentuan dari polis asuransi.
Melaporkan pada perusahaan asuransi secara tertulis

Setelah anda melakukan pelaporan maka anda akan masuk ke tahap berikutinya yaitu tahap investigation atau tahap investigasi.

Investigation
Dalam tahap investigasi terdapat beberapa hal yang perlu anda ketahui antra lain :

Fact-finding Survey di lokasi.
Dokumen pembuktian dari nilai kerugian dan lainnya
Penunjukkan Jasa penilai kerugian

Submission

Pengiriman dokumen yang mendukung klaim
Pemerikasan kesesuaian dokumen sesuai dengan polis

Definisi dari asuransi di Indonesia telah ditetapkan dalam UU nomor 2 tahun 1992 tentang Usaha perasuransian.

Demikian tadi pengertian dan tahapan dari klaim asuransi. Sebelum anda memilih/membeli asuransi terdapat beberapa hal yang perlu untuk diperhatikan, diantaranya adalah :

Tanyakan apa saja yang dijamin oleh polis dan apa yang tidak, berapa premi yang harus dibayar? Apa saja manfaat yang akan diterima? Bagaimana dan kapan manfaat diterima? Dan lain lain.

Ketahui pengalaman dan kualifikasinya agen asuransi. Rapa lama agen asuransi berkerja. Karena banyak sekali agen-agen asuransi yang tidak bertahan lama. Dan yang paling penting adalah setiap agen harus berlisensi agar dapat menjual asuransi.

Ketahui reputasi perusahaan asuransi yang menjual produk. Hati hati saat membeli asuransi dari perusahaan yang kualitasnya berlum teruji.

Bandingkan produk yang ditawarkan dengan produk sejenis dari pesaing.

Pelajari ilustrasi polis. seperti: berapa tingkat suku bunga atau pengembalian investasi.

Ketika agen asuransi menyerahkan polis asuransi periksa dan bacalah dengan seksama. Luangkan waktu anda untuk mempelajarinya, jika ada yang tidak mengerti jangan ragu untuk menanyakannya.

Ketahui masa awal dan masa akhir polis, termasuk jatuh tempo premi, jumlah hingga masa tenggang dan masa pemulihan polis.

Jika membeli asuransi seumur hidup ketahui berapa lama jangka waktu pinjaman dan tingkat suku bunga yang dikenakan.

Pelajari juga mengenai perubahan plan.

Dan yang paling penting adalah proses Klaim dari perusahaan asuransi karena sering terjadi banyak agen yang berpindah-pindah perusahaan asuransi sehingga jika kita ingin klaim jangan sampai terkendala masalah agen nya. Ketahui siapa yang harus dihubungi bila terjadi klaim, apa saja persyaratan yang harus dilengkapi, berapa lama perusahaan asuransi harus memproses klaim Anda.

Referensi :

http://www.kaskus.co.id/thread/52145ae91cd7194b78000002/tips-memilih-asuransi

Pengertian klaim asuransi

Histats