TEMPO.CO, Jakarta - The Indonesian Consumers Foundation (YLKI) urges the Financial Services Authority (OJK) to revoke the co-payment rule for health insurance risk sharing. This rule obligates policyholders to bear 10 percent of the claim costs.
YLKI considers the postponement of the regulation, agreed upon by OJK and the House of Representatives (DPR) in a meeting on Monday, June 30, 2025, as insufficient in protecting consumers. "And not in line with the initial agreement in the policy," said YLKI's Executive Secretary Rio Priambodo in a written statement to Tempo on Wednesday, July 2, 2025. He believes this policy will make consumers think twice before continuing their insurance policies.
YLKI also requests OJK to involve consumers in policy development. According to Rio, OJK should resolve fundamental issues such as claims processes and hospital services. "Resolving insurance-related issues will enhance OJK's dignity in the eyes of consumers," he said.
In a hearing with the DPR, Commission XI member Eric Hermawan asked OJK to postpone the implementation of co-payment until 2027. He believes OJK did not involve the public and did not consult with the DPR before issuing this policy. "There should be a people-oriented approach. The public should be asked if they want to adopt co-payment. The industry is the one benefiting," said Eric.
Commission XI Chairman Mukhamad Misbakhun asked OJK to change the form of the regulation from a circular letter to an official regulation. "Should not be a circular letter, but a formal regulation," he said. OJK's Executive Director of Insurance Supervision Ogi Prastomiyono stated that OJK will follow the DPR's request.
Previously, the Indonesian Life Insurance Association (AAJI) cited the surge in health insurance claims as the reason for the issuance of the co-payment rule. "Health insurance claims have been increasing from year to year, especially after the pandemic," said Head of the Claim and Benefit Department of AAJI, Dian Budiani, in a media gathering in Bogor on Wednesday, June 25, 2025.
AAJI recorded the claim value in 2021 at Rp 12.11 trillion. This figure increased to Rp 16.67 trillion in 2022, then soared to Rp 20.77 trillion in 2023. In 2024, claims reached Rp 24.18 trillion with 3.79 million beneficiaries.
Adil Al Hasan contributed to the writing of this article.
Editor's Choice: DPR and OJK Postpone Controversial Health Insurance Co-Payment Scheme
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