Approval and Reporting of Insurance Products

To:

Board of Directors of General Insurance Companies;
Board of Directors of Life Insurance Companies;
Board of Directors of Sharia General Insurance Companies; and
Board of Directors of Sharia Life Insurance Companies,
At their respective addresses.

COPY

CIRCULAR LETTER OF THE FINANCIAL SERVICES AUTHORITY REPUBLIC OF INDONESIA NUMBER 14/SEOJK.05/2024

CONCERNING

APPROVAL AND REPORTING OF INSURANCE PRODUCTS

In relation to the mandate of the provisions of Article 41, Article 45, Article 63 paragraph (4), and Article 77 of Financial Services Authority Regulation Number 8 of 2024 concerning Insurance Products and Insurance Product Marketing Channels (State Gazette of the Republic of Indonesia Year 2024 Number 10/OJK, Supplement to the State Gazette of the Republic of Indonesia Number 78/OJK), it is necessary to further regulate the procedures, forms, and formats for applications for approval of insurance product implementation, reporting of insurance products, opinions from the Sharia supervisory board, and reporting of insurance product cessation in this Financial Services Authority Circular Letter as follows:

I. GENERAL PROVISIONS

In this Financial Services Authority Circular Letter, the following terms are meant:

Insurance Product is a service program for indemnity/risk management carried out by general insurance companies and/or life insurance companies, including those organized based on Sharia principles.
Investment-Linked Insurance Product, hereinafter referred to as PAYDI, is an Insurance Product that provides at least protection against the risk of death and provides benefits referring to the investment results of a fund pool specifically formed for the Insurance Product, whether expressed in unit form or non-unit form.
Joint Insurance Product is an Insurance Product designed to be marketed and underwritten or have its risk managed by 2 (two) or more insurance companies or Sharia insurance companies.
Micro Insurance Product is an Insurance Product designed to provide protection against financial risks faced by the public, especially low-income communities.
Insurance Policy is an insurance agreement deed or other document equated with an insurance agreement deed, and other documents that are an inseparable part of the insurance agreement, and contain an agreement between the insurance company or Sharia insurance company and the policyholder, which is made in writing in either printed or electronic form.
Insurance Company means general insurance companies and life insurance companies.
Sharia Insurance Company means Sharia general insurance companies and Sharia life insurance companies.
Policyholder is a party that binds itself based on an agreement with the Insurance Company, Sharia Insurance Company, reinsurance company, or Sharia reinsurance company to obtain protection or risk management for themselves, the insured, or other participants.
Insured is a party facing risks as regulated in the insurance agreement or reinsurance agreement.
Participant is a party facing risks as regulated in the Sharia insurance agreement or Sharia reinsurance agreement.
Premium is a sum of money determined by the Insurance Company or reinsurance company and approved by the Policyholder to be paid based on an insurance agreement or reinsurance agreement, or a sum of money determined based on statutory regulations underlying mandatory insurance programs to obtain benefits.
Contribution is a sum of money determined by the Sharia Insurance Company or Sharia reinsurance company and approved by the Policyholder to be paid based on a Sharia insurance agreement or Sharia reinsurance agreement to obtain benefits from the tabarru’ fund and/or participant investment fund and to pay management costs, or a sum of money determined based on statutory regulations underlying mandatory insurance programs to obtain benefits.
Board of Directors is the organ of the Insurance Company and Sharia Insurance Company that has the authority and full responsibility for the management of the Insurance Company and Sharia Insurance Company for the interests of the Insurance Company and Sharia Insurance Company, in accordance with the purpose and objectives of the Insurance Company and Sharia Insurance Company and represents the Insurance Company and Sharia Insurance Company, both inside and outside the court, in accordance with the articles of association for Insurance Companies and Sharia Insurance Companies in the form of limited liability companies, or equivalent to the Board of Directors for Insurance Companies and Sharia Insurance Companies in the form of cooperatives or joint ventures.
Company Actuary is an individual who has obtained certification from the association overseeing the actuarial field, who is appointed and works full-time as an actuary at the Insurance Company or Sharia Insurance Company where they work.

II. TYPES AND CRITERIA OF INSURANCE PRODUCTS

Insurance Products marketed by Insurance Companies, Sharia Insurance Companies, and Sharia units within Insurance Companies include:

a. programs that promise protection against 1 (one) or more insurable risks arising from uncertain events by providing compensation to the Policyholder, Insured, or Participant for losses, damages, costs incurred, loss of profit, or legal liability to third parties that may be suffered by the Policyholder, Insured, or Participant;

b. programs that promise protection against 1 (one) or more risks related to the death and/or life of the Insured/Participant, or life insurance annuities;

c. programs that promise protection against 1 (one) or more risks by providing compensation or payment to the Policyholder, Insured, or Participant, or other entitled parties related to the physical health condition of a person or the decline in the health condition of the insured person; and

d. programs that promise protection against 1 (one) or more risks by providing compensation or payment to the Policyholder, Insured, or Participant, or other entitled parties in the event of an accident.

In addition to Insurance Products as referred to in item 1, Insurance Companies, Sharia Insurance Companies, and Sharia units within Insurance Companies may market:

a. programs that provide indemnity/risk management for the risk of debtor failure to fulfill financial obligations to creditors in accordance with credit agreements, or programs that provide risk management for the risk of debtor failure to fulfill financial obligations to creditors in accordance with Sharia financing agreements;

b. programs that provide guarantees over the principal's ability to perform agreements in accordance with the main agreement between the principal and the obligee; and

c. PAYDI.

III. APPROVAL OF INSURANCE PRODUCTS

Insurance Companies, Sharia Insurance Companies, and Sharia units within Insurance Companies must first obtain approval from the Financial Services Authority in the implementation of Insurance Products in the form of:

a. New Insurance Products; and

b. Insurance Products with specific criteria.

The obligation to obtain approval from the Financial Services Authority as referred to in item 1 applies to Insurance Products that cumulatively meet the requirements of being New Insurance Products and Insurance Products with specific criteria.
New Insurance Products as referred to in item 1 letter a are Insurance Products that:

a. have never been marketed by the respective Insurance Company, Sharia Insurance Company, and Sharia units within the Insurance Company; or

b. are developments of Insurance Products that have been marketed and result in material changes to the design of the Insurance Product that has been marketed by the Insurance Company, Sharia Insurance Company, and Sharia units within the Insurance Company, the scope of which changes includes:

risks covered, including exclusions or restrictions on the causes of risks covered; and/or
methods for calculating cash value.

Insurance Products meeting specific criteria as referred to in item 1 letter b are:

a. Insurance Products that have savings elements or cash value;

b. Credit Insurance Products or Sharia Financing Insurance Products; and

c. Insurance Products in the suretyship business line or Sharia suretyship business line.

The implementation of Joint Insurance Products that meet the criteria and conditions as referred to in item 1 must first obtain approval from the Financial Services Authority.
The obligation to first obtain approval from the Financial Services Authority as referred to in item 5 is carried out at the time of:

a. the first application for the implementation of Joint Insurance Products; or

b. the addition of members and/or change of chairman in the implementation of Joint Insurance Products.

To obtain approval from the Financial Services Authority as referred to in item 1, the Board of Directors of the Insurance Company or Sharia Insurance Company must submit an Insurance Product approval application accompanied by documents as follows:

a. self-identification and assessment results that have been determined by the Insurance Product Development Committee, which is prepared in accordance with the form and format as referred to in Appendix I which is an inseparable part of this Financial Services Authority Circular Letter;

b. Insurance Product approval application forms, for:

approval of Insurance Products that have savings elements or cash value other than PAYDI, which is prepared in accordance with the form and format as referred to in Appendix II which is an inseparable part of this Financial Services Authority Circular Letter; or
approval of credit/Sharia financing insurance and/or suretyship/Sharia suretyship, which is prepared in accordance with the form and format as referred to in Appendix III which is an inseparable part of this Financial Services Authority Circular Letter;

c. projections of Premium/Contribution income and expenses associated with the marketing of Insurance Products for a period of 3 (three) years;

d. Insurance Product descriptions prepared in accordance with the form and format as referred to in Appendix IV which is an inseparable part of this Financial Services Authority Circular Letter;

e. specimen Insurance Policies;

f. opinions from the Sharia supervisory board, for Sharia Insurance Products, which are prepared in accordance with the form and format as referred to in Appendix V which is an inseparable part of this Financial Services Authority Circular Letter; and

g. matrix comparing Insurance Products before and after changes, if the reported New Insurance Product is a development of an Insurance Product that has been marketed and results in material changes, which is prepared in accordance with the form and format as referred to in Appendix VI which is an inseparable part of this Financial Services Authority Circular Letter.

The form and format for PAYDI approval applications are prepared with reference to the provisions in Financial Services Authority Circular Letters regarding PAYDI.
In addition to the document completeness as referred to in item 7, approval applications for Insurance Products in the form of Joint Insurance Products are also accompanied by documents:

a. written agreements for the implementation of Joint Insurance Products, if the Joint Insurance Product is a New Insurance Product that has never been marketed by the Insurance Company or Sharia Insurance Company as referred to in item 3 letter a; and

b. letters of approval for previous Joint Insurance Products, if the Joint Insurance Product is a New Insurance Product that is a development of an Insurance Product that has been marketed as referred to in item 3 letter b.

IV. REPORTING OF INSURANCE PRODUCT IMPLEMENTATION

Insurance Companies and Sharia Insurance Companies may implement and market Insurance Products first without approval from the Financial Services Authority, for:

a. Insurance Products that have never been marketed by the Insurance Company or Sharia Insurance Company and such Insurance Products do not meet specific criteria as referred to in Section III item 4;

b. Insurance Products that are developments of Insurance Products that have been marketed by the Insurance Company or Sharia Insurance Company and result in material changes, but do not meet specific criteria as referred to in Section III item 4; and

c. Insurance Products that are developments of Insurance Products that have been marketed by the Insurance Company or Sharia Insurance Company, which meet specific criteria as referred to in Section III item 4 but do not result in material changes.

Insurance Companies and Sharia Insurance Companies must submit reports on the implementation of Insurance Products as referred to in item 1 no later than 5 (five) business days after the Insurance Product in question is marketed by the Insurance Company or Sharia Insurance Company.
The implementation of Joint Insurance Products that meet the criteria and conditions as referred to in item 1 must be reported to the Financial Services Authority.
The reporting obligation to the Financial Services Authority as referred to in item 3 is carried out at the time of:

a. the submission of the first report on the implementation of Joint Insurance Products; or

b. the addition of members and/or change of chairman in the implementation of Joint Insurance Products.

The submission of reports on the implementation of Insurance Products as referred to in item 2 must be accompanied by documents as follows:

b. statements from the Company Actuary and the Board of Directors of the Insurance Company or Sharia Insurance Company, which are prepared in accordance with the form and format as referred to in Appendix VII which is an inseparable part of this Financial Services Authority Circular Letter;

c. specimen Insurance Policies;

d. opinions from the Sharia supervisory board, for Sharia Insurance Products, which are prepared in accordance with the form and format as referred to in Appendix V which is an inseparable part of this Financial Services Authority Circular Letter;

e. matrix comparing Insurance Products before and after changes, specifically for Insurance Products that are developments of Insurance Products that have been marketed, which are prepared in accordance with the form and format as referred to in Appendix VI which is an inseparable part of this Financial Services Authority Circular Letter; and

f. written agreements, for Joint Insurance Products.

V. REPORTING OF INSURANCE PRODUCT CESSATION

Insurance Product cessation is carried out based on:

a. the initiative of the respective Insurance Company and Sharia Insurance Company; or

b. an order from the Financial Services Authority.

Insurance Companies and Sharia Insurance Companies must report the cessation of Insurance Products as referred to in item 1 to the Financial Services Authority no later than 10 (ten) business days since the cessation of the Insurance Product.
The calculation of the time period for the obligation to report the cessation of Insurance Products as referred to in item 2 is calculated starting from:

a. the date of the Board of Directors' decision letter on the cessation of the Insurance Product in the event that the Insurance Product is ceased based on the initiative of the respective Insurance Company and Sharia Insurance Company as referred to in item 1 letter a; or

b. the date of the Financial Services Authority's order letter in the event that the Insurance Product is ceased based on an order from the Financial Services Authority as referred to in item 1 letter b.

The reporting of cessation of Insurance Products as referred to in item 2 must be submitted by the Board of Directors accompanied by:

a. an explanation regarding the reasons for ceasing the marketing of the Insurance Product; and

b. data on active Insurance Policies.

The explanation regarding the reasons for ceasing the marketing of the Insurance Product is accompanied by a Board of Directors' statement regarding responsibility for the decision to cease the Insurance Product.
The submission of reports on the cessation of Insurance Products is prepared in the form and format as contained in Appendix VIII which is an inseparable part of this Financial Services Authority Circular Letter.
Cessation of Insurance Products based on an order from the Financial Services Authority as referred to in item 1 letter b may be temporary or permanent based on the Financial Services Authority's assessment.
Temporary cessation of Insurance Products based on an order from the Financial Services Authority is given in the event that Insurance Companies and Sharia Insurance Companies:

a. do not apply adequate risk management for the implemented Insurance Products; and/or

b. are in specific conditions related to financial health issues.

Permanent cessation of Insurance Products based on an order from the Financial Services Authority is given in the event that the implementation of Insurance Products is assessed to:

a. harm the Policyholder, Insured, or Participant;

b. contradict statutory regulations and norms applicable in society; and/or

c. endanger the financial condition of the Insurance Company or Sharia Insurance Company.

Insurance Companies and Sharia Insurance Companies ordered by the Financial Services Authority to cease Insurance Products as referred to in item 1 letter b must:

a. cease the offer, marketing, and/or closing of new indemnity/participation for the Insurance Product;

b. convey information to the Policyholder, Insured, or Participant regarding the cessation of the Insurance Product;

c. submit an action plan to the Financial Services Authority regarding the cessation of the Insurance Product no later than 1 (one) month since the Insurance Company or Sharia Insurance Company was ordered to cease the Insurance Product; and

d. implement the action plan as referred to in letter c.

The action plan to the Financial Services Authority regarding the cessation of Insurance Products as referred to in item 10 letter c must at least include steps to be taken in:

a. resolution of the causes of the cessation of the implementation of the Insurance Product;

b. settlement of obligations to the Policyholder, Insured, or Participant; and

c. refinement and improvement of the Insurance Product.

VI. PROCEDURES FOR SUBMITTING APPROVAL, IMPLEMENTATION REPORTING, AND CESSATION REPORTING OF INSURANCE PRODUCTS

Insurance Companies and Sharia Insurance Companies must submit applications for approval, implementation reports, and cessation reports of Insurance Products to the Financial Services Authority in accordance with the forms and formats as contained in the Appendices which are an inseparable part of this Financial Services Authority Circular Letter.
The submission of applications for approval, implementation reports, and cessation reports of Insurance Products as referred to in item 1 is submitted to the Financial Services Authority online through the Financial Services Authority's data communication network system.
In the event that the Financial Services Authority's data communication network system as referred to in item 2 is not yet available or experiences technical disturbances, Insurance Companies and Sharia Insurance Companies must submit applications for approval, implementation reports, and cessation reports of Insurance Products online via email to the Financial Services Authority.
In the event that Insurance Companies and Sharia Insurance Companies must submit applications for approval, implementation reports, and cessation reports of Insurance Products online via email to the Financial Services Authority as referred to in item 3, the Financial Services Authority conveys to the Insurance Companies and Sharia Insurance Companies the email addresses used for the submission of applications for approval, implementation reports, and cessation reports of Insurance Products.
In the context of submission online via email as referred to in item 3, Insurance Companies and Sharia Insurance Companies must submit in writing to the Financial Services Authority the email addresses of the Insurance Companies and Sharia Insurance Companies used for the submission of applications for approval, implementation reports, and cessation reports of Insurance Products to the Financial Services Authority.
In the event that the Financial Services Authority's data communication network system as referred to in item 2 experiences technical disturbances, or Insurance Companies and Sharia Insurance Companies experience disturbances so that they cannot submit applications for approval, implementation reports, and cessation reports of Insurance Products online, the submission of applications for approval, implementation reports, and cessation reports of Insurance Products is submitted offline accompanied by written notification and supporting documents in electronic copy form and sent to the Financial Services Authority addressed to:

Executive Head of Insurance, Guarantee, and Pension Supervision Financial Services Authority c/o Director of Insurance, Guarantee, and Pension Licensing Wisma Mulia 2 Building Mailing Room, 17th Floor mailingroomwismul@ojk.go.id

Jl. Jenderal Gatot Subroto Kav.42
South Jakarta, 12710.

In the event that Insurance Companies or Sharia Insurance Companies submit applications for approval or reports on the implementation of Insurance Products, Part A.I and/or B.I of the Insurance Product description as referred to in Appendix IV which is an inseparable part of this Financial Services Authority Circular Letter are prepared in spreadsheet format.
In the event of changes to the Financial Services Authority's office address as referred to in item 6, the Financial Services Authority conveys such address changes via letter, announcement, or other communication media.
The submission of applications for approval, implementation reports, and cessation reports of Insurance Products offline as referred to in item 6 is accompanied by a cover letter signed by:

a. the Board of Directors of the Insurance Company or Sharia Insurance Company; or

b. the Board of Directors of the Insurance Company or Sharia Insurance Company appointed as chairman in the marketing of Joint Insurance Products.

The submission of applications for approval, implementation reports, and cessation reports of Insurance Products offline as referred to in item 6 can be done in one of the following ways:

a. handed directly to the Financial Services Authority office; or

b. sent via a courier service company.

Submission of offline requests for approval, reporting of implementation, and reporting of cessation of Insurance Products shall be submitted to the Financial Services Authority on working days and during the working hours of the Financial Services Authority.
Insurance Companies and Shariah Insurance Companies are deemed to have submitted requests for approval, reporting of implementation, and reporting of cessation of Insurance Products with the following provisions:
a. for online submission via:
1) the Financial Services Authority's data communication network system, proven by a receipt from the Financial Services Authority's data communication network system; or
2) electronic mail to the Financial Services Authority, proven by proof of electronic mail transmission; or
b. for offline submission, proven by a receipt or validation from the Financial Services Authority.

VII. OTHER PROVISIONS

Implementation of Insurance Products that do not meet the approval provisions as referred to in Chapter III and the reporting provisions as referred to in Chapter IV do not need to obtain approval from the Financial Services Authority and are not reported to the Financial Services Authority.
The Board of Directors of Insurance Companies and Shariah Insurance Companies must ensure the completeness, accuracy, currency, integrity of data, and timeliness in the submission of requests for approval and reporting of insurance product implementation, as well as reporting of insurance product cessation.
Insurance Companies and Shariah Insurance Companies are required to conduct studies or testing on new Insurance Products as referred to in Chapter III item 3 and Chapter IV item 1 letters a and b.
The matrix of Insurance Product implementation as referred to in items 1 and 3 is contained in Appendix IX, which is an integral part of this Financial Services Authority Circular.

VIII. CLOSING PROVISIONS

At the time this Financial Services Authority Circular comes into force:
a. Financial Services Authority Circular Number 13/SEOJK.05/2016 concerning Reporting of Insurance Products for Insurance Companies; and b. Financial Services Authority Circular Number 18/SEOJK.05/2016 concerning Reporting of Insurance Products for Shariah Insurance Companies and Insurance Companies that Implement Part of Their Business Based on Shariah Principles, are repealed and declared invalid.

https://jdih.ojk.go.id/

This copy corresponds to the original
Director of Legal Development
Legal Department
Aat Windradi

The provisions in this Financial Services Authority Circular shall take effect on the date of determination.

Determined in Jakarta on October 29, 2024
EXECUTIVE HEAD OF INSURANCE, INSURANCE GUARANTEE, AND PENSION FUNDS SUPERVISOR FINANCIAL SERVICES AUTHORITY REPUBLIC OF INDONESIA, OGI PRASTOMIYONO signed signed https://jdih.ojk.go.id/

APPENDIX I
FINANCIAL SERVICES AUTHORITY CIRCULAR
REPUBLIC OF INDONESIA
NUMBER 14/SEOJK.05/2024
CONCERNING
APPROVAL AND REPORTING OF INSURANCE PRODUCTS https://jdih.ojk.go.id/

I. SELF-ASSESSMENT IDENTIFICATION AND ASSESSMENT FORM FOR PLANNED DEVELOPMENT OF INSURANCE PRODUCTS RELATED TO INSURANCE PRODUCT CATEGORIES

GENERAL INFORMATION
Insurance Company Name, Shariah Insurance Company, or Shariah Unit within an Insurance Company: Filled with the name of the Insurance Company, Shariah Insurance Company, or Shariah unit within the Insurance Company. *for Insurance Products other than Joint Insurance Products Chairman: Member(s): Filled with the name of the Insurance Company/Shariah Insurance Company acting as chairman and member. *for Joint Insurance Products Contact Person Name and Phone/email Technical PIC: Director responsible for Insurance Product Development:
Insurance Product Name
Classification/Business Line
Insurance Product Marketing Target: Filled with Policyholder Data Individual Policyholders Non-Individual Policyholders (companies, etc.) Individual and Non-Individual Policyholders (companies, etc.) Brief Description of Insurance Product https://jdih.ojk.go.id/

NO DESCRIPTION YES NO NOTES
I ANALYSIS OF INSURANCE PRODUCT IMPLEMENTATION CHARACTERISTICS

Characteristics and Type of Insurance Product Implementation
a. New Insurance Product
1. has never been marketed; or
2. development of an already marketed Insurance Product resulting in material changes, including:
  Provide a brief explanation of the changes made by the Insurance Company/Shariah Insurance Company, categorized into:
  a. changes in covered risks; b. changes in cash value calculation methods; and/or
  c. other changes (if any).
  a) covered risks include exclusions or restrictions on risk causes covered; and/or b) cash value calculation methods. b. Insurance Product meeting certain criteria Provide a brief explanation reflecting the type and characteristics of the Insurance Product, whether it meets or does not meet the criteria as referred to in items 1), 2), or 3).
3. Insurance Product with savings or cash value elements;
4. Shariah credit/financing Insurance Product; and
5. Insurance Product in the suretyship/suretyship syariah business line.
  c. Addition of members and/or change of chairman in the implementation of Joint Insurance Products
  https://jdih.ojk.go.id/

II RECOMMENDATION
Based on the self-assessment results above, we propose that the Insurance Product:
(check mark in the appropriate column) a. requires approval from the Financial Services Authority b. only needs to be reported to the Financial Services Authority We, the undersigned, hereby declare that the aforementioned self-assessment form is consistent with the actual situation and has been completed with sufficient documents. … (filled with city name, date, month, and year) Director responsible for Insurance Product Development (filled with job title or name of Insurance Company/Shariah Insurance Company as Chairman, for Joint Insurance Products) Company Actuary (filled with name of Insurance Company/Shariah Insurance Company or name of Insurance Company/Shariah Insurance Company acting as Chairman, for Joint Insurance Products) signature signature (name) (name and registration number) *)Note: For Joint Insurance Products, the self-assessment form is signed by the Board of Directors and Company Actuaries of the Insurance Company/Shariah Insurance Company acting as chairman in the implementation of the Joint Insurance Product. https://jdih.ojk.go.id/

This copy corresponds to the original
Director of Legal Development
Legal Department
Aat Windradi

II. STATEMENT OF THE INSURANCE PRODUCT DEVELOPMENT COMMITTEE
We, the undersigned, hereby declare that:

we have conducted studies or testing on Insurance Product … [filled with Insurance Product name]; and
the information we included in the self-assessment identification and assessment form is consistent with the actual situation and has been completed with sufficient documents.
Furthermore, regarding the aforementioned Insurance Product, we designate it as an Insurance Product that requires approval from the Financial Services Authority or only needs to be reported to the Financial Services Authority*). This statement is made truthfully and all provisions of Insurance Product … comply with applicable legislation. If it is later found that this statement is untrue, we are willing to be held responsible and subject to sanctions according to applicable legislation. … (filled with city name, date, month, and year) Chairman of the Insurance Product Development Committee signature (name) *)cross out one Determined in Jakarta on October 29, 2024 EXECUTIVE HEAD OF INSURANCE, INSURANCE GUARANTEE, AND PENSION FUNDS SUPERVISOR FINANCIAL SERVICES AUTHORITY REPUBLIC OF INDONESIA, OGI PRASTOMIYONO signed signed https://jdih.ojk.go.id/

APPENDIX II
FINANCIAL SERVICES AUTHORITY CIRCULAR
REPUBLIC OF INDONESIA
NUMBER 14/SEOJK.05/2024
CONCERNING
APPROVAL AND REPORTING OF INSURANCE PRODUCTS https://jdih.ojk.go.id/

INSURANCE PRODUCT APPROVAL REQUEST FORM WITH SAVINGS OR CASH VALUE ELEMENTS OTHER THAN PAYDI

I. INSURANCE PRODUCT APPROVAL ASSESSMENT FORM FOR PRODUCTS WITH SAVINGS OR CASH VALUE ELEMENTS OTHER THAN PAYDI

NO DESCRIPTION YES NO NOTES
I PRELIMINARY ANALYSIS

Name of the Insurance Product to be marketed meets the requirements:
State the name of the Insurance Product for which approval is requested.
The Insurance Product Name must be used consistently throughout all Insurance Product approval request documents. a. using the word insurance, kata lain yang semakna, or words characterizing the activities of the Insurance Company or Shariah unit within the Insurance Company; b. using the word sharia insurance/takaful, kata lain yang semakna, or words characterizing the activities of the Shariah Insurance Company;
c. not causing interpretation that the product is not an Insurance Product; and
d. consistent with the Insurance Product name when reported to the Financial Services Authority.
Insurance Product is included in the business plan of the Insurance Company/Shariah Insurance Company.
State the period and date of submission of the business plan of the Insurance Company or Shariah Insurance Company. For Joint Insurance Products, information is filled with the period and date of submission of the business plan of each Insurance Company or Shariah Insurance Company participating in the implementation of the Joint Insurance Product.
Fulfillment of Financial Health and Compliance Requirements.
Insurance Company, Shariah Insurance Company, or Shariah unit within the Insurance Company meets the requirements:
For Joint Insurance Products, this information is filled by each Insurance Company, Shariah Insurance Company, or Shariah unit within the Insurance Company participating in the implementation of the Joint Insurance Product. a. minimum solvency ratio: State the RBC achievement ratio for the last month. b. investment adequacy; and State the investment adequacy ratio for the last month.
c. not currently subject to administrative sanctions in the form of business activity restrictions, for part or all of business activities.
If the Insurance Company, Shariah Insurance Company, or Shariah unit within the Insurance Company is subject to sanctions, state:

type of violation;
sanction letter number; and
type of sanction.
II DOCUMENT COMPLETENESS ANALYSIS

Self-assessment identification and assessment results that have received determination from the Insurance Product Development Committee.
Attach the self-assessment identification and assessment results as referred to in Appendix I. https://jdih.ojk.go.id/
Covering letter signed by the Board of Directors or equivalent from the Insurance Company/Shariah Insurance Company.
Attach the covering letter.
Premium/Contribution income projection or service fee and expenses linked to the marketing of the Insurance Product for a period of 3 (three) years.
Attach:

underwriting projection accompanied by qualitative explanation of assumptions used (specifically for Premium/Contribution or service fee growth, claim ratio, and profitability), and its relation to historical data, for Insurance Products with coverage periods less than 1 (one) year; and
profit testing/asset share, for Insurance Products with coverage periods more than 1 (one) year.

Description of Insurance Product. Attach the description of the Insurance Product as referred to in Appendix IV.
https://jdih.ojk.go.id/
Specimen Insurance Policy. Attach:

Policy provisions;
Policy summary accompanied by dummy coverage/participation data;
Policy certificate/participation proof accompanied by dummy coverage/participation data (specifically for Group Insurance Products); and
example list of Insured/Participants accompanied by dummy coverage/participation data (specifically for Group Insurance Products).

Statement letter from Company Actuary.
As per the Company Actuary statement letter as referred to in Chapter II and Chapter III of this assessment form.
Statement letter from the Board of Directors stating that the Insurance Company/Shariah Insurance Company meets financial health and compliance requirements.
Attach the Board of Directors statement letter as referred to in Chapter IV and Chapter V of this assessment form.
Product and/or Service Information Summary (RIPLAY).
Attach example:
a. RIPLAY general version; and b. RIPLAY personal version according to the format in the Financial Services Sector RIPLAY Standard Guidelines. RIPLAY is not a contract document and differs from offer documents such as brochures and leaflets, and differs from the Insurance Product description. In the event of marketing the Insurance Product through long-distance communication media such as telemarketing, the information contained in the telemarketing script contains the minimum information required in the Financial Services Sector RIPLAY Standard Guidelines.
Example Life Insurance Request Letter (SPAJ) or Shariah Life Insurance Request Letter (SPAJS).
Attach example SPAJ/SPAJS.
In the event of marketing the Insurance Product through long-distance communication media, attached documents include among others:
insurance or sharia insurance closing flow in screenshot form if marketed digitally/electronically; and
telemarketing script if marketed via telemarketing.
Risk profile, investment return rate from Premium/Contribution, mortality or morbidity tables, and estimated investment returns from Contribution, acquisition costs, administrative costs, and other general costs for calculating Premium/Contribution.
Attach:
mortality table or morbidity table; and
data sources used.
Cash value development. Attach example format of cash value development report, specifically for Insurance Products with guaranteed cash values.
Opinion from the Shariah Supervisory Board.
Attach the Shariah Supervisory Board opinion as referred to in Appendix V.
Cooperation documents for the implementation of Joint Insurance Products.
Attach cooperation documents for the implementation of Joint Insurance Products.
III COMPLIANCE AND SUBSTANTIVE ANALYSIS
Coverage Object/Participation
a. provides protection from at least 1 (one) type of insurable risk; State the risk covered in the Insurance Product. b. consistent with the scope of life insurance company business and consistent with generally applicable insurance principles; State the life insurance business line according to classification as referred to in Appendix IV.
c. consistent with the scope of Shariah life insurance company or Shariah unit within the life insurance company business, and consistent with:
1. generally applicable insurance principles; and
2. Shariah principles.
  State the Shariah life insurance business line according to classification as referred to in Appendix IV.
Specimen Insurance Policy
a. benefits agreed upon in the Insurance Policy are consistent with the Insurance Product description; State the article in the Insurance Policy governing this. b. includes the amount of Premium/Contribution rates; Premium/Contribution rates are stated in the Specimen Insurance Policy.
c. provisions within the Insurance Policy contain at least the following:
1. General Provisions
  a) start and end dates of coverage/participation; State the article in the Insurance Policy governing this. b) description of agreed benefits and excluded risks, including amounts, timing, requirements, and conditions for benefit provision; State the article in the Insurance Policy governing this. c) method and timing of Premium/Contribution payment; State the article in the Insurance Policy governing this. d) grace period for Premium/Contribution payment; State the article in the Insurance Policy governing this. e) use of equivalent exchange rate issued by Bank Indonesia at the time of payment for Policies in foreign currency if Premium/Contribution payment and/or benefits are linked to the rupiah currency; State the article in the Insurance Policy governing this. Exchange rate used for Policies in foreign currency must be the equivalent exchange rate issued by Bank Indonesia at the time of payment. f) time recognized as the time of receipt of Premium/Contribution payment; State the article in the Insurance Policy governing this. g) Insurance Company or Shariah Insurance Company policy set if Premium/Contribution payment is made after the agreed grace period; State the article in the Insurance Policy governing this. h) period during which the Insurance Company or Shariah Insurance Company cannot review the validity of the insurance contract on Life or Health Insurance Products with coverage/participation periods more than 1 (one) year; State the article in the Insurance Policy governing this. i) cash value table for Insurance Products with guaranteed cash values according to the Insurance Policy; State the article in the Insurance Policy governing this and attach the cash value table. j) calculation method for the size of cash values for Insurance Products with non-guaranteed cash value benefits according to the Insurance Policy; State the article in the Insurance Policy governing this. k) calculation of Insurance Policy dividends or similar, for Insurance Products marketed by life insurance companies, Shariah life insurance companies, or Shariah units of life insurance companies promising Insurance Policy dividends or similar; State the article in the Insurance Policy governing this. l) termination of coverage/participation, from either the Insurance Company or Shariah Insurance Company or from the Policyholder, Insured, or Participant, including conditions, causes, obligations of each party, and rights or benefits obtained by the Policyholder, Insured, or Participant; State the article in the Insurance Policy governing this. m) conditions and procedures for filing claims, including relevant supporting evidence needed for claim filing; State the article in the Insurance Policy governing this. n) procedures and timeframes for claim settlement and payment; State the article in the Insurance Policy governing this. o) dispute resolution containing at least mechanisms for resolution within and outside court and selection of dispute
  resolution venue; State the article in the Insurance Policy governing this. Dispute resolution outside court is conducted through Alternative Dispute Resolution Institutions (LAPS) listed in the LAPS list established by the Financial Services Authority. Dispute resolution in court includes religious courts, for Shariah Insurance Companies. p) language used as reference in case of disputes or disagreements, for Policies printed in 2 (two) or more languages; State the article in the Insurance Policy governing this. q) procedures for resolving complaints from Policyholders, Insured, or Participants; State the article in the Insurance Policy governing this. r) policy examination period for Policies with periods more than 1 (one) year; and State the article in the Insurance Policy governing this. s) waiting period if any; State the article in the Insurance Policy governing this.
2. Application of Shariah Insurance Contracts in the Insurance Policy
  a) contracts used;
  - tabarru’ contract between Participants;
    State the article in the Insurance Policy governing this.
  - tanahud contract between Participants;
    State the article in the Insurance Policy governing this.
  - wakalah bil ujrah contract between Participants and the Shariah Insurance Company or Shariah unit within the Insurance Company in activities other than investment;
    State the article in the Insurance Policy governing this.
  - wakalah bil ujrah, mudharabah, or mudharabah musytarakah contract between Participants and the Shariah Insurance Company or Shariah unit within the Insurance Company in investment activities other than Participant funds and tanahud funds (among other tabarru’ funds); and
    State the article in the Insurance Policy governing this.
  - wakalah bil ujrah, mudharabah, or mudharabah musytarakah contract between Participants and the Shariah Insurance Company or Shariah unit within the Insurance Company in investment activities for Participant investment funds or tanahud funds.
    State the article in the Insurance Policy governing this. b) rights, obligations, and authorities of each party based on the agreed contract;
  - rights of individual Participants in the tabarru’ contract, including obtaining insurance benefits, sharing underwriting surplus, and/or receiving return of part of the Contribution if the Insurance Policy is cancelled;
    State the article in the Insurance Policy governing this.
  - rights of individual Participants in the tanahud contract, including obtaining insurance benefits, and/or receiving return of part of the Contribution if the Insurance Policy is cancelled;
    State the article in the Insurance Policy governing this.
  - rights of collective Participants in the tabarru’ contract, including obtaining investment results and underwriting surplus;
    State the article in the Insurance Policy governing this.
  - rights of collective Participants in the tanahud contract, including obtaining investment results; and
    State the article in the Insurance Policy governing this.
  - obligations of Participants individually or collectively in the tabarru’, tanahud, wakalah bil ujrah, mudharabah, and mudharabah musytarakah contracts, including paying Contribution and providing remuneration to the Shariah Insurance Company.
    State the article in the Insurance Policy governing this. c) rights and obligations of the Shariah Insurance Company or Shariah unit within the Insurance Company;
  - rights of the Shariah Insurance Company or Shariah unit within the Insurance Company in the wakalah bil ujrah contract for activities other than investment, including obtaining ujrah;
    State the article in the Insurance Policy governing this.
  - rights of the Shariah Insurance Company or Shariah unit within the Insurance Company in the wakalah bil ujrah, mudharabah, or mudharabah musytarakah contracts for investment activities of tabarru’ funds, tanahud funds, or Participant investment funds, including obtaining ujrah or investment profit sharing;
    State the article in the Insurance Policy governing this.
  - obligations of the Shariah Insurance Company or Shariah unit within the Insurance Company in the wakalah bil ujrah, mudharabah, and mudharabah musytarakah contracts for activities other than
    State the article in the Insurance Policy governing this.

investment and investment activities of tabarru’ funds and/or investment of tanahud funds, including for executing powers granted by Participants and for covering losses caused by deliberate errors, negligence, or breach of contract by the Sharia Insurance Company Sharia unit at the Insurance Company; and

powers granted by
Participants individually and/or collectively to the Sharia Insurance Company Sharia unit at the Insurance Company, including conducting marketing activities, underwriting, administration, risk portfolio management, fund management, claim payments, investment of tabarru’ funds and/or investment of tanahud funds. Specify the article in the Insurance Policy that governs it. d) the amount of Contribution allocated in:
tabarru’ funds; Specify the article in the
Insurance Policy that governs it.
tanahud funds; Specify the article in the
Insurance Policy that governs it. https://jdih.ojk.go.id/
ujrah; and Specify the article in the
Insurance Policy that governs it.
Participant investment funds.
Specify the article in the
Insurance Policy that governs it. e) the amount, timing, and method of investment profit-sharing in the event that the Insurance Product uses the mudharabah or mudharabah musytarakah contract; Specify the article in the Insurance Policy that governs it. f) the amount, timing, and method of ujrah deduction in the event of using the wakalah bil ujrah contract; Specify the article in the Insurance Policy that governs it. g) allocation of the use of underwriting surplus for tabarru’ funds, Participant investment funds, and/or Sharia Insurance Company funds or Sharia unit at the Insurance Company; and Specify the article in the Insurance Policy that governs it. h) obligation of the Sharia Insurance Company or Sharia unit at the Insurance Company to provide qardh in the event that tabarru’ funds or tanahud funds are insufficient to pay insurance benefits/ claims. Specify the article in the Insurance Policy that governs it. https://jdih.ojk.go.id/

d. The Specimen Insurance Policy has indicated commission/reward to insurance agents/marketing staff/brokerage services for marketing the Insurance Product, in the event that the Insurance Company/Sharia Insurance Company provides commission/reward to third parties in marketing the Insurance Product. Specify the section in the Insurance Policy that governs it. In the event that the Insurance Company/Sharia Insurance Company markets the Insurance Product through insurance agents, marketing staff, brokerage services or third parties for marketing the Insurance Product, attach a section of the Insurance Policy that indicates the section of Premium/Contribution received by the Insurance Company/Sharia Insurance Company and passed on to insurance agents, marketing staff, brokerage services or third parties for marketing the Insurance Product. e. there is a statement that “this Insurance Agreement/Policy has been drafted in accordance with regulatory provisions including provisions of the Financial Services Authority.” Specify the section in the Insurance Policy that governs it.
3. Summary of Insurance Product and/or Service Information (RIPLAY)
a. The summary of Insurance Product and/or Service Information drafted has covered all information required in regulatory provisions. b. The Insurance Company/Sharia Insurance Company has submitted the general RIPLAY. https://jdih.ojk.go.id/

c. The
Insurance Company/Sharia Insurance Company has submitted the personal RIPLAY. d. The drafted RIPLAY has covered at least containing:

name and/or logo of the
Insurance Company/Sharia Insurance
Company;
name of the Insurance Product being
marketed;
statement that
the Insurance Company/
Sharia Insurance
Company is licensed and supervised by the Financial Services Authority;
amount and period
of Premium/Contribution payment;
amount and timing
of fee imposition (including acquisition costs);
summary data;
benefits;
risks;
insurance term;
requirements and procedures
for claim submission;
simulation/illustration and/or
historical data/performance realization;
service procedures and
complaint resolution procedures; https://jdih.ojk.go.id/
contract used,
for Sharia Insurance Products;
information regarding
the provision of commissions by the Insurance Company/ Sharia Insurance Company to marketing parties;
claim resolution and
payment procedures;
contact details of the
Insurance Company/ Sharia Insurance
Company that can be contacted by the Policyholder, Insured/Participant;
statement that there are
applicable terms and conditions; and
additional
information.

Information in the Life Insurance Application Letter (SPAJ) or Sharia Life Insurance Application Letter (SPAJS)
a. SPAJ for life insurance companies;
Attach an example SPAJ containing items including:
a. identity of the
Insured; b. information regarding the suitability between the Insured's profile and the Insurance Product offered*);
c. a statement containing
the truth of identity as well as the source of funds from the beneficial owner.
*not applicable for
Micro Insurance Products b. SPAJS for
Sharia life insurance companies or Sharia units at the Insurance Company.
Attach an example
SPAJS containing items including:
a. identity of the Participant; https://jdih.ojk.go.id/

b. information regarding
the suitability between the Participant's profile and the Insurance Product offered*);
c. a statement containing
the truth of identity as well as the source of funds from the beneficial owner (beneficial owner); d. approval of the Policyholder/Participant for the tabarru’ contract and/or the tanahud contract between Participants, including the amount of tabarru’ Contribution and/or tanahud*); e. approval of the Policyholder/Participant for the wakalah bil ujrah contract with the Sharia Insurance Company or Sharia unit at the Insurance Company in activities other than investment management, including the amount of ujrah*); f. approval of the Policyholder/Participant for the wakalah bil ujrah, mudharabah, or mudharabah musytarakah contract with the Sharia Insurance Company or Sharia unit at the Insurance Company in the management of tabarru’ funds investment, including the amount of ujrah or investment profit-sharing*); and g. approval of the Policyholder/Participant for the use of underwriting surplus*) https://jdih.ojk.go.id/

*not applicable for
Micro Insurance Products
5. Premium/Contribution Calculation
a. The Insurance Company,
Sharia Insurance Company, or Sharia unit at the Insurance Company has established the size of the Premium/Contribution tariff; b. the determination of Premium/Contribution tariff elements must be supported by reasonable data and/or assumptions and general insurance practice;
c. the Premium/Contribution tariff is in accordance with the benefits
promised, which is established at a sufficient level, not excessive, and not established in a discriminatory manner; Specify the section in the Insurance Product description that contains the formula for calculating Premium/Contribution. d. there is a clear formula in the tariff calculation for risks including that there is relevance between data on the risk profile and the tariff for risks; Specify the section in the Insurance Product description that contains the formula for calculating Premium/Contribution. e. the determination of the calculation of Premium/Contribution considers at least:

Pure Premium/Contribution calculated based on
risk profile data, interest rate/discount rate, mortality tables, and/or morbidity tables;
estimated investment returns
from Premium/Contribution;
acquisition costs; Specify the proportion
of the acquisition cost component in
Premium/Contribution or gross service fee. https://jdih.ojk.go.id/
administrative costs; Specify the proportion
of the administrative cost component in
Premium/Contribution or gross service fee.
other general costs; and Specify the proportion
of other general cost components in
Premium/Contribution or gross service fee.
profit; Specify the proportion
of profit in
Premium/Contribution or gross service fee. f. there is a clear formula in the calculation of cost components within the calculation of Premium/Contribution including that there is relevance between cost data and the cost tariff established by the Insurance Company/Sharia Insurance Company for the Insurance Product for which approval is requested; and Specify the section in the Insurance Product description that contains the formula for calculating Premium/Contribution. g. the methodology for calculating Premium/Contribution for the Insurance Product for which approval is requested has been in accordance with general insurance principles and commonly used (best practice and common practice).

Cash Value
a. Formula for calculating cash value (for Insurance Products that contain cash value).
Describe the formula used in calculating cash value. b. The calculation of cash value has been based on reasonable actuarial assumptions and general insurance practice.
c. The Insurance Company,
Sharia Insurance Company, or Sharia unit at the Describe the investment strategy and target investment returns for https://jdih.ojk.go.id/

Insurance Company has an investment strategy that is appropriate and supports the development of cash value. supporting the development of cash value, as well as the source of funds for the development of cash value (Participant investment funds, tanahud funds, or company funds).
7. Profit Testing or Asset Share, for Life
Insurance Products a. presented in accordance with the coverage period/ membership period; b. has considered all insurance benefits;
c. there is reasonableness of the assumptions used; and
d. the surplus from the Insurance Product reported is sufficient for the Insurance Company.
8. Profit testing or asset share, specifically for
Sharia Life Insurance Products a. Profit testing or asset share must reflect the separation of assets and liabilities of the Sharia Insurance Company into:

tabarru’ funds;
Sharia Insurance Company funds; and
tanahud funds or Participant investment funds.
b. There is reasonableness of the assumptions used.
c. The surplus from the Insurance Product reported is sufficient
for tabarru’ funds, tanahud funds and funds of the Sharia Insurance Company or Sharia unit at the Insurance Company.

Insurance Products marketed jointly
a. The Insurance Company/Sharia
Insurance Company fulfills the written agreement covering:

membership composition,
including the
Insurance Company/Sharia
Insurance Company that will act as the chair to coordinate marketing activities for Joint Insurance Products;
rights and obligations of each
Insurance Company/Sharia Insurance Company that is part of the organization of Joint Insurance Products, namely:
a) duties of the
Insurance Company/Sharia
Insurance Company that acts as the chair; and b) obligations of the parties to maintain the confidentiality of data of Policyholders, Insured, or Participants;
specifications and design
of the Joint Insurance Product that is the object of the agreement or marketing;
risks
covered/managed by each
Insurance Company/Sharia
Insurance Company;
clauses regarding procedures
or methods:
a) insurance application; b) risk selection (underwriting) and determination of Premium/Contribution; c) receipt of Premium/Contribution from Policyholders, Insured, or Participants; https://jdih.ojk.go.id/

d) forwarding of
Premium/Contribution to all
Insurance Companies or Sharia
Insurance Companies that are part of the organization of Joint Insurance Products; e) claim resolution and payment; and f) resolution of complaints from Policyholders, Insured, or Participants.
6) term of the cooperation agreement
for the organization of
Joint Insurance Products;
7) dispute resolution procedures between
Insurance
Companies/Sharia Insurance Companies that are part of the organization of Joint Insurance Products; and
8) conditions causing
the termination of the agreement. b. Written agreement documents, in the event that Joint Insurance Products are new Insurance Products that have never been marketed by the Insurance Company/Sharia Insurance Company.
c. Approval letter for previous
Joint Insurance Products, in the event that Joint Insurance Products are developments of Insurance Products that have been marketed. IV CONCLUSION All approval requirements for Insurance Products with savings or cash value elements other than PAYDI have been met. https://jdih.ojk.go.id/

We, the undersigned below, hereby declare that the aforementioned self-assessment form has been in accordance with the actual situation and has been completed with sufficient documents. … (fill in city name, date, month, and year) Director responsible for Insurance Product Development (fill in job title or name of Insurance Company/Sharia Insurance Company as Chair, for Joint Insurance Products) Company Actuary (fill in name of Insurance Company/Sharia Insurance Company or name of Insurance Company/Sharia Insurance Company that acts as Chair, for Joint Insurance Products) signature signature (name) (name and registration number) *)Note: for Joint Insurance Products, the self-assessment form is signed by the Directors and Company Actuaries of the Insurance Company/Sharia Insurance Company acting as chair in the organization of Joint Insurance Products. https://jdih.ojk.go.id/

II. STATEMENT OF COMPANY ACTUARY
We, the undersigned below, hereby declare that the calculation of Premium/Contribution and technical reserves/provisioning for the Insurance Product … [filled with the name of the Insurance Product for which approval is requested] has been in accordance with regulatory provisions and is based on reasonable assumptions and general insurance practice. This statement is made truthfully and all provisions of the Insurance Product are in accordance with regulatory provisions. If it is later found that this statement is not true, then we are willing to be responsible and may be subject to sanctions in accordance with regulatory provisions. … (fill in city name, date, month, and year) Company Actuary (filled with the name of the Insurance Company) signature (name and registration number) *)Note: for Joint Insurance Products, the Company Actuary's statement letter is signed by the Company Actuary of the Insurance Company/Sharia Insurance Company acting as chair and members in the organization of Joint Insurance Products. https://jdih.ojk.go.id/

III. DIRECTOR'S STATEMENT
We, the undersigned below, hereby declare that:

The Insurance Company/Sharia Insurance Company fulfills
minimum solvency ratio and investment adequacy requirements;
The Insurance Company/Sharia Insurance Company is not currently
subject to administrative sanctions in the form of business activity restrictions, for part or all of the business activities; and
The Insurance Product … [filled with the name of the Insurance Product for
which approval is requested] is included in the business plan of the Insurance Company/Sharia Insurance Company that has been approved by the Board of Commissioners and communicated to Shareholders. This statement is made truthfully and all provisions of the Insurance Product are in accordance with regulatory provisions. If it is later found that this statement is not true, then we are willing to be responsible and may be subject to sanctions in accordance with regulatory provisions. … (fill in city name, date, month, and year) Director responsible for Insurance Product Development signature (name) *)Note: for Joint Insurance Products, the Director's statement letter is signed by the Director responsible for Insurance Product Development at the Insurance Company/Sharia Insurance Company acting as chair and members in the organization of Joint Insurance Products. https://jdih.ojk.go.id/

This copy is consistent with the original
Director of Legal Development
Legal Department
Aat Windradi
Established in Jakarta on October 29, 2024
EXECUTIVE HEAD OF SUPERVISOR
OF INSURANCE, GUARANTEE, AND PENSION FUNDS
FINANCIAL SERVICES AUTHORITY
REPUBLIC OF INDONESIA,
OGI PRASTOMIYONO signed signed https://jdih.ojk.go.id/

APPENDIX III
LETTER OF THE FINANCIAL SERVICES AUTHORITY
REPUBLIC OF INDONESIA
NUMBER 14/SEOJK.05/2024
REGARDING
APPROVAL AND REPORTING OF INSURANCE PRODUCTS https://jdih.ojk.go.id/

APPLICATION FORM FOR APPROVAL
OF CREDIT INSURANCE/SHARIA FINANCING PRODUCTS
AND/OR SURETYSHIP/SURETYSHIP SHARIA PRODUCTS
I. ASSESSMENT FORM FOR APPROVAL OF CREDIT INSURANCE/SHARIA FINANCING PRODUCTS AND/OR
SURETYSHIP/SURETYSHIP SHARIA PRODUCTS
GENERAL INFORMATION
Name of
Insurance Company, Sharia
Insurance Company, or
Sharia unit at the Insurance Company
Filled with the name of the Insurance Company, Sharia Insurance Company, or Sharia unit at the Insurance Company *for Insurance Products other than Joint Insurance Products Chair :
Member :
Filled with the name of the
Insurance Company/Sharia Insurance Company that acts as chair and member *for Joint Insurance Products Name and Phone/email Contact Person Technical PIC:
Director responsible for Insurance Product
Development :
Name of Insurance Product
Classification/Line of Business Credit Insurance/Sharia Financing Suretyship/Suretyship Sharia Target Market for the Insurance Product Filled with Policyholder data Individual Policyholders Non-Individual Policyholders (company, etc.) Individual and Non-Individual Policyholders (company, etc.) Brief Description of the Insurance Product https://jdih.ojk.go.id/

NO DESCRIPTION YES NO NOTES
I PRELIMINARY ANALYSIS

The name of the Insurance Product to be marketed
meets the requirements:
Specify the name of the Insurance Product for which approval is requested.
The name of the Insurance
Product must be used consistently throughout the entire application document for Insurance Product approval. a. using the word insurance, insurance, other synonymous words, or words that characterize the activities of the Insurance Company; b. using the word Sharia insurance, sharia insurance/takaful, other synonymous words, or words that characterize the activities of the Sharia Insurance Company or Sharia unit at the Insurance Company;
c. does not give rise to the interpretation
that the product is not an Insurance Product; and d. consistent with the name of the Insurance Product when reported to the Financial Services Authority.
The Insurance Product is included in
the business plan of the
Insurance Company/Sharia Insurance
Company.
Specify the period and date of submission of the business plan of the Insurance Company or Sharia Insurance Company. For Joint Insurance Products, the information is filled with the period and date of submission of the business plan of each https://jdih.ojk.go.id/

Insurance Company or Sharia Insurance
Company that is part of the organization of Joint Insurance Products.
3. Fulfillment of Financial Health and Compliance Requirements.

The Insurance Company,
Sharia Insurance Company, or Sharia unit at the Insurance Company meets the requirements:
For Joint Insurance Products, this information is filled by each Insurance Company, Sharia Insurance Company, or Sharia unit at the Insurance Company that is part of the organization of Joint Insurance Products. a) health level with a composite rating of at least rating 2 (two); Specify the ratio of RBC achievement for the last month. b) minimum solvency ratio; Specify the ratio of RBC achievement for the last month. c) investment adequacy; and Specify the ratio of investment adequacy for the last month. d) not currently subject to administrative sanctions in the form of business activity restrictions, for part or all of business activities. If the Insurance Company, Sharia Insurance Company, or Sharia unit at the Insurance Company is subject to sanctions, specify:
type of violation;
sanction letter number;
and
type of sanction.
The Insurance Company
meets the liquidity ratio of at least
150% (one hundred fifty percent);
Specify the liquidity ratio for the last month. https://jdih.ojk.go.id/
The Sharia Insurance Company or Sharia
unit at the
Insurance Company meets the liquidity ratio of company funds and tabarru’ funds each of at least 150% (one hundred fifty percent). Specify the liquidity ratio for the last month.

The Insurance Company/Sharia Insurance
Company meets the minimum equity of at least:
Specify the equity for the last month. a. For the Insurance Company:

Rp250,000,000,000.00 (two
hundred fifty billion rupiah) or 150% (one hundred fifty percent) of the applicable minimum equity regulations, whichever is higher until December 31, 2028; and
Rp1,000,000,000,000.00
(one trillion rupiah) after
December 31, 2028. b. For the Sharia Insurance Company:
Rp100,000,000,000.00
(one hundred billion rupiah) or
150% (one hundred fifty percent) of the applicable minimum equity regulations, whichever is higher until December 31, 2028; and
Rp500,000,000,000.00
(five hundred billion rupiah) after December 31, 2028.
has an information system that is at least capable
of being used for:
Attach documents, including:

screenshots of
the information system used;
SOP or flowchart
that a) obtains, maintains, and processes information regarding the object of insurance for:
to illustrate the operational mechanism of the information system used; and/or
guidelines that
prove that the information system used has met the criteria.

assessment of the level
of risk from the object of insurance;
determination of Premium;
valuation of technical
reserves; and
monitoring and
evaluation of product performance; b) review the accuracy of insurance closure.
has a working unit or
function responsible for the management of credit insurance/Sharia financing insurance and suretyship/suretyship Sharia; Attach the organizational structure of the working unit or function thereof. Specify the name and position of the person in charge of the working unit or function thereof.

The Insurance Company/Sharia Insurance
Company has expert personnel who are responsible for the working unit or function, who meet the requirements:
a) has at least 3 (three) years of experience as an underwriter in the line of business of credit insurance, Sharia financing insurance, suretyship, suretyship Sharia or as a credit analyst; Attach:

Copy of the
Appointment Decree as manager of the line of business of credit insurance/Sharia financing insurance or suretyship/ suretyship Sharia;
Copy of the certificate
in the name of the expert personnel;
Copy of the certificate
of training in the name of the expert personnel; and
Curriculum vitae of the expert personnel
concerned. b) has previously attended education or training that is specifically organized in the field of credit insurance/Sharia financing insurance; and https://jdih.ojk.go.id/

c) possesses underwriter certification qualifications in the field of suretyship or Sharia suretyship issued by a professional certification body in the insurance sector registered with the Financial Services Authority (OJK); Specifically for suretyship and Sharia suretyship products. Attach:

Photocopy of the Decree of Appointment as a manager of the credit insurance or suretyship business line;
Photocopy of the certificate in the name of the aforementioned expert personnel;
Photocopy of the training certificate in the name of the aforementioned expert personnel; and
Curriculum vitae of the relevant expert personnel.

The Insurance Company/Sharia Insurance Company has employees at the head office and branches who are specifically assigned to manage credit insurance/Sharia financing insurance and have undergone specific education and training in the field of credit insurance/Sharia financing insurance;
Attach:

List of employees managing the credit insurance/Sharia financing insurance business line; and
Photocopy of the training certificate in the name of the aforementioned employees.

The Insurance Company/Sharia Insurance Company conducts continuous education and training programs for employees responsible for managing credit insurance/Sharia financing insurance; and
Specify the type of education and training programs that have been implemented or the planned programs to be implemented, along with their schedules.
The Insurance Company/Sharia Insurance Company has risk selection (underwriting) guidelines that reflect that the risk selection process is carried out carefully and in accordance with generally accepted insurance practices.

II. DOCUMENT COMPLETENESS ANALYSIS

Results of self-identification and assessment that have been determined by the Insurance Product Development Committee.
Attach the results of self-identification and assessment as referred to in Appendix I.
Cover letter signed by the Board of Directors or equivalent from the Insurance Company/Sharia Insurance Company.
Attach the cover letter.
Projection of Premium/Contribution income or remuneration and expenses linked to the marketing of the Insurance Product for a period of 3 (three) years.
Attach the underwriting projection completed with a qualitative explanation of the assumptions used (especially regarding the growth of Premium/Contribution or remuneration, claim ratio, and profitability), as well as its relation to historical data.
Description of the Insurance Product.
Attach the description of the Insurance Product as referred to in Appendix IV.
Specimen of the Insurance Policy or other documents containing the credit/Sharia financing insurance or suretyship/Sharia suretyship agreement.
Attach:

Insurance Policy provisions;
Policy summary or guarantee certificate issued by the Insurance Company/Sharia Insurance Company accompanied by dummy coverage/participation data;
Policy certificate/participation proof accompanied by dummy insurance/Sharia insurance coverage/participation data (specifically for Group Insurance Products); and
Example list of insureds/participants accompanied by dummy insurance/Sharia insurance coverage/participation data (specifically for Group Insurance Products).

Actuarial Statement of the Company.
As per the Actuarial Statement of the Company as referred to in sections II and III of this assessment form.
Board of Directors' Statement stating that the Insurance Company/Sharia Insurance Company meets financial health and compliance requirements.
Attach the Board of Directors' Statement as referred to in sections IV and V of this assessment form.
Product and/or Service Information Summary (RIPLAY).
Attach examples:
a. RIPLAY general version; and b. RIPLAY personal version in accordance with the format in the RIPLAY Standard Guidelines for the Financial Services Sector. RIPLAY is not a contract document and differs from offer documents such as brochures and leaflets, as well as from the description of the Insurance Product. In the event of marketing the Insurance Product through remote communication media such as telemarketing, the information contained in the telemarketing script must contain the minimum information required in the RIPLAY Standard Guidelines for the Financial Services Sector.
Example of Insurance or Sharia Insurance Application Request Letter (SPPA/SPPAS).
Attach an example of SPPA/SPPAS.
In the event of marketing the Insurance Product through remote communication media, the attached documents include:
the insurance or Sharia insurance closing flow in the form of screenshots if marketed digitally/electronically; and
telemarketing script if marketed via telemarketing.
Risk and loss profile of the relevant insurance type, with the following provisions:
Attach the risk and loss profile table containing information regarding coverage/participation, Premium/Contribution or remuneration income, and claim values paid per year. a. for at least the last 5 (five) years to calculate Premium/Contribution or remuneration; or b. in the event that it is not available, the following may be used:

risk and loss profile data of the relevant insurance type for less than the last 5 (five) years; or
accurate information from trusted sources to predict the frequency and magnitude of risk (severity).
Attach data or information describing the frequency and magnitude of risk (severity) of similar Insurance Products.

Opinion from the Sharia Supervisory Board, for Sharia Insurance Products.
Attach the Sharia Supervisory Board opinion as referred to in Appendix V.
Cooperation documents for the implementation of Joint Insurance Products.
Attach the cooperation documents for the implementation of Joint Insurance Products.

III. COMPLIANCE AND SUBSTANTIVE ANALYSIS

Object of Coverage/Participation
a. provides protection from at least 1 (one) type of insurable risk; and Specify the type of guarantee provided. b. is in accordance with the business scope of the general insurance company and in accordance with generally accepted insurance principles; and Specify the general insurance business line with classification as referred to in Appendix IV.
c. is in accordance with the business scope of the Sharia general insurance company or the Sharia unit within the general insurance company and in accordance with:

generally accepted insurance principles; and
Sharia principles.
Specify the Sharia general insurance business line in accordance with the classification as referred to in Appendix IV.

General insurance companies, Sharia general insurance companies, and Sharia units within general insurance companies must establish that the risk covered for creditors is at least 25% (twenty-five percent) of the credit balance or Sharia financing value at the time the covered risk occurs.
a. credit transactions; and Specify the magnitude of risk covered for creditors. b. trade transactions. Specify the magnitude of risk covered for creditors.
Specimen of the Insurance Policy or other documents containing the credit/Sharia financing insurance or suretyship/Sharia suretyship agreement.
a. The benefits agreed upon in the specimen Insurance Policy/guarantee certificate have been in accordance with the description of the Insurance Product. Specify the article in the Insurance Policy governing this. b. Tariff magnitude (Premium/Contribution or remuneration). The Premium/Contribution or remuneration tariff is stated in the certificate/specimen Insurance Policy.
c. Provisions within the Insurance Policy/guarantee certificate must at least contain the following:

General Provisions.
a) the start and end dates of coverage/participation; Specify the article in the Insurance Policy governing this. b) description of agreed benefits and excluded risks, including magnitude, time, requirements, and conditions for benefit provision; Specify the article in the Insurance Policy governing this. c) method and time of payment of Premium/Contribution or remuneration; Specify the article in the Insurance Policy governing this. d) grace period for payment of Premium/Contribution or remuneration; Specify the article in the Insurance Policy governing this. e) use of equivalent exchange rates issued by the Bank Indonesia at the time of payment for Insurance Policies with foreign currency if the payment of Premium/Contribution and/or benefits is linked to the Rupiah currency; The exchange rate used for Insurance Policies with foreign currency must be the equivalent exchange rate issued by the Bank Indonesia at the time of payment. Specify the article in the Insurance Policy governing this. f) time recognized as the time of receipt of payment of Premium/Contribution or remuneration; Specify the article in the Insurance Policy governing this. g) policy of the Insurance Company or Sharia Insurance Company established if payment of Premium/Contribution or remuneration is made after the agreed grace period; Specify the article in the Insurance Policy governing this. h) termination of coverage/participation, either from the Insurance Company or Sharia Insurance Company or from the Policyholder, Insured, or Participant, including terms, causes, obligations of each party, and rights or benefits obtained by the Policyholder, Insured, or Participant; Specify the article in the Insurance Policy governing this. i) conditions and procedures for filing claims, including relevant supporting evidence required in claim submission; Specify the article in the Insurance Policy governing this. j) procedures and timeframes for claim settlement and payment; Specify the article in the Insurance Policy governing this. k) dispute resolution at least containing dispute resolution mechanisms in court and out of court, and the choice of dispute resolution venue; Dispute resolution out of court is conducted through an Alternative Dispute Resolution Institution (LAPS) included in the list of LAPS determined by the Financial Services Authority. Dispute resolution in court includes through religious courts, for Sharia Insurance Companies. Specify the article in the Insurance Policy governing this. l) language used as reference in the event of disputes or differences of opinion, for Insurance Policies printed in 2 (two) or more languages; Specify the article in the Insurance Policy governing this. m) procedures for resolving complaints from Policyholders, Insured, or Participants; Specify the article in the Insurance Policy governing this. n) policy review period for Insurance Policies with a period of more than 1 (one) year; and Specify the article in the Insurance Policy
governing this. o) waiting period, if any; Specify the article in the Insurance Policy governing this. p) rights and obligations of the principal in suretyship or Sharia suretyship agreements; Specify the article in the Insurance Policy governing this. q) rights and obligations of the obligee in suretyship or Sharia suretyship agreements. Specify the article in the Insurance Policy governing this.
Application of Sharia insurance contracts in the Insurance Policy.
a) Contracts used

tabarru’ contract among Participants;
Specifically for Sharia Financing Insurance Products.
Specify the article in the Insurance Policy governing this.
kafalah bil ujrah contract;
Specifically for Sharia suretyship.
Specify the article in the Insurance Policy governing this.
wakalah bil ujrah contract between Participants and the Sharia Insurance Company or Sharia unit within the Insurance Company in activities other than investment;
Specifically for Sharia Financing Insurance Products.
Specify the article in the Insurance Policy governing this.
wakalah bil ujrah, mudharabah, or mudharabah musytarakah contract between Participants and the Sharia Insurance Company or Sharia unit within the Insurance Company in investment activities other than Participant investment funds (including tabarru’ funds);
Specifically for Sharia Financing Insurance Products.
Specify the article in the Insurance Policy governing this. b) rights, obligations, and authorities of each party based on the agreed contract;
rights of individual Participants in the tabarru’ contract, including obtaining insurance benefits, sharing underwriting surplus and/or receiving a refund of part of the Contribution in the event the Insurance Policy is cancelled;
Specify the article in the Insurance Policy governing this.
rights of collective Participants in the tabarru’ contract, including obtaining investment results and underwriting surplus; and
Specify the article in the Insurance Policy governing this.
obligations of Participants individually or collectively in the tabarru’, kafalah, wakalah bil ujrah, mudharabah, and mudharabah musytarakah contracts, including paying Contribution and providing remuneration to the Sharia Insurance Company or Sharia unit within the Insurance Company.
Specify the article in the Insurance Policy governing this. c) rights and obligations of the Sharia Insurance Company;
rights of the Sharia Insurance Company or Sharia unit within the Insurance Company in the wakalah bil ujrah contract for activities other than investment, including obtaining ujrah;
Specify the article in the Insurance Policy governing this.
rights of the Sharia Insurance Company or Sharia unit within the Insurance Company in the wakalah bil ujrah, mudharabah, or mudharabah musytarakah contracts for investment activities of tabarru’ funds, including obtaining ujrah or investment profit sharing;
Specify the article in the Insurance Policy governing this.
obligations of the Sharia Insurance Company or Sharia unit within the Insurance Company in the wakalah bil ujrah, mudharabah, and mudharabah musytarakah contracts for activities other than investment and investment activities of tabarru’ funds and/or investment, including executing powers of attorney given by Participants and bearing losses caused by intentional errors, negligence, or breach of contract by the Sharia Insurance Company or Sharia unit within the Insurance Company; and
authorities given by Participants individually and/or collectively to the Sharia Insurance Company or Sharia unit within the Insurance Company, including conducting marketing, underwriting, administration, risk portfolio management, fund management, claim payment, and investment of tabarru’ funds.
Specify the article in the Insurance Policy governing this. d) magnitude of Contribution allocated in:
tabarru’ funds; Specify the article in the Insurance Policy governing this.
ujrah; and Specify the article in the Insurance Policy governing this.
Participant investment funds
Specify the article in the Insurance Policy governing this. e) magnitude, time, and method of payment of investment profit sharing in the event the Insurance Product uses the mudharabah or mudharabah musytarakah contract; Specify the article in the Insurance Policy governing this. f) magnitude, time, and method of ujrah deduction in the event the wakalah bil ujrah contract is used; Specify the article in the Insurance Policy governing this. g) allocation of underwriting surplus usage for tabarru’ funds, Participant investment funds, and/or Sharia Insurance Company funds or Sharia unit within the Insurance Company; and Specify the article in the Insurance Policy governing this. h) obligation of the Sharia Insurance Company or Sharia unit within the Insurance Company to provide qardh in the event tabarru’ funds are insufficient to pay insurance benefits/claims. Specify the article in the Insurance Policy governing this.

d. The specimen Insurance Policy must state the commission/remuneration to insurance agents/marketing personnel/brokerage services for the marketing of the Insurance Product, in the event the Insurance Company/Sharia Insurance Company provides commission/remuneration to third parties in the marketing of the Insurance Product. Specify the section in the Insurance Policy governing this. In the event the Insurance Company/Sharia Insurance Company markets the Insurance Product through insurance agents, marketing personnel, brokerage services, or third parties for the marketing of the Insurance Product, attach the section of the Insurance Policy stating the portion of Premium/Contribution received by the Insurance Company/Sharia Insurance Company and forwarded to insurance agents, marketing personnel, brokerage services, or third parties for the marketing of the Insurance Product.

e. There is a statement that "This Insurance Agreement/Policy has been drafted in accordance with statutory regulations, including provisions of the Financial Services Authority regulations." Specify the section in the Insurance Policy governing this.

Cooperation agreements with creditors or marketers
Attach the cooperation agreement a. agreement duration; Specify the section in the cooperation agreement governing this. b. procedures/methods along with the rights, obligations, and responsibilities of the parties;
c. marketing commission magnitude for marketers; and
d. evaluation and review of cooperation.
Product and/or Service Information Summary (RIPLAY)
a. The Product and/or Service Information Summary drafted has covered all information required by statutory regulations. b. The Insurance Company/Sharia Insurance Company has submitted the general RIPLAY.
c. The Insurance Company/Sharia Insurance Company has submitted the personal RIPLAY.
d. The drafted RIPLAY must at least contain:

name and/or logo of the Insurance Company/Sharia Insurance Company;
name of the Insurance Product marketed;
statement that the Insurance Company/Sharia Insurance Company is licensed and supervised by OJK;
magnitude and period of Premium/Contribution payment;
magnitude and timing of fee imposition (including acquisition costs);
summary data;
benefits;
risks;
insurance duration;
requirements and procedures for claim submission;
simulation/illustration and/or historical data/performance realization;
service procedures and complaint resolution;
contract used, for Sharia Insurance Products;
information regarding the provision of commissions by the Insurance Company/Sharia Insurance Company to marketing parties;
other additional information;
contact information of the Insurance Company/Sharia Insurance Company that can be contacted by Policyholders, Insured/Participants; and
statement that there are terms and conditions that apply.

Information in the Insurance Application Request Letter (SPPA) or Sharia Insurance Application Request Letter (SPPAS).
a. SPPA for general insurance companies; or
Attach an example SPPA containing items including:
a. Insured identity; b. information regarding the suitability between the Insured's profile and the offered Insurance Product*); and
c. statement containing the truthfulness of identity and the source of funds from the beneficial owner.
*not applicable for Micro Insurance Products

b. SPPAS for Sharia general insurance companies or Sharia units within Insurance Companies; Attach an example SPPAS containing items including:

a. Participant identity;
b. information regarding the suitability between the Participant's profile and the offered Insurance Product*); a. statement containing the truthfulness of identity and the source of funds from the beneficial owner;
c. consent of the Policyholder/Participant to the tabarru’ contract among Participants, including the magnitude of tabarru’ Contribution;
d. consent of the Policyholder/Participant to the wakalah bil ujrah contract with the Sharia Insurance Company in activities other than investment, including the magnitude of ujrah*); e. consent of the Policyholder/Participant to the wakalah bil ujrah, mudharabah, or mudharabah musytarakah contract with the company in the management of tabarru’ fund investments, including the magnitude of ujrah or investment profit sharing*);; and f. consent of the Policyholder/Participant to the use of underwriting surplus*). *) not applicable for Micro Insurance Products

Premium/Contribution Calculation.
a. The Insurance Company, Sharia Insurance Company, or Sharia unit within the Insurance Company has established the magnitude of the Premium/Contribution tariff or remuneration. b. The establishment of Premium/Contribution or remuneration tariff elements must be supported by reasonable data and/or assumptions and generally accepted insurance practices.
c. The acquisition cost element in tariff establishment is at most 10% (ten percent) of the Premium/Contribution tariff or remuneration.
d. The Premium/Contribution or remuneration tariff is in accordance with the promised benefits, established at a sufficient level, not excessive, and not established discriminatively. Specify the section in the Insurance Product description containing the formulation of the Premium/Contribution or remuneration calculation. e. There is a clear formulation in the tariff calculation for risks, including relevance between risk profile data and the tariff for risks. Specify the section in the Insurance Product description containing the formulation of the Premium/Contribution or remuneration calculation. f. The establishment of the Premium/Contribution or remuneration calculation considers at least:

the tariff for risks calculated based on the risk and loss profile of the relevant insurance type for at least the last 5 (five) years;
Explain the suitability between pure Premium/Contribution and risk profile data as referred to in Appendix IV.
acquisition costs; Specify the proportion of the acquisition cost component in the gross Premium/Contribution or remuneration. Acquisition costs for the first time are established at most 10% (ten percent) of the Premium/Contribution tariff.
administrative costs; Specify the proportion of the administrative cost component in the gross Premium/Contribution or remuneration.
other general costs; and Specify the proportion of the other general cost component in the gross Premium/Contribution or remuneration.
profit. Specify the proportion of profit in the gross Premium/Contribution or remuneration.
g. There is a clear formulation in the calculation of cost components within the Premium/Contribution or remuneration calculation or including relevance between cost data and the cost tariffs established by the Insurance Company/Sharia Insurance Company for the Insurance Product for which approval is requested. Specify the section in the Insurance Product description containing the formulation of the Premium/Contribution or remuneration calculation. h. The methodology for calculating Premium/Contribution or remuneration for the Insurance Product for which approval is requested has been in accordance with generally accepted insurance principles and commonly used practices (best practice and common practice).

Guarantee Value Limit.
a. Gross guarantee limit. State in the underwriting manual. At most 30% (thirty percent)

from equity. b. Limit of own retention guarantee. Include in underwriting manual.
Maximum 10%
(ten percent) of equity.
9. Risk selection guidelines (underwriting)
include:
Attach the approved underwriting manual by the Board of Directors. a. criteria for the object of insurance or guarantee that can be covered or guaranteed; b. limitation of the scope of risks that can be guaranteed, including terms and conditions of coverage, exclusions, duration of insurance or guarantee, and risk sharing with the policyholder if any;
c. the amount of coverage that can be accepted by the Company
by considering the Company's capacity and reinsurance support; d. data and information that are required for risk assessment on the object of insurance or guarantee; and e. stages and procedures for risk selection and premium/contribution determination, including authority and responsibility of each level of position in the stages thereof.
10. Risk assessment on the object of insurance or
guarantee. a. For credit financing Shariah insurance products.

The debtor's ability
to meet its financial obligations;
The quality of the credit portfolio
or Shariah financing from the creditor; https://jdih.ojk.go.id/
The level of risk on
the object of insurance for each type of risk covered (proximate cause); and
Availability of subrogation.
b. For Suretyship/Suretyship
Shariah products, at least the principal's ability to meet its obligations based on the main agreement and availability of subrogation.

Premium/Contribution Revenue Projection.
a. there is fairness in the assumption of Premium/Contribution revenue; b. there is fairness in the assumption of claim expenses;
c. there is fairness in the assumption
of technical reserves; d. there is fairness in the assumption of costs; e. underwriting surplus is sufficiently adequate; and f. elements in the underwriting projection are complete.
Insurance Products Marketed Jointly.
a. Insurance Company/Sharia Insurance Company meet the written agreement that includes:

membership composition,
including the Insurance Company/Sharia
Insurance Company that will act as the chair to coordinate the marketing activities of Joint Insurance Products;
rights and obligations of each
Insurance Company/Sharia
Insurance Company that https://jdih.ojk.go.id/

is part of the implementation of Joint Insurance Products, namely:
a) duties of the Insurance Company/Sharia
Insurance Company that acts as the chair; and b) obligations of the parties to maintain confidentiality of data of Policyholders, Insured, or Participants;
3) specifications and design
of Joint Insurance Products that are the subject of agreement or marketing;
4) risks covered/managed by each
Insurance Company/Sharia
Insurance Company;
5) clauses regarding procedures
or methods; a) insurance application; b) risk selection (underwriting) and Premium/Contribution determination; c) receipt of Premium/Contribution from Policyholders, Insured, or Participants; d) forwarding of Premium/Contribution to all Insurance Companies or Sharia Insurance Companies that are part of the implementation of Joint Insurance Products; e) settlement and payment of claims; and f) settlement of complaints from Policyholders, https://jdih.ojk.go.id/

Insured, or
Participants.
6) duration of the cooperation agreement
for the implementation of
Joint Insurance Products;
7) dispute resolution procedures between
Insurance Companies/Sharia Insurance Companies that are part of the implementation of Joint Insurance Products; and
8) conditions causing
the termination of the agreement. b. Written agreement documents in the event that Joint Insurance Products are new Insurance Products that have never been marketed by Insurance Companies/Sharia Insurance Companies.
c. Approval letter for previous Joint Insurance Products,
in the event that Joint Insurance Products are a development of Insurance Products that have been marketed. IV CONCLUSION All requirements for the application for approval of Credit Financing Shariah Insurance and/or Suretyship/Suretyship Shariah Insurance products have been met. We, the undersigned, hereby declare that the aforementioned self-assessment form is in accordance with the actual conditions and has been completed with sufficient documents. https://jdih.ojk.go.id/

… (fill in city name, date, month, and year)
Directors in charge of
Insurance Product Development
(fill in job title or Insurance Company name)
Company Actuary
(fill in Insurance Company name) signature signature (name) (name and registration number) https://jdih.ojk.go.id/

II. COMPANY ACTUARY STATEMENT
We, the undersigned, hereby declare that the calculation of Premium/Contribution and technical reserves/technical provisions for Insurance Product … [filled with the name of the Insurance Product for which approval is requested] is in accordance with the provisions of legislation and is based on reasonable assumptions and general insurance practices. This statement is made truthfully and all provisions of the Insurance Product are in accordance with the provisions of legislation. If it is later found that this statement is not true, we are willing to be responsible and may be subject to sanctions in accordance with the provisions of legislation. … (fill in city name, date, month, and year) Company Actuary (fill in Insurance Company name) signature (name and registration number) https://jdih.ojk.go.id/

III. BOARD OF DIRECTORS STATEMENT
We, the undersigned, hereby declare that:

The Insurance Company/Sharia Insurance Company meets
the minimum solvency ratio and investment adequacy requirements;
The Insurance Company/Sharia Insurance Company is not
currently subject to administrative sanctions in the form of restrictions on business activities, for part or all of the business activities; and
Insurance Product … [filled with the name of the Insurance Product for which
approval is requested] is included in the business plan of the Insurance Company/Sharia Insurance Company that has been approved by the Board of Commissioners and communicated to Shareholders. This statement is made truthfully and all provisions of the Insurance Product are in accordance with the provisions of legislation. If it is later found that this statement is not true, we are willing to be responsible and may be subject to sanctions in accordance with the provisions of legislation. … (fill in city name, date, month, and year) Directors in charge of Insurance Product Development signature (name) https://jdih.ojk.go.id/

This copy is in accordance with the original
Director of Legal Development
Legal Department
Aat Windradi
Determined in Jakarta on October 29, 2024
EXECUTIVE HEAD OF INSURANCE, GUARANTEE, AND
PENSION FUND SUPERVISOR FINANCIAL SERVICES AUTHORITY OF THE REPUBLIC OF INDONESIA, OGI PRASTOMIYONO signed signed https://jdih.ojk.go.id/

APPENDIX IV
LETTER OF THE FINANCIAL SERVICES AUTHORITY
OF THE REPUBLIC OF INDONESIA
NUMBER 14/SEOJK.05/2024
REGARDING
APPROVAL AND REPORTING OF INSURANCE PRODUCTS https://jdih.ojk.go.id/

INSURANCE PRODUCT DESCRIPTION FORM
A. GENERAL INSURANCE/SHARIA GENERAL INSURANCE
Part A.I

Name of Insurance Product. State the name of the Insurance Product
to be marketed.
Name of Insurance Company,
Sharia Insurance Company, or Sharia unit on
Insurance Company.
State the name of the Insurance
Company, Sharia Insurance Company or Sharia unit on Insurance Company.
Name of Chair. Specifically for Joint Insurance Products (PAB).
Member Name 1. Specifically for Joint Insurance Products (PAB).
Member Name 2. Specifically for Joint Insurance Products (PAB).
Member Name 3. Specifically for Joint Insurance Products (PAB).
Member Name 4. Specifically for Joint Insurance Products (PAB).
Member Name 5. Specifically for Joint Insurance Products (PAB). etc. Specifically for Joint Insurance Products (PAB).
Insurance Product Business Line. Select the type of business line according to
the classification provided.
Type of Insurance Product.
a. Standard or non-standard. Select the type of Insurance Product standard or non-standard. b. Individual or Group. Select the type of Insurance Product individual or group. https://jdih.ojk.go.id/
Benefits or Risks Covered.
a. Insurance benefits or risks covered.
Describe the insurance benefits and risks covered in the Insurance Policy. b. Risks excluded.
Describe the risks excluded in the Insurance Policy.
c. Clarity regarding risk
sharing (specifically for
PAB).
Describe risk sharing according to the scope of business (specifically for PAB). d. Deductible or risks covered by the Policyholder, Insured, or Participant in the event of a covered loss. Describe the amount of deductible or risks covered by Policyholders, Insured, or Participants.
Characteristics of Insurance Product.
a. Underwriting provisions. Describe the underwriting provisions.
(including criteria, parameters, and/or factors that are considerations for the company in conducting the acceptance process) b. Coverage period/ membership period. Describe the coverage period/membership period. (1 month, 1 year, 10 years, etc.)
c. Premium/Contribution payment
scheme.
Describe the Premium/Contribution payment scheme.
(e.g., annual, monthly, quarterly, lump sum, etc.) d. Premium/Contribution payment method.
Describe the Premium/Contribution payment method.
(e.g., cash, transfer, autodebit, credit card, etc.) e. Currency (Rupiah, USD, other).
Select the currency (Rupiah, USD, other).
Application of Shariah Principles. Filled specifically for Shariah Insurance Products.
a. Contract between Participants.
State the type of contract used.
(not applicable to Shariah suretyship) https://jdih.ojk.go.id/

b. Amount of tabarru' Contribution or similar.
State the amount of tabarru' Contribution or similar.
c. Contract for managing activities
other than investment.
State the type of contract used. wakalah bil ujrah or kafalah bil ujrah. d. Amount of ujrah for activities other than investment. State the amount of ujrah. e. Contract for managing investment of tabarru' funds or similar. State the type of contract used. (not applicable to Shariah suretyship) f. Amount of ujrah or profit sharing from investment of tabarru' funds or similar. State the amount of ujrah or nisbah of profit sharing from tabarru' funds investment. (not applicable to Shariah suretyship) g. Contract for managing investment of Participant investment funds. State the type of contract used. Only applicable to Shariah Insurance Products that have Participant investment funds. h. Amount of ujrah or profit sharing from investment of Participant investment funds. State the amount of ujrah or nisbah of profit sharing. Only applicable to Shariah Insurance Products that have Participant investment funds.
i. Underwriting surplus allocation.
State the percentage of underwriting surplus allocation for tabarru' funds, Participants, and/or the company. (not applicable to Shariah suretyship)
9. Risk and Loss Profile Data.
For Insurance Products marketed by general insurance companies, Sharia general insurance companies, and Sharia units on general insurance companies:
https://jdih.ojk.go.id/

a. Risk Premium/Contribution rates
(based on risk profile data for at least
5 (five) years).
State the Risk Premium/Contribution rates based on risk profile data for at least 5 (five) years for similar Insurance Products. In the event that risk profile data is not available, state the Risk Premium/Contribution rates based on:
a. risk profile data for less than 5
(five) years; and/or b. accurate information from trusted sources. b. Percentage (%) of loss ratio (loss ratio). State the percentage (%) of loss ratio (loss ratio) based on data for at least 5 (five) years for similar Insurance Products. In the event that loss profile data is not available, state the Premium/Contribution rate for losses based on:
a. loss profile data for less than 5 (five) years; and/or b. accurate information from trusted sources.
c. Percentage (%) of acquisition
costs.
State the percentage (%) of acquisition costs based on data for 3 (three) years for similar Insurance Products. d. Percentage (%) of administrative and general costs. State the percentage (%) of administrative and general costs based on data for 3 (three) years for similar Insurance Products. e. Profit margin. State the profit margin based on data for 5 (five) years for similar Insurance Products.
10. For PAYDI, Health Insurance Products, and/or Personal
Accident Insurance Products marketed by general insurance companies, Sharia general insurance companies, and Sharia units on general insurance companies:
a. Premium/Contribution rates
(based on risk profile data, interest rates/discount rates, mortality tables, and/or morbidity tables). State the Premium/Contribution rates based on risk profile data, interest rates/discount rates, mortality tables, and/or morbidity tables. b. Estimated investment returns from Premium/Contribution. State the estimated investment returns of Premium/Contribution.
c. Percentage (%) of acquisition
costs.
State the percentage (%) of acquisition costs based on data for 3 (three) years for similar Insurance Products. d. Percentage (%) of administrative and general costs. State the percentage (%) of administrative and general costs based on data for 3 (three) years for similar Insurance Products. e. Profit margin. State the profit margin based on data for 5 (five) years for similar Insurance Products.
11. Composition of Gross Premium/Contribution
(total a+b+c+d+e =100%). a. Pure Premium/Contribution (%). State the allocation of Pure Premium/Contribution in percentage (%) and total composition of Premium/Contribution must be 100% (one hundred percent). b. Acquisition costs (%). State the allocation of acquisition costs in percentage (%) and total composition of Premium/Contribution must be 100% (one hundred percent).
c. Administrative costs (%). State the allocation of administrative
costs in percentage (%) and total composition of Premium/Contribution must be 100% (one hundred percent). d. Profit margin (%). State the allocation of profit margin in percentage (%) and total composition of Premium/Contribution must be 100% (one hundred percent). https://jdih.ojk.go.id/

e. Others (%). State the allocation of other costs in percentage (%) if any and state.
12. Description of Treaty Reinsurance Support.
a. Identity of Reinsurance Company.
State at least 2 (two) names of reinsurers providing treaty reinsurance support, as well as their ratings (if any). In the event that reinsurance support is obtained from foreign reinsurers, state the reasons/considerations of the company. b. Type of reinsurance. State the type of reinsurance used. (e.g., surplus, quota share, excess of loss, etc.)
c. Amount of own retention. State the amount of own retention.
13. Marketing Description.
a. Distribution channels. Select the distribution channel according to the classification provided. b. Marketing media. Describe the marketing media used. (e.g., telemarketing, scratch card, website, brochure, and others)
c. Marketing target. Select the marketing target according to
the classification provided.
14. Specifically for changes.
a. Name of the initial Insurance Product according to the approval letter or report.
State the name of the initial Insurance Product according to the approval letter or report (specifically for name changes). b. Number of approval or report letter. State the number of the approval or report letter for the Insurance Product before the change.
c. Date of the approval or
report letter.
State the date of the approval or report letter for the Insurance Product before the change. https://jdih.ojk.go.id/

d. Brief explanation regarding changes to the Insurance Product.
Describe briefly regarding the
Insurance Product before and after the change.
Note:
If submitted in softcopy format, it must be arranged in spreadsheet format https://jdih.ojk.go.id/

Part A.II

Premium/Contribution rate calculation:
a. Formula for calculating Pure Premium/Contribution calculated based on:
For Insurance Products marketed by general insurance companies/Sharia general insurance companies:

risk and loss profile data of the relevant insurance type for at least 5 (five) years;
or
risk and loss profile data of the relevant insurance type for less than 5 (five) years and/or accurate information from trusted sources (in the event that data for at least 5 (five) years is not available).
For PAYDI, Health Insurance Products, and/or Personal Accident Insurance Products marketed by general insurance companies/Sharia general insurance companies, using risk profile data, interest rates/discount rates, mortality tables, and/or morbidity tables. b. Estimated investment returns from Premium/Contribution (for PAYDI, Health Insurance Products, and/or Personal Accident Insurance Products).
c. Cost assumptions or loading (acquisition costs, administrative costs, and
other general costs) and profit margin. d. Basis for setting administrative and general costs using cost data for at least 3 (three) years. e. Range of Gross Premium/Contribution. f. Range of sum insured/membership.

Formula for Technical Reserves/Technical Provisions Calculation
a. Formula for Premium/Contribution reserves/provisions. b. Formula for claim reserves/provisions.
c. Formula for ujrah provisions.
Note: Premium/Contribution components in A.II must be consistent with Premium/Contribution components in A.I. https://jdih.ojk.go.id/

Part A.III
Describe additional information regarding the Insurance Product for which approval/reporting is requested. Note:
a)
Business Line
Property
Motor Vehicles
Transportation
Ship Hulls
Aircraft Hulls
Satellites
Offshore Energy
Onshore Energy
Engineering
Liability
Personal Accident
Health
Credit/Sharia Financing
Suretyship/Suretyship Shariah
Miscellaneous
Others b)
Type of Insurance Product 1
Standard Product
Non-standard Product c)
Type of Insurance Product 2
Individual (individual)
Group (group) d)
Currency
Rupiah
USD
Others e)
Distribution Channel
Directly (direct marketing)
Insurance agents
Bancassurance
Non-Bank Financial Institutions (state....)
Marketers (specifically for Micro Insurance Products) https://jdih.ojk.go.id/

f)
Marketing Target
Individual Policyholders
Non-Individual Policyholders (companies, etc.)
Individual and Non-Individual Policyholders (companies, etc.) https://jdih.ojk.go.id/

B. LIFE INSURANCE/SHARIA LIFE INSURANCE
Part B.I

Name of Insurance Product. State the name of the Insurance Product
to be marketed.
Name of Insurance Company,
Sharia Insurance Company, or Sharia unit on
Insurance Company.
State the name of the Insurance
Company, Sharia Insurance Company or Sharia unit on Insurance Company.
Name of Chair. Specifically for Joint Insurance Products (PAB).
Member Name 1. Specifically for Joint Insurance Products (PAB).
Member Name 2. Specifically for Joint Insurance Products (PAB).
Member Name 3. Specifically for Joint Insurance Products (PAB).
Member Name 4. Specifically for Joint Insurance Products (PAB).
Member Name 5. Specifically for Joint Insurance Products (PAB). etc. Specifically for Joint Insurance Products (PAB).
Insurance Product Business Line. Select the type of business line according to
the classification provided.
Type of Insurance Product.
a. Standard or non-standard. Select the type of Insurance Product standard or non-standard. b. Individual or group. Select the type of Insurance Product individual or group. https://jdih.ojk.go.id/

c. Traditional or
non-traditional.
Select the type of Insurance Product traditional or non-traditional. d. Unitized or non-unitized (specifically for PAYDI). Select the type of Insurance Product unitized or non-unitized. e. Basic or supplementary. Select the type of Insurance Product basic or supplementary.
6. Benefits or Risks Covered.
a. Insurance benefits or risks covered.
Describe the insurance benefits and risks covered in the Insurance Policy. b. Risks excluded.
Describe the risks excluded in the Insurance Policy.
c. Clarity regarding risk
sharing (specifically for
PAB).
Describe risk sharing according to the scope of business (specifically for PAB).
7. Characteristics of Insurance Product.
a. Underwriting provisions. Describe the underwriting provisions.
(including criteria, parameters, and/or factors that are considerations for the company in conducting the acceptance process)
i. type of underwriting. Select the type of underwriting used according to the classification provided.
ii. minimum or
maximum sum insured/ membership.
Describe the minimum and maximum sum insured/membership.
iii. Coverage period/
membership period.
Describe the coverage period/membership period.
(1 month, 1 year, 10 years, etc.) b. Premium/Contribution payment scheme.
Describe the Premium/Contribution payment scheme.
(e.g., annual, monthly, quarterly, lump sum, etc.)
c. Premium/Contribution payment
method.
Describe the Premium/Contribution payment method.
(e.g., cash, transfer, autodebit, credit card, etc.) https://jdih.ojk.go.id/

d. Currency (Rupiah, USD, other).
Select the currency (Rupiah, USD, other).
8. Application of Shariah Principles. *). Filled specifically for Shariah Insurance Products.
a. Contract between Participants.
State the type of contract used. b. Amount of tabarru' Contribution and/or Participant investment funds. State the amount of tabarru' Contribution and/or Participant investment funds.
c. Contract for managing activities
other than investment.
State the type of contract used. d. Amount of ujrah for activities other than investment.
State the amount of ujrah. e. Contract for managing investment of tabarru' or tanahud funds.
State the type of contract used. f. Amount of ujrah or profit sharing from investment of tabarru' or tanahud funds. State the amount of ujrah or nisbah of profit sharing from tabarru' or tanahud funds investment. g. Contract for managing investment of Participant investment funds or tanahud funds. State the type of contract used. h. Amount of ujrah or profit sharing from investment of Participant investment funds or tanahud funds. State the amount of ujrah or nisbah of profit sharing.

i. Underwriting surplus allocation.
State the percentage of underwriting surplus allocation for tabarru' funds, Participant investment funds, and/or the company.
9. Risk Profile Data.
a. Premium/Contribution rates
(based on risk profile data, interest rates/discount rates, mortality tables, and/or morbidity tables). State the Premium/Contribution rates based on risk profile data, interest rates/discount rates, mortality tables, and/or morbidity tables. b. Estimated investment returns from Premium/Contribution. State the estimated investment returns of Premium/Contribution.
c. Percentage (%) of acquisition
costs.
State the percentage (%) of acquisition costs based on data for 3 (three) https://jdih.ojk.go.id/

last year for similar Insurance Products. d. Percentage (%) of administrative and general costs.
State the percentage (%) of administrative and general costs based on data from the last 3 (three) years for similar Insurance Products. e. Profit margin. State the profit margin based on data from the last 5 (five) years for similar Insurance Products.

Composition of Gross Premium/Contribution (total a+b+c+d+e = 100%)
a. Pure Premium/Contribution (%).
State the allocation of Pure Premium/Contribution in percentage (%) and the total composition of Premium/Contribution must be 100% (one hundred percent). b. Acquisition costs (%). State the allocation of acquisition costs in percentage (%) and the total composition of Premium/Contribution must be 100% (one hundred percent).
c. Administrative costs (%). State the allocation of administrative costs in percentage (%) and the total composition of Premium/Contribution must be 100% (one hundred percent).
d. Profit margin (%). State the allocation of profit margin in percentage (%) and the total composition of Premium/Contribution must be 100% (one hundred percent). e. Others (%). State the allocation of other costs in percentage (%) if any and specify.
Assumption of Interest Rate/Discount Rate.
a. Calculation of Premium/Contribution.
Describe the magnitude of the interest rate assumption in the calculation of Premium/Contribution. b. Calculation of technical reserves/technical provisions. Describe the magnitude of the interest rate assumption in the calculation of technical reserves/technical provisions. https://jdih.ojk.go.id/
Type of Mortality or Morbidity Table.
a. Calculation of Premium/Contribution.
State the type of mortality or morbidity table used as the basis for the calculation of Premium/Contribution. b. Calculation of technical reserves/technical provisions. State the type of mortality or morbidity table used as the basis for the calculation of technical reserves/technical provisions.
Description of Reinsurance Support.
a. Identity of Reinsurance Company.
State at least 2 (two) names of reinsurers providing treaty reinsurance support, and their rating (if any). In the event that reinsurance support is obtained from foreign reinsurers, state the reasons/considerations of the company. b. Type of reinsurance. State the type of reinsurance used (e.g., surplus, quota share, excess of loss, etc.).
c. Amount of self-retention. State the amount of self-retention.
Marketing Description.
a. Distribution channels. Select the distribution channel according to the provided classification. b. Marketing Media. Describe the marketing media used (e.g., telemarketing, scratch card, website, brochure, etc.).
c. Marketing Target. Select the marketing target according to the provided classification.
Specifically for changes.
a. Name of the initial Insurance Product according to the approval letter or report.
State the name of the initial Insurance Product according to the approval letter or report (specifically for name changes). b. Number of approval letter or report. State the number of the approval letter or report for the Insurance Product before the change. https://jdih.ojk.go.id/

Note:
*) filled specifically for Sharia Insurance Companies submitted in softcopy, then arranged in spreadsheet format.

c. Date of approval letter or report.
State the date of the approval letter or report for the Insurance Product before the change. d. Brief explanation regarding the change of Insurance Product. Describe briefly regarding the Insurance Product before and after the change. https://jdih.ojk.go.id/

Part B.II

Premium/Contribution Rate Calculation:
a. Formula for calculating Pure Premium/Contribution calculated based on risk profile, interest rate/discount rate, mortality table, and/or morbidity table. b. Estimated investment results from Premium/Contribution.
c. Cost or loading assumptions (acquisition costs, administrative costs, and other general costs) and profit margin.
d. Gross Premium/Contribution range. e. Sum insured/membership amount range. f. Interest rate/investment yield rate used to calculate Premium/Contribution (including an explanation regarding the basis for setting the interest rate/discount rate, which considers historical investment results). g. Type of mortality or morbidity table used.
Formula for Calculating Cash Value (for Insurance Products containing cash value).
Formula for Calculating Technical Reserves/Technical Provisions
a. Formula for Premium/Contribution reserves/provisions. b. Formula for claim reserves/provisions.

Note: The Premium/Contribution components in B.II must correspond to the Premium/Contribution components in B.I. https://jdih.ojk.go.id/

Part B.III

Describe additional information regarding the Insurance Product requested for approval/reported)

Note:
a)
Business Line
Personal Accident
Health
Yearly Term
Term Life
Endowment
Endowment Combination
Whole Life
Whole Life Combination
General Annuity
Pension Fund Annuity
PAYDI
Others

b)
Type of Insurance Product 1
Standard
Non-standard

c)
Type of Insurance Product 2
Individual (individual)
Group (group)

d)
Type of Insurance Product 3
Traditional products
Non-traditional products

e)
Type of Insurance Product 4
PAYDI - unitized (unit link)
PAYDI – non-unitized

f)
Underwriting Type
Guaranteed acceptance
Non-guaranteed acceptance
Simplified underwriting

g)
Currency
Rupiah
USD
Others https://jdih.ojk.go.id/

This copy is consistent with the original
Director of Legal Development
Legal Department
Aat Windradi

h)
Distribution Channel
Directly (direct marketing)
Insurance agents
Bancassurance
Non-Bank Financial Institutions (specify....)
Marketing personnel (specifically for Micro Insurance Products)

i)
Marketing Target
Individual Policyholders
Non-Individual Policyholders (companies, etc.)
Individual and Non-Individual Policyholders (companies, etc.)

Established in Jakarta on October 29, 2024
EXECUTIVE HEAD OF INSURANCE, INSURANCE GUARANTEE, AND PENSION FUND SUPERVISOR, FINANCIAL SERVICES AUTHORITY OF THE REPUBLIC OF INDONESIA, OGI PRASTOMIYONO

signed signed https://jdih.ojk.go.id/

APPENDIX V
CIRCULAR LETTER OF THE FINANCIAL SERVICES AUTHORITY OF THE REPUBLIC OF INDONESIA NUMBER 14/SEOJK.05/2024 REGARDING APPROVAL AND REPORTING OF INSURANCE PRODUCTS https://jdih.ojk.go.id/

I. OPINION OF THE SHARIA SUPERVISORY BOARD (DPS)
Insurance Product Name: ………………………
(the name of the Insurance Product to be marketed has met the requirements using the words Islamic insurance, sharia insurance/takaful, other synonymous words, or words characterizing the activities of Sharia Insurance Companies) No. Description Opinion

Insurance Products must be based on fatwas from institutions having authority in setting fatwas in the field of Sharia.
The conformity of Insurance Products with fatwas or statements of Sharia conformity from institutions having authority in setting fatwas in the field of Sharia, at least covering:
a. Insurance Policy; b. the contract used has met the characteristics of the implementation of Insurance Products;
c. the object and purpose of risk management;
d. policies and procedures for asset management; e. the conformity of the determination of Contributions with the contract used; and/or f. the termination of membership and the determination of costs in the termination of membership.
Standard operating procedures for Insurance Products regarding the fulfillment of Sharia principles.
The results of the review of the concept of contracts/Insurance Policies/Request for Islamic Insurance (SPPAS)/Request for Islamic Life Insurance (SPAJS)/Management of Premiums/Contributions for such Insurance Products have met the fulfillment of Sharia principles.
Conclusion:
…………………………………………………………………………………........……..
………………………………………………………………………………………….......
… (filled with city name, date, month, and year) Chairman of the Sharia Supervisory Board signature (name) https://jdih.ojk.go.id/

II. STATEMENT OF THE SHARIA SUPERVISORY BOARD
REGARDING INSURANCE PRODUCTS ... (FILLED WITH THE NAME OF THE INSURANCE PRODUCT) Bismillahirrahmanirrahim, In connection with the request for approval/reporting of Insurance Products ... (filled with the name of the Insurance Product requested for approval/reporting) by ...... (filled with the name of the Sharia Insurance Company), we as the Sharia Supervisory Board of ...... (filled with the name of the Sharia Insurance Company) have:
a. studied Insurance Policies, Insurance Product specifications, media and marketing methods, asset management policies, and accounting policies; and b. discussed with management regarding Insurance Policies, Insurance Product specifications, media and marketing methods, asset management policies, and accounting policies, for such Insurance Products. Based on the results of the study and discussion, we state that Insurance Products ... (filled with the name of the Insurance Product requested for approval/reporting) have met Sharia principles. This statement is made truthfully and all provisions of Insurance Products … have met statutory regulations. If it is later found that this statement is incorrect, we are willing to be responsible and may be subject to sanctions in accordance with statutory regulations. … (filled with city name, date, month, and year) Chairman of the Sharia Supervisory Board signature (name) Members of the Sharia Supervisory Board Members of the Sharia Supervisory Board signature signature (name) (name) *)Note:

The objects studied and discussed by the Sharia Supervisory Board can be expanded and detailed more specifically according to the needs in this statement.
For Joint Insurance Products, the Sharia Supervisory Board's statement letter is signed by the Sharia Supervisory Board of the Sharia Insurance Company or the Sharia unit of the Insurance Company as the chairman and members in the implementation of Joint Insurance Products.
https://jdih.ojk.go.id/

This copy is consistent with the original
Director of Legal Development
Legal Department
Aat Windradi

Established in Jakarta on October 29, 2024
EXECUTIVE HEAD OF INSURANCE, INSURANCE GUARANTEE, AND PENSION FUND SUPERVISOR, FINANCIAL SERVICES AUTHORITY OF THE REPUBLIC OF INDONESIA, OGI PRASTOMIYONO

signed signed https://jdih.ojk.go.id/

APPENDIX VI
CIRCULAR LETTER OF THE FINANCIAL SERVICES AUTHORITY OF THE REPUBLIC OF INDONESIA NUMBER 14/SEOJK.05/2024 REGARDING APPROVAL AND REPORTING OF INSURANCE PRODUCTS https://jdih.ojk.go.id/

MATRIX COMPARISON OF INSURANCE PRODUCTS
BEFORE AND AFTER CHANGES
(SPECIFICALLY FOR INSURANCE PRODUCTS THAT HAVE BEEN MARKETED BEFORE) No. Category/Type of Change Background of Change Impact of Change Documents that Changed Before Change After Change

Example of category/type of change, including: insurance benefits, excluded risks, costs, interest rate assumptions, premium rates, sum insured, validity period, distribution channels, claim requirement documents, dispute clauses.
Can be filled by stating information including whether the submission of Insurance Product changes is an initiation of the Insurance Company/Sharia Insurance Company or a request/recommendation from OJK. Can be filled by stating the impact of changes, including whether the changes affect new Policyholders and/or existing Policyholders or not. 2. 3. etc. We, the undersigned, hereby state that the matrix above is consistent with the actual situation and has been completed with sufficient documents. … (filled with city name, date, month, and year) Board of Directors specializing in Insurance Product Development (filled with job title) Company Actuary (filled with Insurance Company name) signature signature (name) (name and registration number) *)Note: for Joint Insurance Products, the Insurance Product comparison matrix is signed by the Board of Directors and Company Actuary of the Insurance Company/Sharia Insurance Company as the chairman in the implementation of Joint Insurance Products. https://jdih.ojk.go.id/

This copy is consistent with the original
Director of Legal Development
Legal Department
Aat Windradi

Established in Jakarta on October 29, 2024
EXECUTIVE HEAD OF INSURANCE, INSURANCE GUARANTEE, AND PENSION FUND SUPERVISOR, FINANCIAL SERVICES AUTHORITY OF THE REPUBLIC OF INDONESIA, OGI PRASTOMIYONO

signed signed https://jdih.ojk.go.id/

APPENDIX VII
CIRCULAR LETTER OF THE FINANCIAL SERVICES AUTHORITY OF THE REPUBLIC OF INDONESIA NUMBER 14/SEOJK.05/2024 REGARDING APPROVAL AND REPORTING OF INSURANCE PRODUCTS https://jdih.ojk.go.id/

STATEMENT LETTER OF COMPANY ACTUARY AND DIRECTORS OF INSURANCE COMPANY OR SHARIA INSURANCE COMPANY REGARDING THE REPORTING OF INSURANCE PRODUCT IMPLEMENTATION

I. STATEMENT OF COMPANY ACTUARY REGARDING THE REPORTING OF INSURANCE PRODUCT IMPLEMENTATION
We, the undersigned, hereby state that the calculation of Premium/Contribution and technical reserves/technical provisions for Insurance Products … [filled with the name of the Insurance Product reported] has met statutory regulations and is based on reasonable assumptions and general insurance practices. This statement is made truthfully and all provisions of Insurance Products have met statutory regulations. If it is later found that this statement is incorrect, we are willing to be responsible and may be subject to sanctions in accordance with statutory regulations. … (filled with city name, date, month, and year) Company Actuary (filled with Insurance Company name) signature (name and registration number) *)Note: for Joint Insurance Products, the Company Actuary's statement letter is signed by the Company Actuary of the Insurance Company/Sharia Insurance Company as the chairman and members in the implementation of Joint Insurance Products. https://jdih.ojk.go.id/

II. STATEMENT OF THE BOARD OF DIRECTORS REGARDING THE REPORTING OF INSURANCE PRODUCT IMPLEMENTATION
We, the undersigned, hereby state that Insurance Products … [filled with the name of the Insurance Product reported] are included in the business plan of the Insurance Company/Sharia Insurance Company which has been approved by the Board of Commissioners and communicated to Shareholders. This statement is made truthfully and all provisions of Insurance Products have met statutory regulations. If it is later found that this statement is incorrect, we are willing to be responsible and may be subject to sanctions in accordance with statutory regulations. … (filled with city name, date, month, and year) Board Member specializing in Insurance Product Development (filled with job title) signature (name) *)Note: for Joint Insurance Products, the Board of Directors' statement letter is signed by the Board Member specializing in Insurance Product Development on the Insurance Company/Sharia Insurance Company as the chairman and members in the implementation of Joint Insurance Products. https://jdih.ojk.go.id/

III. STATEMENT OF COMPANY ACTUARY AND DIRECTORS OF INSURANCE COMPANY OR SHARIA INSURANCE COMPANY
We, the undersigned, hereby state that:

in the context of reporting Insurance Products, we have conducted analyses with results as stated in the self-assessment form below; and
the results of the analysis are consistent with the actual situation and have been completed with sufficient documents.
… (filled with city name, date, month, and year) Board Member specializing in Insurance Product Development (filled with job title) Company Actuary (filled with Insurance Company/Sharia Insurance Company name) signature signature (name) (name and registration number) *)Note: for Joint Insurance Products, the statement letter is signed by the Board of Directors and Company Actuary of the Insurance Company/Sharia Insurance Company as the chairman in the implementation of Joint Insurance Products. https://jdih.ojk.go.id/

IV. ASSESSMENT FORM FOR REPORTING INSURANCE PRODUCT IMPLEMENTATION
GENERAL INFORMATION
Name of Insurance Company, Sharia Insurance Company, or Sharia unit on Insurance Company Filled with the name of the Insurance Company, Sharia Insurance Company, or Sharia unit on Insurance Company *for Insurance Products other than Joint Insurance Products Chairman:
Members:
Filled with the name of the Insurance Company/Sharia Insurance Company that is the chairman and members *for Joint Insurance Products Name and Phone/email Contact Person Technical PIC:
Board Member specializing in Insurance Product Development:
Name of Insurance Product
Date First Time Insurance Product was Marketed Classification/Business Line Marketing Target Insurance Product Filled with Policyholder Data Individual Policyholders Non-Individual Policyholders (Companies, etc.) Individual and Non-Individual Policyholders (Companies, etc.) Brief Description of Insurance Product https://jdih.ojk.go.id/

NO. DESCRIPTION YES NO NOTES
I PRELIMINARY ANALYSIS

Name of Insurance Product
The name of the Insurance Product to be marketed meets the requirements:
State the name of the Insurance Product to be reported.
The name of the Insurance Product must be used consistently in all Insurance Product reporting documents. a. using the words insurance, insurance, other synonymous words, or words characterizing the activities of Insurance Companies; b. using the words Islamic insurance, sharia insurance/takaful, other synonymous words, or words characterizing the activities of Sharia Insurance Companies;
c. not causing interpretations that the product is not an Insurance Product; and
d. consistent with the name of the Insurance Product when reported to the Financial Services Authority.
Insurance Products are included in the business plan of the Insurance Company/Sharia Insurance Company
State the period and date of submission of the business plan of the Insurance Company/Sharia Insurance Company. For Joint Insurance Products, information is filled with the period and date of submission of the business plan of each Insurance Company or Sharia Insurance Company combined in the implementation of Joint Insurance Products.

II ANALYSIS OF DOCUMENT COMPLETENESS

Results of self-identification and assessment that have received determination from the Insurance Product Development Committee.
Attach the results of self-identification and assessment as referred to in Appendix I.
Cover letter signed by the Board of Directors of the Insurance Company/Sharia Insurance Company.
Attach the cover letter.
Description of Insurance Product. Attach
Description of Insurance Product as referred to in Appendix IV.
Specimen of Insurance Policy. Attach:

Insurance Policy provisions;
summary of Insurance Policy accompanied by dummy coverage/membership data;
Insurance Policy certificate/membership proof accompanied by dummy coverage/membership data (specifically for Group Insurance Products); and
example list of Insured/Participants accompanied by dummy coverage/membership data (specifically for Group Insurance Products).

Statement letter of Company Actuary.
Consistent with the Statement letter of Company Actuary as referred to above.
Statement letter of the Board of Directors.
Consistent with the Statement letter of the Board of Directors as referred to above.
Summary of Insurance Product and/or Service Information (RIPLAY).
Attach example:
a. RIPLAY general version; and b. RIPLAY personal version consistent with the format in the RIPLAY Standard Guidelines for the Financial Services Sector. RIPLAY is not a contract document and differs from offer documents such as brochures and leaflets as well as differing from the Description of Insurance Products. In the event of marketing Insurance Products through remote communication media such as telemarketing, the information contained in the telemarketing script contains minimum information required in the RIPLAY Standard Guidelines for the Financial Services Sector.
Example of Request for Insurance/Islamic Insurance (SPPA/SPPAS) or Request for Life Insurance/Islamic Life Insurance (SPAJ/SPAJS).
Attach example SPPA/SPPAS/SPAJ/SPAJS.
In the event of marketing Insurance Products through remote communication media, the attached documents include:
life insurance or Islamic insurance closing flow in the form of screenshots if marketed digitally/electronically; and
telemarketing script if marketed through telemarketing.
Opinion from the Sharia Supervisory Board. Attach the opinion of the Sharia Supervisory Board as referred to in Appendix V.
Cooperation documents for the implementation of Joint Insurance Products.
Attach cooperation documents for the implementation of Joint Insurance Products.

III COMPLIANCE AND SUBSTANTIVE ANALYSIS

Object of Coverage/Membership
a. provides protection from at least 1 (one) type of insurable risk; https://jdih.ojk.go.id/

b. consistent with the business scope of general insurance companies/general Sharia insurance companies and consistent with general insurance principles; State the general insurance/Sharia general insurance business line consistent with the classification as referred to in Appendix IV.

c. consistent with the business scope of life insurance companies/life Sharia insurance companies and consistent with:

general insurance principles; and
Sharia principles.
State the life insurance/life Sharia insurance business line consistent with the classification as referred to in Appendix IV.

Specimen of Insurance Policy
a. benefits agreed upon in the Insurance Policy have met the Description of Insurance Products; State the article in the Insurance Policy that regulates it.

b. has stated the amount of Premium/Contribution rates; Premium/Contribution rates are stated in the Specimen of Insurance Policy.

c. provisions in the Insurance Policy at least contain the following:

General Provisions.
a) time of commencement and termination of coverage/membership; State the article in the Insurance Policy that regulates it.

b. description of agreed benefits and excluded risks, including magnitude, time, requirements, and conditions for providing benefits; State the article in the Insurance Policy that regulates it.

c. method and time of payment of Premium/Contribution;
State the article in the Insurance Policy that regulates it.

d. grace period for payment of Premium/Contribution; State the article in the Insurance Policy that regulates it.

e. use of equivalent exchange rates issued by Bank Indonesia at the time of payment for Insurance Policies with foreign currency if payment of Premium/Contribution and/or benefits are linked to the Rupiah currency; State the article in the Insurance Policy that regulates it. The exchange rate used for Insurance Policies with foreign currency must be an equivalent exchange rate issued by Bank Indonesia at the time of payment.

f. time recognized as the time of receipt of payment of Premium/Contribution; State the article in the Insurance Policy that regulates it.

g. policies of the Insurance Company or Sharia Insurance Company established if payment of Premium/Contribution is made after the agreed grace period; State the article in the Insurance Policy that regulates it.

h. period during which the Insurance Company or Sharia Insurance Company cannot review the validity of insurance contracts on Life or Health Insurance Products with coverage/membership periods longer than 1 (one) year; State the article in the Insurance Policy that regulates it.

i. cash value table, for Insurance Products having guaranteed cash values according to the Insurance Policy;
State the article in the Insurance Policy that regulates it. https://jdih.ojk.go.id/

j) calculation of the cash value amount for Insurance Products that have cash value benefits whose amounts are not guaranteed according to the Insurance Policy; Mention the article in the Insurance Policy that regulates it. k) calculation of Insurance Policy dividends or similar, for Insurance Products marketed by life insurance companies, Shariah life insurance companies, or Shariah units of life insurance companies that promise Insurance Policy dividends or similar; Mention the article in the Insurance Policy that regulates it. l) termination of coverage/membership, both from the Insurance Company/Shariah Insurance Company and from the Policyholder, Insured, or Participant, including conditions, causes, obligations of each party, and rights or benefits obtained by the Policyholder, Insured, or Participant; Mention the article in the Insurance Policy that regulates it. m) conditions and procedures for filing claims, including relevant supporting evidence required in the claim submission; Mention the article in the Insurance Policy that regulates it. n) procedures and timeframes for claim settlement and payment; Mention the article in the Insurance Policy that regulates it. o) dispute resolution at least containing dispute resolution mechanisms in court and out of court, and choice of venue Mention the article in the Insurance Policy that regulates it. Dispute resolution out of court; court resolution is conducted through an Alternative Dispute Resolution Institution (LAPS) which is included in the list of LAPS determined by the Financial Services Authority. Dispute resolution in court, including through religious courts, for Shariah Insurance Companies. p) language used as reference in the event of disputes or differences of opinion, for Insurance Policies printed in 2 (two) or more languages; Mention the article in the Insurance Policy that regulates it. q) procedures for resolving complaints from Policyholders, Insured, or Participants; Mention the article in the Insurance Policy that regulates it. r) policy review period for Insurance Products that have a period longer than 1 (one) year; and Mention the article in the Insurance Policy that regulates it. s) waiting period if any; Mention the article in the Insurance Policy that regulates it. t) Rights and obligations of the principal in suretyship or Shariah suretyship agreements; and Mention the article in the Insurance Policy that regulates it. u) Rights and obligations of the obligee in suretyship or Shariah suretyship agreements. Mention the article in the Insurance Policy that regulates it.
2) Application of Shariah insurance contracts in the Insurance Policy

Contracts used:
a) tabarru’ contract among Participants;
Does not apply to Shariah suretyship products.
Mention the article in the Insurance Policy that regulates it. b) kafalah bil ujrah contract; Specific to Shariah suretyship products. Mention the article in the Insurance Policy that regulates it c) tanahud contract among Participants; Only applies to insurance products that provide cash value from tanahud funds. Mention the article in the Insurance Policy that regulates it d) wakalah bil ujrah contract between Participants and Shariah Insurance Companies or Shariah units of Insurance Companies in activities other than investment; Does not apply to Shariah suretyship products. Mention the article in the Insurance Policy that regulates it. e) wakalah bil ujrah, mudharabah, or mudharabah musytarakah contracts between Participants and Shariah Insurance Companies or Shariah units of Insurance Companies in investment activities other than Participant investment funds and tanahud funds (including tabarru’ funds); Does not apply to Shariah suretyship products. Mention the article in the Insurance Policy that regulates it. f) wakalah bil ujrah, mudharabah, or mudharabah musytarakah contracts between Participants and Shariah Insurance Companies or Shariah units of Insurance Companies in investment activities for Participant investment funds or tanahud funds. Only applies to insurance products that provide cash value from tanahud funds or Participant investment funds. Mention the article in the Insurance Policy that regulates it.
rights, obligations, and authority of each party based on the agreed contract:
a) rights of individual Participants in the tabarru’ contract, including to obtain insurance benefits, distribution of underwriting surplus and/or to receive a portion of the Contribution in the event the Insurance Policy is cancelled; Does not apply to Shariah suretyship products. Mention the article in the Insurance Policy that regulates it. b) rights of individual Participants in the tanahud contract, including to obtain insurance benefits, and/or to receive a portion of the Contribution in the event the Insurance Policy is cancelled; Only applies to insurance products that provide cash value from tanahud funds. Mention the article in the Insurance Policy that regulates it. c) rights of collective Participants in the tabarru’ contract, including to obtain investment results and underwriting surplus; Does not apply to Shariah suretyship products. Mention the article in the Insurance Policy that regulates it. d) rights of collective Participants in the tanahud contract, including to obtain investment results; and Only applies to Insurance Products that provide cash value from tanahud funds. Mention the article in the Insurance Policy that regulates it. e) obligations of Participants individually or collectively in tabarru’, tanahud, kafalah, wakalah bil ujrah, mudharabah, and mudharabah musytarakah contracts, including paying Contributions and providing remuneration to Shariah Insurance Companies or Shariah units of Insurance Companies. Mention the article in the Insurance Policy that regulates it.
rights and obligations of Shariah Insurance Companies or Shariah units of Insurance Companies:
a) rights of Shariah Insurance Companies in the wakalah bil ujrah contract for activities other than investment, including to obtain ujrah; Does not apply to Shariah suretyship products. Mention the article in the Insurance Policy that regulates it. b) rights of Shariah Insurance Companies or Shariah units of Insurance Companies in the wakalah bil ujrah, mudharabah, or mudharabah musytarakah contracts for investment activities of tabarru’ funds, including to obtain ujrah or investment profit sharing; Does not apply to Shariah suretyship products. Mention the article in the Insurance Policy that regulates it. c) obligations of Shariah Insurance Companies or Shariah units of Insurance Companies in the wakalah bil ujrah, mudharabah, and mudharabah musytarakah contracts for activities other than investment and investment activities of tabarru’ funds and/or investment of tanahud funds, including to execute powers of attorney given by Participants and to bear losses caused by intentional errors, negligence, or breach of contract by Shariah Insurance Companies or Shariah units of Insurance Companies; and d) authority given by Participants individually and/or collectively to Shariah Insurance Companies or Shariah units of Insurance Companies, including conducting marketing activities, underwriting, administration, risk portfolio management, fund management, claim payment, investment of tabarru’ funds and/or investment of tanahud funds. Mention the article in the Insurance Policy that regulates it.
Amount of Contributions allocated to:
a) tabarru’ funds; Mention the article in the Insurance Policy that regulates it. b) tanahud funds; Mention the article in the Insurance Policy that regulates it. c) ujrah; and Mention the article in the Insurance Policy that regulates it. d) Participant investment funds. Mention the article in the Insurance Policy that regulates it.
amount, time, and method of payment of investment profit sharing in the event Insurance Products use mudharabah or mudharabah musytarakah contracts;
Does not apply to Shariah suretyship products.
Mention the article in the Insurance Policy that regulates it.
amount, time, and method of deduction of ujrah in the event of using wakalah bil ujrah contracts;
Does not apply to Shariah suretyship products.
Mention the article in the Insurance Policy that regulates it.
allocation of use of underwriting surplus for tabarru’ funds, Participant investment funds, and/or Shariah Insurance Companies or Shariah units of Insurance Companies; and
Does not apply to Shariah suretyship products.
Mention the article in the Insurance Policy that regulates it.
obligations of Shariah Insurance Companies or Shariah units of Insurance Companies to provide qardh in the event tabarru’ funds are insufficient to pay insurance benefits/claims.
Does not apply to Shariah suretyship products.
Mention the article in the Insurance Policy that regulates it. d. The specimen of the Insurance Policy has stated commissions/remuneration to insurance agents/marketing personnel/brokerage services for the marketing of Insurance Products, in the event Insurance Companies/Shariah Insurance Companies provide commissions/remuneration to third parties in the marketing of Insurance Products. Mention the section in the Insurance Policy that regulates it. In the event Insurance Companies/Shariah Insurance Companies market Insurance Products through insurance agents, marketing personnel, brokerage services, or third parties for the marketing of Insurance Products, attach a section of the Insurance Policy that states the portion of Premiums/Contributions received by the Insurance Company/Shariah Insurance Company and passed on to insurance agents, marketing personnel, brokerage services, or third parties for the marketing of Insurance Products. e. There is a statement that "This Agreement/Insurance Policy has been drafted in accordance with statutory regulations including Financial Services Authority regulations" Mention the section in the Insurance Policy that regulates it.

Summary of Insurance Product and/or Service Information (RIPLAY)
a. The Summary of Insurance Product and/or Service Information drafted has included all information required by statutory regulations. b. Insurance Companies/Shariah Insurance Companies have submitted the general RIPLAY.
c. Insurance Companies/Shariah Insurance Companies have submitted the personal RIPLAY.
d. The drafted RIPLAY has included at least:

name and/or logo of the Insurance Company/Shariah Insurance Company;
name of the Insurance Product marketed;
statement that the Insurance Company/Shariah Insurance Company is licensed and supervised by the Financial Services Authority;
amount and period of Premium/Contribution payment;
amount and timing of fee imposition (including acquisition costs);
summary data;
benefits;
risks;
insurance period;
requirements and procedures for filing claims;
simulation/illustration and/or historical data/performance realization;
service procedures and complaint resolution;
contracts used, for Shariah Insurance Products;
information regarding the provision of commissions by Insurance Companies/Shariah Insurance Companies to marketing parties;
procedures for claim settlement and payment;
contact from the Insurance Company/Shariah Insurance Company that can be contacted by Policyholders, Insured/Participants;
statement that there are terms and conditions that apply; and
other additional information.

Information in the Insurance Request Form (SPPA) or Shariah Insurance Request Form (SPPAS)
SPPA for general insurance companies or SPAJ for life insurance companies; or
Attach an example of SPPA/SPAJ that contains items including:
a. identity of the Insured; b. information regarding the suitability between the Insured's profile and the offered Insurance Product*); and
c. a statement containing the truth of identity and the source of funds of the beneficial owner.
*) not applicable to Micro Insurance Products
SPPAS for general Shariah insurance companies or SPAJS for Shariah life insurance companies.
Attach an example of SPPAS/SPAJS that contains items including:
a. identity of the Participant; b. information regarding the suitability between the Participant's profile and the offered Insurance Product*); a. a statement containing the truth of identity and the source of funds of the beneficial owner;
c. approval of the tabarru’ contract and/or tanahud contract among Participants, including the amount of tabarru’ and/or tanahud Contributions*);
d. approval of the wakalah bil ujrah contract with Shariah Insurance Companies in activities other than investment, including the amount of ujrah*); e. approval of the wakalah bil ujrah, mudharabah, or mudharabah musytarakah contracts with companies in the management of tabarru’ funds investment, including the amount of ujrah or investment profit sharing*); f. approval of the use of underwriting surplus*); and g. approval of the kafalah bil ujrah contract in Shariah suretyship, including the amount of ujrah or service remuneration*) *) not applicable to Micro Insurance Products
Calculation of Premiums/Contributions
a. Insurance Companies, Shariah Insurance Companies, or Shariah units of Insurance Companies have established the amount of Premium/Contribution tariffs or service remuneration; b. the determination of Premium/Contribution or service remuneration components must be supported by reasonable data and/or assumptions and generally accepted insurance practices;
c. Premium/Contribution tariffs or service remuneration are in accordance with the promised benefits, established at levels that are sufficient, not excessive, and not established discriminatorily;
Mention the section in the Insurance Product description that contains the formulation of the calculation of Premiums/Contributions or service remuneration. d. there is a clear formulation in the risk calculation tariff, including relevance between risk profile data and risk tariffs; Mention the section in the Insurance Product description that contains the formulation of the calculation of Premiums/Contributions or service remuneration. e. the determination of Premium/Contribution or service remuneration calculations considers at least:

For general insurance companies/general Shariah insurance companies:
a) tariffs for risks calculated based on the loss profile (risk and loss profile) of the relevant insurance type for the last 5 (five) years; Explain the suitability between pure Premiums/Contributions and risk profile data as referred to in Appendix IV. b) acquisition costs; Mention the proportion of acquisition cost components in gross Premiums/Contributions or service remuneration. Acquisition costs for the first time are established at a maximum of 10% (ten percent) of the Premium/Contribution tariff. c) administrative costs; Mention the proportion of administrative cost components in gross Premiums/Contributions or service remuneration. d) other general costs; and Mention the proportion of other general cost components in gross Premiums/Contributions or service remuneration. e) profit. Mention the proportion of profit in gross Premiums/Contributions or service remuneration.
For life insurance companies/Shariah life insurance companies:
a) pure Premiums/Contributions calculated based on risk profile data, interest rates/discount rates, mortality tables, and/or morbidity tables; b) estimated investment returns from Premiums/Contributions; c) acquisition costs; Mention the proportion of acquisition cost components in gross Premiums/Contributions or service remuneration. d) administrative costs; Mention the proportion of administrative cost components in gross Premiums/Contributions or service remuneration. e) other general costs; and Mention the proportion of other general cost components in gross Premiums/Contributions or service remuneration. f) profit; Mention the proportion of profit in gross Premiums/Contributions or service remuneration.
Calculation of PAYDI Premiums/Contributions, Health Insurance Products, and/or Personal Accident Insurance Products marketed by general insurance companies/general Shariah insurance companies:
a) pure Premiums/Contributions calculated based on risk profile data, interest rates/discount rates, mortality tables, and/or morbidity tables; b) estimated investment returns from Premiums/Contributions; c) acquisition costs; Mention the proportion of acquisition cost components in gross Premiums/Contributions or service remuneration. d) administrative costs; Mention the proportion of administrative cost components in gross Premiums/Contributions or service remuneration. e) other general costs; and Mention the proportion of other general cost components in gross Premiums/Contributions or service remuneration. f) profit. Mention the proportion of profit in gross Premiums/Contributions or service remuneration. f. there is a clear formulation in the calculation of cost components in the calculation of Premiums/Contributions or service remuneration or including relevance between cost data and the cost tariffs established by Insurance Companies/Shariah Insurance Companies for the Insurance Products whose approval is requested; and Mention the section in the Insurance Product description that contains the formulation of the calculation of Premiums/Contributions or service remuneration. g. the methodology for calculating Premiums/Contributions or service remuneration for the reported Insurance Products has been in accordance with generally accepted and commonly used insurance principles (best practice and common practice).

Insurance Products Marketed Jointly
a. Insurance Companies/Shariah Insurance Companies fulfill written agreements that include:

membership composition, including Insurance Companies/Shariah Insurance Companies that serve as chairmen who will coordinate the marketing activities of Joint Insurance Products;
rights and obligations of each Insurance Company/Shariah Insurance Company participating in the implementation of Joint Insurance Products, namely:
a) duties of Insurance Companies/Shariah Insurance Companies serving as chairmen; and b) obligations of parties to maintain the confidentiality of Policyholder, Insured, or Participant data;
specifications and design of Joint Insurance Products that are the object of the agreement or marketing;
risks covered/managed by each Insurance Company/Shariah Insurance Company;
clauses regarding procedures or methods for:
a) insurance applications; b) risk selection (underwriting) and determination of Premiums/Contributions; c) acceptance of Premiums/Contributions from Policyholders, Insured, or Participants; d) forwarding of Premiums/Contributions to all Insurance Companies or Shariah Insurance Companies participating in the implementation of Joint Insurance Products; e) claim settlement and payment; and f) resolution of complaints from Policyholders, Insured, or Participants;
duration of the cooperation agreement for the implementation of Joint Insurance Products;
dispute resolution procedures between Insurance Companies/Shariah Insurance Companies participating in the implementation of Joint Insurance Products; and
conditions causing the termination of the agreement.
b. The written agreement document for the marketing of Joint Insurance Products has been signed by the Board of Directors of each Insurance Company/Shariah Insurance Company participating in the marketing of Joint Insurance Products. IV CONCLUSION All insurance product reporting requirements have been met. This copy is in accordance with the original Director of Legal Development Legal Department Aat Windradi Established in Jakarta on October 29, 2024 EXECUTIVE HEAD OF INSURANCE, GUARANTEE, AND PENSION FUND SUPERVISOR FINANCIAL SERVICES AUTHORITY REPUBLIC OF INDONESIA, OGI PRASTOMIYONO signed signed https://jdih.ojk.go.id/

APPENDIX VIII
CIRCULAR LETTER OF THE FINANCIAL SERVICES AUTHORITY REPUBLIC OF INDONESIA NUMBER 14/SEOJK.05/2024 CONCERNING APPROVAL AND REPORTING OF INSURANCE PRODUCTS https://jdih.ojk.go.id/

INSURANCE PRODUCT CESSATION REPORT FORM

I. INSURANCE PRODUCT CESSATION REPORT
(place), (date, month, and year)
Number :
Attachment :
To the Financial Services Authority
Attn: Director of Licensing for Insurance, Guarantee, and Pension Funds Subject : Insurance Product Cessation Report In relation to the above matter, we hereby submit the report on the cessation of the Insurance Product as follows:

Insurance Product Business Line : …………………………………………
Name of Insurance Product : …………………………………………
Date of Insurance Product Cessation : …………………………………………
As consideration material, we hereby submit supporting documents as required by the attached checklist. This report is submitted, thank you for your attention. … (fill in city name, date, month, and year) Director in charge of Insurance Product Development (fill in job title) Company Actuary (fill in Insurance Company name) signature signature (name) (name and registration number) *)Note: for Joint Insurance Products, the insurance product cessation report form is signed by the Board of Directors and Company Actuary of the Insurance Company/Shariah Insurance Company serving as the chairman in the implementation of the Joint Insurance Product. https://jdih.ojk.go.id/

This copy is in accordance with the original
Director of Legal Development
Legal Department
Aat Windradi
II. INSURANCE PRODUCT CESSATION DOCUMENT CHECKLIST
No. Document Check Description

Explanation regarding the reasons for ceasing the marketing of the Insurance Product;
Board of Directors' statement regarding responsibility for the decision to cease the marketing of the Insurance Product; and
Data of active Insurance Policies.
We, the undersigned, hereby state that the above checklist is in accordance with the actual situation and has been completed with sufficient documents. … (fill in city name, date, month, and year) Director in charge of Insurance Product Development (fill in job title) Company Actuary (fill in Insurance Company name) signature signature (name) (name and registration number) *)Note: for Joint Insurance Products, the insurance product cessation document checklist is signed by the Board of Directors and Company Actuary of the Insurance Company/Shariah Insurance Company serving as the chairman in the implementation of the Joint Insurance Product. Established in Jakarta on October 29, 2024 EXECUTIVE HEAD OF INSURANCE, GUARANTEE, AND PENSION FUND SUPERVISOR FINANCIAL SERVICES AUTHORITY REPUBLIC OF INDONESIA, OGI PRASTOMIYONO signed signed https://jdih.ojk.go.id/

APPENDIX IX
CIRCULAR LETTER OF THE FINANCIAL SERVICES AUTHORITY REPUBLIC OF INDONESIA NUMBER 14/SEOJK.05/2024 CONCERNING APPROVAL AND REPORTING OF INSURANCE PRODUCTS https://jdih.ojk.go.id/

This copy is in accordance with the original
Director of Legal Development
Legal Department
Aat Windradi
INSURANCE PRODUCT IMPLEMENTATION MATRIX
No. Criteria Approval Reporting Review/Testing 1.

never marketed; and
meets certain criteria.
✓ - ✓

previously marketed
but underwent material changes; and
meets certain criteria.
✓ - ✓

never marketed; and
does not meet certain criteria.
✓ ✓

previously marketed
but underwent material changes; and
does not meet certain criteria.
✓ ✓

previously marketed
but did not undergo material changes; and
meets certain criteria.
✓ -

previously marketed
but did not undergo material changes; and
does not meet certain criteria.

Established in Jakarta on October 29, 2024
EXECUTIVE HEAD OF INSURANCE, GUARANTEE, AND PENSION FUND SUPERVISOR FINANCIAL SERVICES AUTHORITY REPUBLIC OF INDONESIA, OGI PRASTOMIYONO signed signed https://jdih.ojk.go.id/

Approval and Reporting of Insurance Products

Lineage: In force

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