JANJI SUCI YANG TERKOYAK OLEH PIHAK KETIGA: PERLINDUNGAN KONSUMEN ATAS INTERVENSI POLIS ASURANSI KESEHATAN BERBASIS CO-PAYMENT OLEH OTORITAS JASA KEUANGAN (OJK) DITINJAU DARI TEORI KEPASTIAN HUKUM
DOI:
10.54443/sibatik.v4i11.3661Published:
2025-10-31Downloads
Abstract
This study examines the legal implications of the Financial Services Authority (OJK) Circular Letter No. 7 of 2025, which mandates a 10% Co-Payment system for all health insurance policyholders, including existing policies. Although the regulation aims to curb medical inflation and prevent moral hazard, it has sparked controversy for violating the principle of pacta sunt servanda—agreements must be kept—and for reducing consumer rights without consent. Using a normative legal approach, this research analyzes the legal standing of the circular within the framework of legal certainty and consumer protection theories. The findings indicate that Circular Letter 7/25 potentially exceeds its administrative authority, creates legal uncertainty, and contradicts the principles of consumer protection as stipulated in the Consumer Protection Law, the OJK Law, and the Insurance Law. The study emphasizes the need for a policy review to ensure a balance between the interests of the insurance industry and public welfare. It recommends that OJK coordinate with relevant ministries to address medical inflation through national healthcare cost regulation rather than by transferring additional financial burdens to policyholders.
Keywords:
Consumer protection legal certainty health insurance OJK Co-PaymentReferences
Achmad Irwan Hamzani. Tyas Vika Widyastuti. Nur Khasanah. Mohd Hazmi Mohd Rusli., “Implementation approach in legal research,” Int. J. Adv. Appl. Sci., vol. 13, no. 2 June 2024, p. 4, 2024.
Amin Ak, “Kebijakan Co-Payment Sistem Asuransi Kesehatan Swasta Harus Utamakan Keadilan dan Perlindungan Masyarakat,” J. Babel, vol. 1, no. June, 30 2025, p. 1, 2025.
Amylia Noor Alaysia & Labib Muttaqin, “Analisis Penerapan Asas Itikad Baik dan Pertanggungjawaban Para Pihak Terkait Wanprestasi dalam Perjanjian Kerja Sama Pemborongan Rumah,” J. Intepretasi Huk., vol. 4, no. 03 April 2023, p. 1, 2023.
Ariska Agustina & Prima Paramita & Evi Kusumastuti & Budi Hartono & Alfani Ghutsa Daud, “Health Insurance Model In The Prespective of Health Economics: Transformation, Regulation, And Implementation in Indonesia,” Int. J. Heal. Pharm., vol. 5, no. August 03, 2025, p. 4, 2025.
Aty Herawati dan Muhammad Haikal, “The Influence of Premiums, Claims and Profits on Risk Based Capital in Insurance Subsector Companies on the Indonesian Stock Exchange Period 2022-2023,” Econ. Financ. Account., vol. 5, no. 03 July 2024, p. 1, 2024.
Cahya E. Prasetyo & Ascobat Gani, “Medical cost inflation and its drivers in Indonesian employer-sponsored health insurance for retiree families,” Natl. Institutes Heal., no. 2025, May 8, p. 2, 2025.
Denis Ejikeme Igwe & Godwin Udoh Udoh, “LAW AND SOCIETY: A DISCOURSE ON LON FULLER’S PRINCIPLES OF LAW,” J. Philos., vol. 7, no. June 02, 2024, p. 8, 2024.
Deny Setiyo Utomo, “Kedudukan Surat Edaran Menteri Ketenagakerjaan Tentang Larangan Penahanan Ijazah Dalam Hukum Positif Indonesia,” J. Supremasi, vol. 15, no. 15 Februari 2025, p. 4, 2025.
Dwi Anindya Harimurti, “Eksistensi OJK Pada Lembaga Keuangan di Indonesia,” J. Ilmu Huk. Sos. dan Hum., vol. 1, no. 12 Januari 2024, p. 8, 2024.
F. Mubarak, M.R., Habim, N, & Edrisy, I, “Asas Keseimbangan dan Asas Kebebasan Berkontrak Pada Perjanjian Baku yang Menganut Konsep Take It or Leave It,” J. Huk. Leg., vol. 5, no. Dec 29, 2023, p. 8, 2023.
Faris Ali Sidqi, “Implementasi Asas Keseimbangan dan Asas Itikad Baik Dalam Suatu Perjanjian,” J. Huk. dan Sos., vol. 2, no. Juli-Desember 2024, p. 5, 2024.
Fasa Muhamad & Utang Rosidin & Elan Jaelani, “Perkembangan Tindak Pidana di Sektor Keuangan: Kewenangan Penyidikan Tunggal OJK,” J. Anal. Huk., vol. 6, no. 02 Juni 2023, p. 3, 2023.
Fauziah Fauziah & Anggi Irawan & Munjir Tamam, “Analisis Efektifitas Peraturan OJK Terhadap Perlindungan Konsumen Dalam Transaksi Pinjaman Online (PINJOL),” Surya Kencana Satu, vol. 16, no. 23-08–2025, p. 16, 2025.
Hengki Heriyadi, “TINJAUAN YURIDIS PERAN DAN FUNGSI OTORITAS JASA KEUANGAN (OJK) DALAM SISTEM KEUANGAN INDONESIA,” J. Huk. Progresif, vol. 11, no. 01 April 2023, p. 7, 2023.
Ibrahim Kholilul & Rizky Ronaldo & Reza Yamora, “Interrelationship Between Macroeconomic Variables With Insurance Premiums and Claims Lessons for Indonesia & Asean,” Asean Stud., vol. 11, no. 02 November 2023, p. 1, 2023.
Isdiana Syafitri & Sunarmi & Tan Kamello & Hasim Purba, “Contempory Legal Certainty in Insurance Default Claims: A Comparative Study of Islamic and Positive Law Perspectives,” Metro Islam. Law Rev., vol. 4, no. 01-04–2025, p. 2, 2025.
Jericho Jacsson Salur & Grace H. Tampongangoy & Edwin N. Tinangon, “Perlindungan Hukum Terhadap Pemegang Polis Asuransi Kesehatan Berdasarkan Hukum Positif di Indonesia,” Lex Priv., vol. 15, no. 2025-05–04, p. 5, 2025.
Joseph Hugo Vieri Iusteli Sola Kira & Richard C. Adam, “Penerapan Asas Kebebasan Berkontrak dalam Perjanjian Kemitraan dan Pengaruhnya Terhadap Praktik Persaingan Usaha Tidak Sehat,” J. Ilmu Huk., vol. 5, no. 02 Mei 2025, p. 3, 2025.
Keysha Nashwa Aulia & Ayu Lestari & Lika Mulki Latief & Noerma Kurnia Fajarwati, “Kepastian Hukum dan Keadilan Hukum dalam Pandangan Ilmu Komunikasi,” J. Sains Student Res., vol. 2, no. 01 Februari 2024, p. 6, 2024.
MG. Endang Sumiarni & Theresia Anita Christiani, “Reviewed From The Perspective of Insurance Customer Protection,” J. Law Sustain. Dev., vol. 11, no. 11 Desember 2023, p. 7, 2023.
Muhammad Ramadhani Kesuma et al, “Unveiling Sentiment and Financial Risks: OJK’s 10% Co-Payment in Health Insurance,” Ilmu Data J., vol. 7, no. 23 Juli 2025, p. 2, 2025.
Ni Putu Yuliana Kemalasari, “Legal Certainty of Abuse of Circumstances as Basis for Contract Cancellation in Indonesia,” J. Compr. Sci., vol. 3, no. 11 Maret 2024, p. 9, 2024.
Nikita Alia Rajebta & Anggraeni Dian Ciptaningrum & Riswandy Wasir, “Digitalisasi asuransi kesehatan: Peluang dan tantangan dalam meningkatkan efisiensi layanan kesehatan,” Indones. J. Heal. Sci., vol. 5, no. 20-05–2025, p. 2, 2025.
Otoritas Jasa Keuangan (OJK), Surat Edaran OJK Nomor 7 Tahun 2025 Tentang Penyelenggaraan Produk Asuransi Kesehatan. 2025.
Raihan Andhika Santoso & Elan Jaelani & Utang Rasidin, “Kedudukan dan Kekuatan Hukum Surat Edaran Mahkamah Agung (SEMA) Dalam Hukum Positif Indonesia,” J. Publ. Ilmu Huk., vol. 1, no. 04 Desember 2023, p. 5, 2023.
Ridwan Arifin & Cahya Wulandari & Indah Sri Utari & Tri Imam Munandar, “Discourse of Justice and Legal Certainty in Stolen Assets Recovery in Indonesia: Analysis of Radburch’s Formula and Friedman’s Theory,” J. Ilmu Huk. dan Konstitusi, vol. 3, no. 27 Des 2023, p. 7, 2023.
Seri Mughni Sulubara & T. Saiful Basri & Iskandar Iskandar, “Analisis Konstitusional terhadap perlindungan Hak Asasi Manusia dalam Sistem Hukum Indonesia,” J. Kabar Masy., vol. 2, no. 24 November 2024, p. 3, 2024.
Surono-Supardal, “Penerapan Gerakan Masyarakat Hidup Sehat Dalam Upaya Pencegahan dan Pengendalian Corona Virus Desease 2019 Pada Masa Transisi Menuju Endemi di Kabupaten Sleman,” Ilm. Hosp., vol. 12, no. 02 Desember 2023, p. 4, 2023.
Suryati Suryati & Agustianto gustianto, “Perlindungan Hukum Terhadap Nasabah Asuransi Kesehatan dalam Penyelesaian Klaim Polis Asuransi,” J. Pro Huk., vol. 12, no. 12 Maret 2023, p. 5, 2023.
Tajuddin Noor, “Aspek Yuridis Klaim Asuransi Kesehatan oleh Tertanggung: Studi Pada PT. Prudential Cabang Medan,” J. Huk. Lex Gen., vol. 6, no. 04 April 2025, p. 6, 2025.
Tri Reni Novita & M.Faisal Husna & Debbi Chyntia Ovami, “Perlindungan Hukum Bagi Nasabah Asuransi Kesehatan Berdasarkan Undang-Undang No.40 Tahun 2014,” UNES LAW Rev., vol. 6, no. 2023-12–06, p. 4, 2023.
Universitas Airlangga, “Medical Inflation reachers 13.6 percent; UNAIR expert urges strengthening of domestic pharmaceutical industry,” Unairnews, 2025. https://share.google/9jbxA09W2h5ddA5ph.
Victor Parluhutan Simanjuntak & Fadholli Nur Akwan & Putu Devi Kusumawardani, “Perlindungan Hukum Konsumen Terkait dengan Regulasi Asuransi Khususnya Penyelesaian Klaim Dalam Perkembangan Ekonomi Indonesia,” J. Kaji. Huk. dan Pendidik. Kewarganegaraan, vol. 2, no. 06 Februari 2023, p. 7, 2023.
WTW, “2024 Global Trends Survey,” Asean Stud., vol. 12, no. 28 November 2023, p. 4, 2023.
WTW, “Asia Pasific Expects High Medical Inflastion in 2025,” Health (Irvine. Calif)., no. December 3, 2024, p. 3, 2024.
Yoga Tri Cahyo & Marisa Kurnianigsih, “Pacta Sunt Servanda: Legal Dynamics in Indonesian Context,” Walisongo Law Rev., vol. 5, no. 01 Mei 2023, p. 4, 2023.
Zulfahmi Nur, “Keadilan dan Kepastian Hukum (Refeleksi Kajian Filsafat Hukum Dalam Pemikiran Hukum Imam Syatibi),” J. Kaji. Islam dan Masy., vol. 6, no. 02 Juni 2023, p. 8, 2023.
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