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Dear Sirs,
In reference to the email of (*), we, LUBIS, SANTOSA & MARAMIS, have
been requested to prepare a Legal Memorandum in connection with
A. LEGAL BASIS
1. (*)
B. LEGAL ISSUES
1
Equity Tower, 12th Floor
Sudirman Central Business District (SCBD)
Jl. Jend. Sudirman Kav. 52-53
Jakarta (12190)
Indonesia
Phone +62 21 29035900
Fax +62 21 29035909
www.lsmlaw.co.id
1.
C. CONCLUSION
(*)
D. DISCUSSION
2
Equity Tower, 12th Floor
Sudirman Central Business District (SCBD)
Jl. Jend. Sudirman Kav. 52-53
Jakarta (12190)
Indonesia
Phone +62 21 29035900
Fax +62 21 29035909
www.lsmlaw.co.id
1
Article 4 paragraph (3) of the Insurance Law: Insurance adjuster company may only engage
Business of Insurance Adjuster.
2
Article 1 paragraph 13 of the Insurance Law: Business of Insurance Adjuster shall be
business of claim assessment service and/or consultation service on insurance object.
3
Article 13 paragraph (2) of OJK Regulation No. 68/2016 on Business Permits and
Organizational Structure of Insurance Broker Company, Reinsurance Broker Company and
Insurance Adjuster Company: Insurance adjuster company must have organization structure
that clearly describes at least function on:
b. insurance loss technical assessment;
3
Equity Tower, 12th Floor
Sudirman Central Business District (SCBD)
Jl. Jend. Sudirman Kav. 52-53
Jakarta (12190)
Indonesia
Phone +62 21 29035900
Fax +62 21 29035909
www.lsmlaw.co.id
4
Article 23 of OJK Regulation No. 70/2016: Expert in Insurance Adjuster Company as referred
to in Article 14 paragraph (1) has the following authority:
a. concluding the responsibility of an insurance policy on an insurance loss;
b. concluding the amount of insurance indemnification;
Article 14 paragraph (1) of OJK Regulation No. 70/2016: Insurance Broker Company,
Reinsurance Broker Company, and Insurance Adjuster Company in engaging with their
respective activity must have Expert that in accordance with their respective business field
and competence.
Article 39 paragraph (3) of OJK Regulation No. 68/2016: Expert of Insurance Adjuster
Company as referred to in paragraph (1) placed on responsible unit on loss assessment
technical function.
5
Chapter II, Section A, page 27 of the Attachment of Minister Decree No. 141/2014.
4
Equity Tower, 12th Floor
Sudirman Central Business District (SCBD)
Jl. Jend. Sudirman Kav. 52-53
Jakarta (12190)
Indonesia
Phone +62 21 29035900
Fax +62 21 29035909
www.lsmlaw.co.id
Our view above has also been confirmed by OJK, i.e. an adjuster
company has the authority and function to determine whether or
not a risk is covered under the insurance policy.
6
Article 37 paragraph (2) of OJK regulation No. 69/2016: The Insurance Company or Syariah Unit may appoint an
insurance adjuster company to have an assessment on the filed claim.
5
Equity Tower, 12th Floor
Sudirman Central Business District (SCBD)
Jl. Jend. Sudirman Kav. 52-53
Jakarta (12190)
Indonesia
Phone +62 21 29035900
Fax +62 21 29035909
www.lsmlaw.co.id
7
Even though the insurance adjuster company is paid by the insurance company as the employer.
6
Equity Tower, 12th Floor
Sudirman Central Business District (SCBD)
Jl. Jend. Sudirman Kav. 52-53
Jakarta (12190)
Indonesia
Phone +62 21 29035900
Fax +62 21 29035909
www.lsmlaw.co.id
Code of Ethics:
Code of Conduct:
7
Equity Tower, 12th Floor
Sudirman Central Business District (SCBD)
Jl. Jend. Sudirman Kav. 52-53
Jakarta (12190)
Indonesia
Phone +62 21 29035900
Fax +62 21 29035909
www.lsmlaw.co.id
Based on all of the above, it is clear that in case the insured files a
claim to the insurer, the assessment (report) from an insurance
adjuster company should be (i) the basis to determine whether or
not a claim from an insured is claimable; and (ii) complied by both
insurer and insured.
8
Equity Tower, 12th Floor
Sudirman Central Business District (SCBD)
Jl. Jend. Sudirman Kav. 52-53
Jakarta (12190)
Indonesia
Phone +62 21 29035900
Fax +62 21 29035909
www.lsmlaw.co.id
a) Cause of Damage
b) Policy Liability
9
Equity Tower, 12th Floor
Sudirman Central Business District (SCBD)
Jl. Jend. Sudirman Kav. 52-53
Jakarta (12190)
Indonesia
Phone +62 21 29035900
Fax +62 21 29035909
www.lsmlaw.co.id
c) Payment on Account
8
Interim Report No. 6 dated 23 May 2016 page 6: The loss falls within the period from 25th
July 2011 to 31st July 2015 (after endorsement).
10
Equity Tower, 12th Floor
Sudirman Central Business District (SCBD)
Jl. Jend. Sudirman Kav. 52-53
Jakarta (12190)
Indonesia
Phone +62 21 29035900
Fax +62 21 29035909
www.lsmlaw.co.id
11
Equity Tower, 12th Floor
Sudirman Central Business District (SCBD)
Jl. Jend. Sudirman Kav. 52-53
Jakarta (12190)
Indonesia
Phone +62 21 29035900
Fax +62 21 29035909
www.lsmlaw.co.id
12
Equity Tower, 12th Floor
Sudirman Central Business District (SCBD)
Jl. Jend. Sudirman Kav. 52-53
Jakarta (12190)
Indonesia
Phone +62 21 29035900
Fax +62 21 29035909
www.lsmlaw.co.id
9
Memo CAR dated ... page ...
13
Equity Tower, 12th Floor
Sudirman Central Business District (SCBD)
Jl. Jend. Sudirman Kav. 52-53
Jakarta (12190)
Indonesia
Phone +62 21 29035900
Fax +62 21 29035909
www.lsmlaw.co.id
10
Article 378 of KUH Pidana: Any person who with intent to unlawfully benefit himself or
another, either by assuming a false name or a false capacity, or by crafty artificies, or by web
of fictions, induces someone to deliver any property or to negotiate a loan or to annul a debt,
shall, being guilty of fraud, be punished by a maximum imprisonment of four years.
14
Equity Tower, 12th Floor
Sudirman Central Business District (SCBD)
Jl. Jend. Sudirman Kav. 52-53
Jakarta (12190)
Indonesia
Phone +62 21 29035900
Fax +62 21 29035909
www.lsmlaw.co.id
15
Equity Tower, 12th Floor
Sudirman Central Business District (SCBD)
Jl. Jend. Sudirman Kav. 52-53
Jakarta (12190)
Indonesia
Phone +62 21 29035900
Fax +62 21 29035909
www.lsmlaw.co.id
We refer to Letter dated [...] No. [...] from the Insured by way
of its lawyer. The Letter indicates that there is a perception
of the Insureds side whereas the clauses in Policy
Endorsement especially MRE 115 are laden with unclarity
which mislead the interpretation of exclusions causing the
Insured to be aggrieved. We anticipate this matter can be
the Insureds stance to impose the Insurer with this
provision. However, it is worth noting that up to the date we
have not found any case presedent using this provision to
attack the insurance company.
With regard to the above, if the Insured at certain point takes criminal
recourse by filing for police report, there are several defense strategies to
be considered by the Insurers:
16
Equity Tower, 12th Floor
Sudirman Central Business District (SCBD)
Jl. Jend. Sudirman Kav. 52-53
Jakarta (12190)
Indonesia
Phone +62 21 29035900
Fax +62 21 29035909
www.lsmlaw.co.id
(i) We are of the view that the most significant defense point
in this case is that the issue of claim liability falls within
the scope of civil law rather than being a criminal act.
Therefore it is very important that the Insurers prepare
adequate defense statements confirming so since the
beginning.
17
Equity Tower, 12th Floor
Sudirman Central Business District (SCBD)
Jl. Jend. Sudirman Kav. 52-53
Jakarta (12190)
Indonesia
Phone +62 21 29035900
Fax +62 21 29035909
www.lsmlaw.co.id
(iii) We are aware that there has been approaches from both
parties to settle the dispute with amicable settlement.
Although legally speaking a settlement cannot be used as
basis for terminating an investigation, but in practice, there
are many precedents where this is acceptable to the police.
Taking the option of amicable settlement followed up by
drafting and executing of a settlement agreement to be
presented to police as the basis for petitioning the
termination of the proceedings at the police level is
advisable as a strategy to counter criminal report from the
Insured.
Yours faithfully,
Lubis, Santosa & Maramis
18
Equity Tower, 12th Floor
Sudirman Central Business District (SCBD)
Jl. Jend. Sudirman Kav. 52-53
Jakarta (12190)
Indonesia
Phone +62 21 29035900
Fax +62 21 29035909
www.lsmlaw.co.id
19
Equity Tower, 12th Floor
Sudirman Central Business District (SCBD)
Jl. Jend. Sudirman Kav. 52-53
Jakarta (12190)
Indonesia
Phone +62 21 29035900
Fax +62 21 29035909
www.lsmlaw.co.id
APPENDIX I
ASSUMPTIONS AND QUALIFICATIONS
A. ASSUMPTIONS
1. AIG is duly established and validly existing under the laws of the
Republic of Indonesia, and is properly qualified and entitled and
has the power and authority to own its respective assets and to
carry on its business in accordance with the laws of the
Republic of Indonesia, and holds all material licenses, permits
and certificates required by law and necessary for the conduct
of its respective business as now conducted.
B. QUALIFICATIONS
20
Equity Tower, 12th Floor
Sudirman Central Business District (SCBD)
Jl. Jend. Sudirman Kav. 52-53
Jakarta (12190)
Indonesia
Phone +62 21 29035900
Fax +62 21 29035909
www.lsmlaw.co.id
21
Equity Tower, 12th Floor
Sudirman Central Business District (SCBD)
Jl. Jend. Sudirman Kav. 52-53
Jakarta (12190)
Indonesia
Phone +62 21 29035900
Fax +62 21 29035909
www.lsmlaw.co.id
22
Equity Tower, 12th Floor
Sudirman Central Business District (SCBD)
Jl. Jend. Sudirman Kav. 52-53
Jakarta (12190)
Indonesia
Phone +62 21 29035900
Fax +62 21 29035909
www.lsmlaw.co.id
23