Strengthening Data-Based Clinical Governance, AdMedika Optimises Medical Advisory Board Role
The issuance of Financial Services Authority Regulation (POJK) Number 36 of 2025 represents an important milestone in strengthening healthcare governance in the insurance industry.
This regulation requires insurance companies to ensure adequate medical capability, digital capability, and the presence of an independent and competent Medical Advisory Board.
The regulation confirms that insurance companies must fulfil three key aspects: adequate medical capability, digital capability supporting data-based oversight, and an independent and competent Medical Advisory Board.
In response to this policy, PT Administrasi Medika (AdMedika) is committed to strengthening clinical governance based on data analytics. This effort is being carried out through strengthening the functions of the Medical Advisory Board (MAB).
“With data analytics support, the MAB can conduct medical evaluation and decision-making that is more objective, accurate, and responsive,” stated a company representative, speaking to Kompas.com on Tuesday, 17 March 2026.
The approach ensures a balance between service quality and prudent principles in managing healthcare costs. Through this effort, AdMedika is confident that implementing a data analytics-based MAB will not only support compliance with POJK Number 36/2025.
“This approach also ensures that medical decisions are more aligned with clinical indications, fit-for-purpose, transparent, and sustainable for participants,” the spokesperson said.
AdMedika’s strengthened MAB is designed to address the Financial Services Authority’s policy. On the medical capability side, the MAB is supported by Medical Advisors and a Utilization Review Team with medical backgrounds. The team conducts cost analysis and evaluates service appropriateness to ensure cost-effectiveness and cost efficiency principles operate optimally.
On the digital capability aspect, the review is integrated with data analytics systems, real-time dashboards, and artificial intelligence transaction analysis. This system enables rapid and precise identification of claim patterns, utilisation trends, and potential service misalignment.
AdMedika has also engaged Prof Dr dr Agus Purwadianto, SpF (K) as Medicolegal Ethics Advisor to the MAB. Additionally, retired Major General TNI Dr dr Agus Yunianto, SpBS has been appointed as MAB Chairman alongside a team of specialists from various medical disciplines.
This collaboration is a strategic step to ensure that every medical recommendation has sound ethical, academic, and clinical practice experience foundations.
This momentum also marks the beginning of Medical Advisory Board (MAB) service collaboration with 13 partner insurance companies. This partnership represents a commitment to building a more integrated, transparent, and sustainable healthcare service ecosystem.
The 13 partner insurance companies include Generali Indonesia, AIA Financial, Asuransi Central Asia, Sequis Life, Great Eastern Life Indonesia, AXA Mandiri Financial Services, Tokio Marine Life Indonesia, CAR Life Insurance, Asuransi MAG, Panin Dai-ichi Life, Dayin Mitra, Askrida Syariah, and Staco Mandiri.