The Importance of Understanding the Waiting Period for Insurance Participants: Here's the Explanation

Jakarta, VIVA – When selecting an insurance product that matches their needs and financial capabilities, customers or participants are advised to also understand the mechanisms related to the insurance product, from purchasing and policy application to premium or contribution payments and the claims process.

One process that needs to be understood after purchasing an insurance product is the Waiting Period or Masa Tunggu, which is a specific period of time since the policy becomes active. During this period, the policyholder, insured, or participant cannot yet submit claims or certain benefits.

Chief Health Officer of Prudential Indonesia, Yosie William Iroth, explained that during this period, customers or participants still receive protection from the insurance they own, but there are restrictions on the types of claims that can be submitted.

“The Waiting Period serves as a risk management mechanism for the insurance company to ensure optimal risk selection (underwriting) processes, so that the insurance company can manage risks well, which will contribute to setting more reasonable premiums for customers or participants,” said Yosie in his statement on Monday, 30 March 2026.

In Indonesia, regulations regarding the Waiting Period are strengthened by the Financial Services Authority (OJK) through POJK Number 36 of 2025 on Strengthening the Health Insurance Ecosystem. In those provisions, OJK sets a maximum Waiting Period of 30 calendar days for general benefits from the effective protection period (except due to accidents).

This means that customers or participants who are new to having a health insurance policy cannot submit claims for general benefits in the first 30 days since the policy is active (except due to accidents). In addition, OJK has also shortened the Waiting Period for critical illnesses, chronic conditions, or special conditions from previously 12 months to a maximum of 6 months (except for supplementary PAYDI health insurance).

With these provisions, benefits for critical illnesses, chronic conditions, or special conditions stated in the new Insurance Policy can only be claimed after passing the Waiting Period of at most 6 months since the policy takes effect (except for supplementary PAYDI health insurance). Regarding the changes to the Waiting Period outlined in this new POJK, Yosie assured that Prudential Indonesia and Prudential Syariah welcome and greatly appreciate OJK’s decision.