Deswa Integra Group Launches First Independent Medical Advisory Council In Indonesia

JAKARTA - Deswa Integra Group, a national company focused on strengthening governance, integrity, and efficiency in the insurance and health industry, officially launched the Medical Advisory Council/ Medical Advisory Board (MAB) by Deswa, a pioneer of the Independent Medical Advisory Council. Supported by the healthcare ecosystem Deswa Integra Group with professional staff who are experts in its field, MAB by Deswa is a pillar of medical governance and a strategic partner for the health insurance industry in presenting objective, efficient, and with integrity medical decisions.

CEO of Deswa Integra Group Dedi Dwi Kristianto, said that the launch of MAB by Deswa was an important moment to realize the Company's vision of building a more transparent and accountable claim ecosystem. This is in line with answering challenges in the insurance industry, as well as the provisions of the Financial Services Authority Circular Letter (SEOJK) No. 7/2025 which requires every health insurance company to have a Medical Advisory Board (MAB) as of January 1, 2026.

The current challenge in the insurance industry is a significant claim problem and fraud that can reduce the level of public trust. MAB by Deswa is a tangible manifestation of Deswa Integra Group's commitment to strengthen the foundations of the Indonesian insurance industry through collaboration and integrity. We can become a bridge between the medical world, actuarials, and risk management, creating a healthier, more efficient, and just claim industry for all parties," said Dedi at the launch of MAB by Deswa, in Jakarta, Thursday (10/10/2025).

In the last three years, continued Dedi, based on findings based on the Deswa field investigation, around 40%' 55% of claims of life and health insurance in Indonesia are indicated to contain elements of fraud, with potential industrial losses reaching IDR 2 trillion per year. From this data, 25%-27% of fraud is indicated to occur in health insurance.

Regarding claims, from Deswa's internal data for claim cases that need field investigations, in the last 3 years (in 2023 to 2025 projections) there was a significant increase in claims of 30%, namely in 2023 there were 2,068 cases, in 2024 there were 2,798 cases (up 35.5% from 2023) and in 2025 it was projected to be > 3,500 cases (up 25.1% from 2024).

"There is an increase in the complexity of claim management, both administratively and technically medically. On the other hand, the challenge that is no less important is fraud. If in the past fraud occurred at the level of documents or administration, now it is developing in the realm of medical interpretation, by utilizing gaps in understanding between medical personnel, health service providers, and insurance companies," said Dedi.

This shows that fraud can no longer be handled only with an administrative verification system. A multidisciplinary scientific approach is needed, combining medical analysis, actuarials, and analytic data to really understand the root of the problem. Thus, it is necessary for professionals to bridge the needs of insurance companies, medical personnel, health service providers and consumers.

Dedi explained that MAB by Deswa became a medical governance pillar and a strategic partner for the health insurance industry because it was supported by three Deswa Group business pillars, namely Deswa Invisco Multitama (DIM), Deswa Solusi Multitama (DSM), and Deswa Talenta Multitama (DTM). All three provide comprehensive solutions for the insurance industry, ranging from claim investigations, digital systems and artificial intelligence, to the development of medical and actuarial human resources competencies.

MAB by Deswa

Chairman of the Council of Medical Advisory/Medical Advisory Board (MAB) by Deswa, dr. Nickolai Indrarajasa, MARS., QRGP, confirmed that MAB by Deswa is an independent medical advisory board for second opinion, clinical evaluation, and data-based health policy.

As an independent MAB pioneer, MAB by Deswa can be used by several insurance companies and the Third Party Administrator (TPA) at the same time, efficiently and adaptively to the needs of each client.

MAB is designed as a cross-disciplinary independent model, involving doctors and medical personnel with clinical experience, actuarials that understand the risk structure and financing, products & wellness that are able to provide views, evaluations and refinements of insurance products to suit clinical standards, market needs and regulations. Presenting wellness programs in order to reduce claim figures. Data analysts who are able to interpret claim patterns quantitatively. Investigators, indicating as well as evidence of fraud in the field, as well as executives with in-depth experience in insurance, hospitals and risk management.

With this composition, we present an objective forum that functions as a bridge between the medical world and the insurance world. MAB by Deswa does not aim to replace the company's or regulator's decisions, but provides a credible second opinion, data-based, and scientifically accountable," added dr. Nickolai.

The launch of the MAB by Deswa is Deswa Integra Group's first step in strengthening the foundations of the national insurance industry through multidisciplinary collaboration. By prioritizing the values of integrity, transparency, and accountability, Deswa emphasized his commitment to becoming a catalyst for changes to the future of a more reliable and sustainable insurance industry.