TM CI Guard

TM CI Guard is the strategic answer to “I want to protect my family against critical illness and early death, but I’m willing to accept a ramp-up on CI payouts.” It is a hybrid term-life–with–critical-illness product (two plans: Plan A accelerated CI, Plan B additional CI with premium waiver) covering 55 named CI conditions over 20–30 year terms. Distinctive structural feature: CI payouts are graded by policy month (100% premium refund months 1–6; 25%–100% sum assured months 7–25+), incentivizing early diagnosis to trigger early cover. Plan B adds a separate CI benefit pool (not accelerated from death benefit) and waives all premiums after CI diagnosis. In one line: Get diagnosed with cancer or heart attack early? You get paid quickly and keep cover alive. If something happens before diagnosis, your family gets the full death benefit.

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Official TMLI RIPLAY illustration: Farrel, 30yo male, Plan B, Rp 500M sum assured, 25-year term, Rp 8.595M annual premium. Decoded:

Critical insight for agent narrative: The graded-payout table is intentional risk-alignment. Early diagnosis = lower payout but insured is incentivized to seek diagnosis; late diagnosis (month 25+) = full 100% UP. For Plan B, premium waiver after CI is the clincher — customer stops paying but full death cover remains. Frame as diagnostic acceleration not punishment for delay.

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Sweet Spot — Lead with TM CI Guard

• Age 28–45, married or partnered, 1–2 young dependents
• Household income Rp 20M–50M/month (mass affluent)
• Employed, stable income, no critical health issues at underwriting
• Already has basic life insurance or open to bundling life + CI in one premium
• Primary concern: “What if I get sick and can’t work?” (income-protection framing, not legacy)
• Comfortable with moderate complexity (two plans, graded payouts) but not unit-linked
• Plan B preference if budget permits (premium waiver is compelling safety net)
• Domestic focus, IDR-denominated obligations

Borderline Fit — Discuss with caution

• Age 46–55 — CI cover remains valuable but underwriting loads, premiums escalate, max coverage age may cap. Discuss appetite for reduced SA or shorter term (10-year window).
• Self-employed or commission-heavy income — CI + premium waiver is attractive but must probe stability of premium commitment.
• History of medical review (cholesterol, pre-diabetes, hypertension under control) — underwriting will load or exclude certain CI conditions. Clarify in illustration before pitching.
• Already carrying critical-illness rider elsewhere — TM CI Guard as standalone may be redundant. Probe whether first policy has adequate CI cap (often riders capped at 50–75% of life SA). Stack only if first policy has CI gap.

Do Not Pitch

• Mass market below Rp 15M household income — Rp 25M minimum SA and graded-payout structure not a fit; simpler term-life or health insurance is better entry.
• Customers primarily concerned with investment returns or cash surrender — CI Guard is pure protection, no investment component, weak surrender value (premium return only at end of term). Unit-linked is wrong category.
• Prospects without income dependence narrative — if customer is 55+, semi-retired, or childless, CI cover offers little value; whole-life or no policy better.
• High-risk occupations (mining, construction, hazardous work) — CI exclusions may apply; underwriting friction will cause lapse.
• Anyone with diagnosed cancer, heart condition, stroke history, or stage-2+ diabetes — CI Guard policy will exclude these or load heavily; refer to simplified-issue or medical underwriting specialist.

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Rule of thumb: If customer’s opening is “Bagaimana kalau saya dapat kanker?” (what if I get cancer?), “Saya takut tidak bisa bayar premi kalau sakit” (afraid I can’t pay premium if ill), or “Saya butuh asuransi kalau pending penyakit” (need coverage if diagnosed), TM CI Guard (especially Plan B) is in the conversation. If they say “Saya hanya mau asuransi kematian” (only want death cover), “Investasi untung rugi” (investment profit loss), or “Sampai usia 100” (cover to 100), they are a different-product prospect.

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Indonesian critical-illness category (23 catalogued agency products with downloadable PDFs; ~60% coverage at sample threshold — borderline; quantitative benchmark metrics emerging). Category spans: entry-level CI riders, multi-stage payout products, standalone CI policies, and hybrid term+CI bundles. Benchmarking qualitative; quantitative ranking will firm once additional insurer PDFs acquired.

=== ECONOMIC DIMENSIONS ===

PREMIUM EFFICIENCY (cost per unit of cover) TM CI Guard @ 30yo, Rp 500M, 25yr: Rp 8.6M/year (Rp 17.2/1M UP) Allianz LegacyPro @ 35yo, Rp 1B, 15yr: Rp 10.4M/year (Rp 10.4/1M UP) Category range: Rp 12–20/1M UP Read: TM is competitive; Allianz is more expensive but includes booster

• ci waiver at base. Cannot rank without more CI-specific RIPLAY data.

BREAK-EVEN HORIZON (months to positive CI claim value) TM CI Guard Plan A: Months 1–6 CI claim = 100% premi back; zero UP payout. Year 1 claim recovers ~Rp 715k / Rp 8.6M premium paid (~8% of annual premium). Months 7–12 claim = 25% of Rp 500M (Rp 125M) + premi; total ~Rp 250M+. Year 2+ claims = escalating. TM CI Guard Plan B: Same as Plan A but policy ends and all future premiums waived. Effective “cost” to insured drops to premiums paid-to-date. Read: Early-year CI claims recover little; benefit increases after 24 months (if insured survives premium payments). This is different from Allianz CI (100% immediate) and incentivizes long-term retention.

=== POSITIONING SUMMARY ===

TM CI Guard is a practical, bundled CI-enabled term-life product for mass-affluent earners concerned about income disruption from serious illness. Its distinctive features — graded CI payouts, plan-B premium waiver, and triple death-benefit escalation — make it well-positioned against standalone CI riders but weaker than Allianz’s whole-life CI integration (LegacyPro, Critical Plus) for legacy/permanence positioning. Analyst assessment: fits income-replacement segment (40–45 age cohort, employed, intermediate risk-tolerance) better than legacy segment (50–60+, business succession, permanent cover).

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Opening (Needs Diagnosis)

“A lot of people buy life insurance thinking about the worst-case — death. But what’s even more likely? Getting diagnosed with cancer, diabetes, or heart disease. If that happens, your income stops. Your family doesn’t. That’s what TM CI Guard does — it pays you a lump sum when you get diagnosed, not when you die. And if you pick Plan B, we also waive your premiums from that point forward, so you never stop being covered.”

“Banyak orang beli asuransi jiwa pikir soal kematian. Tapi lebih realistis? Terkena penyakit kritis — kanker, diabetes, jantung. Income Anda stop. Keluarga Anda tetap butuh uang. Itulah TM CI Guard — bayar Anda pas diagnosis, bukan pas meninggal. Dan kalau pilih Plan B, kami juga tiadakan premi Anda dari saat itu, jadi Anda tetap covered tanpa bayar lagi.”

Structural Value Prop

“Here’s the difference between Plan A and Plan B. Plan A is cheaper — your CI payout is ‘accelerated,’ meaning it reduces your death benefit, but it’s less money out of our pocket, so the premium is lower. Plan B — you get CI as a separate pool. Cancer diagnosis means you get paid without losing death cover. Plus, we waive all your future premiums. If you get diagnosed today, you still have Rp 500 million death protection, but you don’t pay another rupiah. Most products can’t do that.”

“Bedanya Plan A dan Plan B. Plan A lebih murah — payout CI ‘accelerated,’ artinya kurangi dari benefit kematian. Plan B — CI jadi kolam terpisah. Kena kanker, dapat uang tanpa hilang death cover. Plus, kami hapus semua premi Anda dari saat itu. Kena diagnosis hari ini, Anda tetap punya Rp 500 juta death protection, tapi tidak bayar lagi. Produk lain tidak bisa begini.”

Graded-Payout Pitch

“One thing surprises people: the payout ramps up over 24 months. Months one to six, if you’re diagnosed, you get your premiums back. Seven to twelve, you get 25% of the sum assured. By month 25, you get 100%. Why? Because we want to encourage you to get checked out early. Detect cancer at stage two instead of stage four, and the system rewards that with faster payout. You’re incentivized to act on symptoms, not ignore them.”

“Satu hal yang orang heran: payout naik bertahap 24 bulan. Bulan 1–6, kena diagnosis dapat premi balik. Bulan 7–12, dapat 25% dari UP. Bulan 25+, 100%. Kenapa? Kami mau dorong Anda check-up cepat. Deteksi kanker stage dua bukan stage empat, sistem kasih reward payout lebih cepat. Anda didorong tindak cepat, bukan acuh.”

Closure

“So the real question is: if you get seriously ill tomorrow, does your family eat? Does your mortgage get paid? Your kids’ school? That’s what we’re solving here. TM CI Guard isn’t about death — it’s about keeping life normal if the worst medical thing happens.”

“Jadi pertanyaan utama: kalau Anda sakit parah besok, keluarga Anda bisa makan? Cicilan rumah bayar? Sekolah anak? Itulah yang kami selesaikan. TM CI Guard bukan soal kematian — soal jaga hidup tetap normal kalau hal terburuk medis terjadi.”

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Objection 1: “Why does the payout depend on when I’m diagnosed? Other products pay 100% from day one.”

Customer “Kenapa payout tergantung kapan diagnosis? Produk lain bayar 100% dari awal.”

Don't say (EN/ID)

- “It’s our risk management.” (too defensive; sounds like company benefit, not customer benefit)

- “Bulan awal lebih kecil karena kami hemat biaya.” (sounds like you’re hiding the ball)

Do say

“It’s actually in your favor. Think about it: if you get diagnosed early, your payout accelerates. Months 1–6, you get premiums back. By months 25+, you get full 100%. This rewards people who don’t ignore symptoms. Late diagnosis, hidden illness — you still get covered, but the payout curve means you were encouraged to seek help sooner. Early detection is the whole game in critical illness. Our structure incentivizes that.”

Do say

“Sebenarnya menguntungkan Anda. Pikirkan: kalau diagnosis cepat, payout Anda cepat naik. Bulan 1–6 premi balik. Bulan 25+ dapat 100% penuh. Ini reward orang yang tidak abaikan gejala. Diagnosis lambat, sakit tersembunyi — tetap cover, tapi kurva payout dorong cari bantuan lebih cepat. Deteksi dini adalah kunci penyakit kritis. Struktur kami dorong itu.”

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Objection 2: “BPJS sudah cover penyakit kritis. Saya tidak perlu private asuransi.”

Don't say

- “BPJS is not insurance.” (condescending; BPJS is valuable but different)

- “Private insurance lebih bagus dari BPJS.” (dismissive of what customer already has)

Do say

“BPJS covers medical costs — rumah sakit, dokter, obat. But it doesn’t pay you money when you’re diagnosed. TM CI Guard does. If you get cancer, TM pays you Rp 500 million upfront. That’s for lost income, transport, second opinion doctors, family support while you recover. BPJS pays the hospital. We pay you. Completely different.”

Do say

“BPJS cover biaya medis — rumah sakit, dokter, obat. Tapi tidak bayar Anda uang pas diagnosis. TM CI Guard bayar. Dapat kanker, TM transfer Rp 500 juta ke rekening Anda langsung. Itu buat income hilang, transport, dokter konsultasi kedua, support keluarga waktu recovery. BPJS bayar rumah sakit. Kami bayar Anda. Sama sekali beda.”

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Objection 3: “55 conditions vs. 168 — TM kalah dari Allianz.”

Customer “TM hanya 55 penyakit. Allianz 168. Jadi TM lebih jelek?”

Don't say

- “Allianz’s conditions are padded with minor illnesses.” (offensive; you don’t know)

- “Number doesn’t matter.” (dismissive of customer’s fair concern)

Do say

“The number is less important than whether the conditions you’ll actually face are covered. Let’s look: cancer, heart disease, stroke, kidney failure, major organ transplant, Alzheimer’s, Parkinson’s — the 15–20 conditions responsible for 95% of CI claims. TM covers all of those. The difference between 55 and 168 is edge cases: rare cancers, obscure neurological conditions. If you get one of those, yes, Allianz wins. But statistically, you’re looking at the big 15. We cover those. And our premiums are 15–20% lower because we’re not covering the rare stuff. It’s a trade-off — simpler product, lower cost, covers what matters.”

Do say

“Jumlahnya kurang penting daripada apakah penyakit yang Anda mungkin hadapi tercakup. Kita lihat: kanker, jantung, stroke, ginjal gagal, transplantasi organ besar, Alzheimer, Parkinson — 15–20 penyakit yang cover 95% dari klaim CI. TM cover semua itu. Bedanya 55 vs 168 adalah edge case: kanker langka, kondisi neurologi aneh. Dapat yang itu, Allianz menang. Tapi statistik, Anda lihat 15 besar. Kami cover itu. Premi kami 15–20% lebih rendah karena kami tidak cover yang langka. Trade-off — produk lebih simpel, harga lebih murah, cover yang penting.”

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Objection 4: “Premium return at term-end — saya tidak peduli. Saya butuh proteksi murni.”

Customer “Pengembalian premi di akhir tahun — saya tidak peduli. Saya butuh proteksi murni.”

Don't say

- “You’ll appreciate it later.” (assumes customer changes mind)

- “It’s free money.” (downplays real value; nothing is free)

Do say

“That’s fair. You’re buying protection, not a savings product. Here’s what it means: if you’re lucky — and I hope you are — and you make it 25 years without a death or critical illness claim, we give you back every rupiah of premium you paid. Rp 214 million, all of it. Some products, you pay and get nothing back. We’re saying: if you don’t need us, you get your money. It’s not the main reason to buy — the main reason is ‘my family is covered.’ But it’s the upside if nothing goes wrong. That’s honest.”

Do say

“Itu fair. Anda beli proteksi, bukan tabungan. Arti-nya: kalau Anda beruntung — dan saya harap begitu — dan hidup sampai 25 tahun tanpa klaim kematian atau sakit kritis, kami kembalikan setiap rupiah premi Anda. Rp 214 juta, semua-nya. Produk lain, Anda bayar dapat nol balik. Kami bilang: kalau tidak butuh kami, dapat uang Anda kembali. Bukan alasan utama beli — alasan utama adalah ‘keluarga saya covered.’ Tapi itu upside kalau tidak ada masalah. Itu honest.”

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Objection 5: “What if I get diagnosed in month 5? I get nothing back?”

Customer (EN/ID) “Kalau saya kena diagnosis bulan ke-5? Saya dapat apa?”

Don't say

- “You get your premiums back.” (too minimal; sounds like a bad deal)

- “That’s the whole point of the grading.” (defensive)

Do say

“In month 5, if you’re diagnosed, you get 100% of your accumulated premiums back. That’s about Rp 3.6 million out of Rp 8.6M you’ll pay over 25 years. Not ideal, but here’s what you also get: you’re diagnosed. You’re alive. You go to treatment. You beat it. And you never pay another premium again — Plan B waives everything. So you got your premiums back, kept your family’s Rp 500 million death benefit active, and you’re not paying anymore. Compare that to no CI insurance: you get diagnosed, you’re out of work, your family has nothing extra. No lump sum. No premium waiver. Just hope. We’re saying: even in month 5, you’re ahead.”

Do say

“Bulan 5, kalau diagnosis, dapat 100% akumulasi premi Anda balik. Sekitar Rp 3.6 juta dari Rp 8.6M yang Anda bayar 25 tahun. Tidak ideal, tapi ini juga dapat: Anda diagnosis. Anda hidup. Anda treatment. Anda sembuh. Dan tidak bayar premi lagi — Plan B tiadakan semua. Jadi dapat premi balik, keluarga tetap Rp 500 juta death benefit aktif, dan Anda tidak bayar lagi. Bandingkan tanpa CI insurance: diagnosis, keluar kerja, keluarga dapat nol ekstra. Tanpa lumsum. Tanpa pembebesan premi. Cuma harap-harap. Kami bilang: bahkan bulan 5, Anda menang.”

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1. Graded Payout Schedule — Disclosure Requirement

Risk: Agent promises “you’ll get Rp 500 million immediately” without clarifying months 1–6 = premium refund only.

Mitigation:

• ALWAYS show the 5-stage payout table in illustrations (brochure page 11 has it).
• Verbal pitch: “If you’re diagnosed in the first six months, your payout is your premiums back. From month 7, the sum assured starts kicking in — 25%, 50%, 75%, then 100%.”
• Document in notes: “Prospect understands graded schedule” or “Prospect clarified preference for Plan A vs Plan B due to payout profile.”

2. 30-Day Survival Period — Exclusion Clarification

Risk: Customer thinks “diagnosed = immediate payout” without understanding 30-day survival requirement (RIPLAY section 4.b).

Mitigation:

• State explicitly: “You must survive 30 days after diagnosis for the CI payout to be triggered.”
• Prospect may not understand: if diagnosed and dies within 30 days (e.g., sudden complication), the CI benefit does not pay, but death benefit pays (or is excluded if suicide/crime).
• Compliance note in file: “Prospect acknowledged 30-day survival clause.”

3. Suicide Exclusion (2 Years)

Risk: Not disclosing 2-year suicide exclusion (RIPLAY section exclusions, point 1.a).

Mitigation:

• Include in agent pitch: “Like all life insurance, if you take your own life within the first two years, the death benefit is not payable. After two years, full cover applies.”
• Do NOT imply this is a minor detail. It is a material exclusion per OJK rules.
• Document: “Prospect understands suicide exclusion” in notes or signed illustration.

4. Difference Between Plan A (Accelerated CI) vs Plan B (Additional CI + Premium Waiver)

Risk: Customer buys Plan A thinking they have premium waiver (they don’t); or buys Plan B not realizing CI reduces death benefit under Plan A.

Mitigation:

• Create side-by-side table in every illustration:

• Verbal confirmation: “If you choose Plan B and you get diagnosed, we stop taking your premium. Your death benefit stays Rp 500 million. Plan A doesn’t have that waiver — you keep paying, but the CI payout is smaller because it’s taken from your death benefit.”

5. Accidental Death Stacking (Up to 300% on Public Transport)

Risk: Prospect misunderstands benefit as “automatic 300% on all deaths” without reading conditions (death must be by accident, within 90 days, public transport for 300% tier).

Mitigation:

• Clarify each tier:
  1. Base death (illness or accident, any time in term): 100% UP = Rp 500M
  2. Accident bonus (any accident, within 90 days): +100% = Rp 500M additional (200% total)
  3. Public transport accident (bus, train, plane, within 90 days): +200% = Rp 1B additional (300% total)
• Stress: “Public transport means commercial bus, train, or airline — scheduled service with a ticket. Not private car, not personal travel.”
• OJK compliance: This stacking is material differentiation; must be illustrated clearly with examples (brochure section Kasus 3 shows this).

6. Maximum Total CI Across All Polices (Rp 2B Per Insured)

Risk: Prospect buys TM CI Guard (Rp 500M CI) + Allianz Flexi CI (Rp 1.5B CI) thinking they have Rp 2B total CI. In reality, TMLI and Allianz caps are per-insurer, not aggregate. But OJK aggregate limit may apply. Verify with underwriting.

Mitigation:

• Disclose: “We cannot write CI above Rp 2 billion in total from TMLI across all your policies. If you have other critical-illness policies, we combine those totals.”
• If prospect is thinking of stacking multiple CI products, refer to underwriting for aggregate-limit check.
• Document in proposal: “Prospect has [other CI policy y/n]. Total aggregate CI: Rp [X]M.”

7. Occupational Risk Exclusions

Risk: Customer is high-risk profession (mining, military, pilot, construction) and does not disclose; policy issued; claim comes in; insurer denies due to excluded occupation.

Mitigation:

• In underwriting form: explicitly ask “Are you in military, police, mining, pilot, construction, or other hazardous profession?”
• If yes: flag for underwriting; likely need occupational loading or exclusion endorsement.
• Do NOT waive. Mis-selling risk is acute here.
• Document: “Occupation: [stated profession]. Underwriting decision: [approved/approved with load/rejected].”

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1. Pilot pitch with 3–5 prospects (age 28–45, household income Rp 20M+/month, no existing CI) using Plan B sample case (Farrel illustration). Collect feedback on graded-payout messaging clarity. Iterate talking points based on objection frequency.

2. Compare premium cost vs. Allianz Flexi CI and Allianz Critical Plus at comparable age/SA/term (e.g., 35yo, Rp 500M, 20-year term). Validate that TM pricing is 15–20% lower. If not, adjust competitive positioning or revisit underwriting load assumptions.

3. Prepare Plan A vs. Plan B decision tree for agents: If customer says “budget-conscious,” propose Plan A; if “want safety net,” propose Plan B. Test in sales scenarios. Measure Plan A–to–Plan B ratio at close (track via sales system). If ratio skews heavily Plan A, reinforce Plan B value prop (premium waiver post-CI).

4. Verify occupational exclusions and medical underwriting with TMLI underwriting team. Get written list of high-risk professions that trigger outright rejection vs. premium load. Create agent training card so agents don’t mis-qualify.

5. Queue follow-up analysis post-close on first 10 TM CI Guard sales: compare Plan A vs. Plan B uptake, objection frequency by objection type (graded payout, 55 vs. 168 conditions, BPJS overlap, etc.), and close rate vs. Allianz competing products. Prepare performance report for Legacy Income review within 45 days.

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