Your SlideShare is downloading. ×
Corporate health plan by manish
Upcoming SlideShare
Loading in...5
×

Thanks for flagging this SlideShare!

Oops! An error has occurred.

×
Saving this for later? Get the SlideShare app to save on your phone or tablet. Read anywhere, anytime – even offline.
Text the download link to your phone
Standard text messaging rates apply

Corporate health plan by manish

226

Published on

Published in: Economy & Finance, Business
0 Comments
0 Likes
Statistics
Notes
  • Be the first to comment

  • Be the first to like this

No Downloads
Views
Total Views
226
On Slideshare
0
From Embeds
0
Number of Embeds
0
Actions
Shares
0
Downloads
11
Comments
0
Likes
0
Embeds 0
No embeds

Report content
Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
No notes for slide
  • But then so what?? Why should you come to us So that gives us two reasons- to keep customers happy and keep IRDA happy Put the Economic Times Article about Agents
  • 1000000 lakhs agents vs 300 brokers Your job ends after intimating us about the claim and we take over from there
  • Transcript

    • 1. Strictly Confidential Group Health Insurance By: Manish Agarwal Senior Risk Manager
    • 2. We are independent intermediaries who represent the client and not the insurance company, unlike an insurance agent who normally represents the company  
    • 3. What do we do…
      • We market Insurance Solutions for
      • “ ALL INSURANCE COMPANIES ”
      • Life & General
      • Public & Private
      • “ Product Range ”
      • ALL TYPES OF INSURANCE
      • And advice the best to our Valuable Client
    • 4.
      • Identify and evaluate your needs
      • Design your Insurance Portfolio
      • Choose the Right Product
      • Negotiate with the Companies for the most competitive rates
      • Assist in documentation
      • Claims Management- After all money matters
      • Claims Handling
      • Legal Representation
      And what do we do for you…
    • 5.
      • Advantages of Group Health
      • Floater cover for Entire Family so higher cover at lower cost
      • Lower Premiums than Individual Plans
      • Easy Claims Settlement
      • Pro Rate Premium if people leave
      • Maternity Benefit
      • Pre Existing Diseases Covered so all disease covered from day one*
      • Parents can be covered too without any Medical Tests upto age 80
      • some exclusions are there
    • 6.
      • We take complete responsibility of any service/claims/other issues during the policy period.
      • Your employee needs to give us intimation during an unfortunate event of a claim and we take over from there managing all documentation, liasioning with the TPA and Insurer for speedy cashless/recovery and other necessary work.
      • We will train all your employees about the procedure of claims so that the claim process becomes hassle free for them.
      • We will provide a 24 hr. Helpline number for any Assistance
      • We will give you One dedicated Service Manager for day-to-day requirements
      • We will also provide assistance related to any other type of insurance that your employees might need
    • 7.
      • Some of Our Group Health Insurance Clientele
      • Keventer Agro
      • Tilaknagar Industries
      • Zentech Pharma
      • Prachar Communications
      • Bengal Ambuja Group
      • South City Projects
      • Hotel Golden Park
      • Hotel Taj Bengal
      • Machino Polymers Ltd
      • Aircon India (Unit of Voltas)
      • Infinity InfoTech Parks Ltd
      • S.P.Jain Institute of Management and Research
      • Purbanchal Cements
      • Maithan Group
      • Orion Edutech
      • N K Realtors
      • Raj Bhavna & Associates
      • Rebecca Technologies
      • JMD Telefilms
      • T B Marketing
    • 8.
      • CREDENTIAL’S
      • We are currently managing more than 20000 lives under Health Insurance
      • We settle more than one claim every day
      • We maintain a 100% claims settlement ratio!!
      • In case of rejection on false grounds, we file the claims with ombudsman and get the claim
      • We have a strong Claims & Customer Service team which is there 24 hours to support your people
    • 9.  
    • 10.
      • About Your Policy
    • 11. Enrolment
    • 12. Guidelines for Hassle-Free Claims
      • In case of Emergency
      • Approach Network Hospital on recommendation of Physician & Show Cashless Card at the Hospital
      • Obtain a Pre-Authorization form and get it filled and signed by the treating doctor and submit to Hospital which will then fax it to the TPA along with other necessary reports
      • After investigation, TPA will fax the approval for Cashless to Hospital
      • Cashless can be rejected
        • If the Disease is not covered
        • Information sent is insufficient
        • Request for Cashless is not sent in time
        • However, you need to pay the bills which can be reimbursed later
      • In case of Planned Hospitalization
        • Go to the Hospital at least 72 Hours before admission and
        • Submit the Pre-Authorization Form available with the Hospital
        • Show your Cashless Card, Doctor’s Advice Letter, Probable Date of Admission so that
        • You will get the Cashless approval even before admission to the Hospital if cashless is
        • approved by the TPA
    • 13. Claims Reimbursement
      • If Cashless is not approved or if you visit a Non-Network Hospital
        • At the time of Discharge, settle the Hospital Bills in full and collect all the original BILLS, DOCUMENTS, REPORTS and DISCHARGE SUMMARY
        • Lodge your claim with the TPA by filling the CLAIM form and attaching Necessary Documents within 7 Days of Discharge
      • Documents to be Submitted:
        • Claims Notification - Within 3 Days of Admission via Letter/Fax/Email
        • Discharge Summary in Original with all Necessary Details
        • Detailed Bill –
          • Proper Bills with Break-up of all the items/medicines/tests
          • Doctor’s Bills must be stamped, with Doctor’s Reg. No.
        • All Supporting Prescriptions and Reports
        • Payment Receipt – Must be stamped and signed by Hospital Authorities
        • Any expenses not pertaining to the Medical Treatment are not covered
    • 14. Do’s and Don'ts
      • Store our Helpline No’s and Also give it to other Family Members
      • Find out whether the disease is covered in the policy or not
      • Always carry Cashless Card while going to the Hospital
      • Maintain All Bills inc. pre and post Hospitalization
      • Take the bill also from the family/consulting doctor
      • Never Disclose the amount of coverage to the Hospital
      • Do not go for very expensive treatment
      • Enquire about the Approx. cost of Treatment beforehand
      • Do not panic. Procedures and Rules have to be followed
      • No Need to call at Weird Hours
      • Push the Hospital Authorities to send all papers to TPA and follow up continuously
    • 15. Reminders
    • 16.  
    • 17. Your Risk We at IDEAL would like to assure you a Seamless Service Experience with a focus on building a Long Term Relationship. NEEDLESS TO SAY WE TAKE COMPLETE RESPONSIBILITY OF YOUR CLAIMS SETTLEMENT We will surely create a Difference both in terms of “ Cost & Quality” With IDEAL
    • 18.  
    • 19.  
    • 20.  

    ×