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WELCOME
TO
OUR PRESENTATION
Presentation topic
Analysis of the IUBAT Student Group Health
Insurance Scheme (SGHIS)Agreement paper
2
Prepared by: Black & White
Promiz Roy Anik
ID# 13102229
Silvy Bhuyian
ID# 13102058
Samsun Nahar
ID# 13102056
3
Milia Rahman
ID# 13102101
Prepared for :
Instructor: Abdullah Al Yousuf Khan
4
Aim
The aim of our presentation is to provide clear idea
about the IUBAT students group health insurance
scheme.
5
Sequences
Introduction Objectives
Scope of the
report
Limitations of the
report
Methodology
A brief description
of the SGHIS
Analysis of the
agreement paper
Findings
Recommendation
& Conclusion
6
Introduction of SGHIS
Introduced: in May15, 2011 Between
International university of Business Progressive Life Insurance
Agriculture & Technology Company Limited
7
And
Objectives
Broad Objective:
 The broad objective of this report is to analyze the policy contract of the IUBAT student
group health insurance scheme .
Specific Objective:
 To gain knowledge of the IUBAT student group health insurance scheme .
 To identify what are the benefits we are going to get from SGHIS.
 To know what will be our premium.
 To know how we get claim amount.
 To know the elements & condition of the contract.
 To identify the overall Procedure & immediate support (SGHIS) of IUBAT and PLIC.
8
Scope of the report
The report is only based on our critical analysis of SGHIS
in IUBAT. This analysis will focus on giving the highest
priority upon student for protecting their physical and
morale hazards.
9
Limitations of the report
 The report was conducted only analyze the IUBAT SGHIS policy
agreement.
 Lack of time & records.
 Large-scale research was not possible due to time constraints.
 Due to the lack of experience.
 Another limitation was that the data gathered could not be verified
for correctness.
10
Methodology
 Primary source and Secondary sources:
For doing this report class lectures, IUBAT SGHIS agreement
paper, our main book “Insurance principles and practice” and face
to face consult with our honorable faculty those are both primary
and secondary information .
11
A brief description of the SGHIS
Health insurance requires sufficient information and data for
development of a good scheme, proper pricing, and health
management.
IUBAT is committed to enhancing the academic success of their
students by helping them to achieve and maintain the highest levels
of health, reduce risks and well being as possible.
It’s a welfare plan for the students of IUBAT.
12
Characteristics
 All students are covered.
 Acute sickness or accidental medical bills are paid by the insurer.
 Gives peace of mind to both students and parents.
 Direct payment if hospitalization in:
1. Ayesha Memorial Hospital
2. Apollo Hospital
3. Samorita Hospital
4. Uttara Crescent Hospital
 For other hospital, bills are paid by the insurer after providing the
valid documents.
13
The benefit of this policy 14
Students aged up to 30 years
For Hospitalization Up to the
amount
Tk.100,000/year
Daily room rent Tk. 2,000
In patient treatment expense Tk. 50,000
ICU/CCU Tk.40,000
Students Pay Premium Tk.130/ semester (390 /annum)
Action on injury or sickness
Accident & Injury:
 Take admission to a hospital immediately
 Inform Mrs. Momena Akter- IUBAT at 01711111155 within 24
hours of hospitalization.
 Alternatively e-mail them momena@iubat.edu &
progress@bdcom.com
For sickness:
 Consult a registered doctor in chamber, clinic or hospital.
 If admission needed inform Mrs. Momena first.
15
Claim procedure of the IUBAT SGHIS
among the students
Direct payment:
 Apollo, Ayesha Memorial, Samorita & Crescent Hospital bill will
be paid directly by PLIC.
 Up to the Limit.
Indirect payment or compensation:
 For other hospital, the medical bill will be paid by PLIC.
 In a Prescribed form.
 With other supporting documents.
 Submitted to Mrs. Momena Akter.
 Within 15 days of discharge from the hospital.
16
Supporting documents for Claim
 Consultants recommendation for hospitalization.
 Discharge certificate.
 Bill of consultants(physician/surgeon) fee
 Bills relating to room charges, investigations and any other service
 Bill of medicine supported by doctors prescription and vouchers
 Bill relating to surgical operation charges(where applicable)
 Bill relating to secondary charges.
17
Analysis of the agreement paper
General
Elements of
Contract
Special Elements
of Contract
Policy
conditions
18
General Elements of Contract 19
• Offer and Acceptance (agreement)
• Legal consideration
• Competent to make contract
• Free consent
• Legal object
Special Elements of Contract
Insurable Interest
Utmost Good Faith
Indemnity
Subrogation
Warranties
Proximate Cause
Assignment and Return of premium
20
Policy conditions
• Commencement of risks
• Premium
• Continuation of policy
• Lapse Condition
• Claims Settlement
21
Findings
 A student up to the age of 30 years shall be qualified for membership of the
scheme on the date of admitting the university.
 PLIC don’t pay any benefit for unregistered hospital.
 No benefit for dental treatment.
 Extra premium charged for students the ages of 31 & 45 years enrolled for any
semester.
 We have to pay premium quarterly in advance at the time of registration for each
semester.
 No benefit is payable for pregnancy & childbirth.
 No benefit for HIV & AIDS related diseases.
 No benefit for dangerous game such as wrestling, boxing, hinting etc.
22
Findings (cont..)
 For withdrawal the claim amount students have to submit a lot of documents .
 The students who are emotional or psychiatric disorders they don’t get any benefit.
 Plastic surgery of an injury due to accident or burn don’t paid benefit
 No seminar, program regarding IUBAT SGHIS was held in our campus.
 PLIC don’t provide any benefit for surgery within the first 12 months of the effective
date of the policy for abdominal.
 No benefit for expenses in respect of outdoor or domiciliary treatment .
23
Recommendations
 Up to the age of 45 years should be qualified for the membership without any
condition imposed by the insurer.
 PLIC should be pay benefit for unregistered hospital.
 More seminar, program regarding IUBAT SGHIS Should be held in our
campus.
 Expenses in respect of dental treatment should be included.
 The students who are emotional or psychiatric disorders they should be paid the
benefit.
 Cosmetic or plastic treatment/surgery of an injury due to accident or burn shall
be paid the benefit.
 Expenses in respect of outdoor or domiciliary treatment should be included.
24
Recommendations (cont…)
 Injury sustained while practicing or actively taking part in any hobby should be
included.
 Successive confinements due to the same illness not separated at least 90 days
shall not be considered as a single confinement.
 We strongly recommend that expenses for confinement in excess of twenty one
days must be covered. It may be covered for 30 days or 1 month.
 Benefit shall be payable for surgery within the first 12 months of the effective date
of the policy for abdominal or inguinal hernia, hemorrhoid/tonsil.
 If the age of membership attains at 30 then his/her membership should not be
ceased.
25
Conclusions
SGHIS is very essential for the students of IUBAT and as a
student’s we are very lucky that they (IUBAT) has introduced
this policy first time in a Non-Government University in
Bangladesh. Finally we are insured on our health risk by taking
the ‘IUBAT Group Health Insurance Scheme (SGHIS).
26
27
28

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Sghis final.pptx anik

  • 2. Presentation topic Analysis of the IUBAT Student Group Health Insurance Scheme (SGHIS)Agreement paper 2
  • 3. Prepared by: Black & White Promiz Roy Anik ID# 13102229 Silvy Bhuyian ID# 13102058 Samsun Nahar ID# 13102056 3 Milia Rahman ID# 13102101
  • 4. Prepared for : Instructor: Abdullah Al Yousuf Khan 4
  • 5. Aim The aim of our presentation is to provide clear idea about the IUBAT students group health insurance scheme. 5
  • 6. Sequences Introduction Objectives Scope of the report Limitations of the report Methodology A brief description of the SGHIS Analysis of the agreement paper Findings Recommendation & Conclusion 6
  • 7. Introduction of SGHIS Introduced: in May15, 2011 Between International university of Business Progressive Life Insurance Agriculture & Technology Company Limited 7 And
  • 8. Objectives Broad Objective:  The broad objective of this report is to analyze the policy contract of the IUBAT student group health insurance scheme . Specific Objective:  To gain knowledge of the IUBAT student group health insurance scheme .  To identify what are the benefits we are going to get from SGHIS.  To know what will be our premium.  To know how we get claim amount.  To know the elements & condition of the contract.  To identify the overall Procedure & immediate support (SGHIS) of IUBAT and PLIC. 8
  • 9. Scope of the report The report is only based on our critical analysis of SGHIS in IUBAT. This analysis will focus on giving the highest priority upon student for protecting their physical and morale hazards. 9
  • 10. Limitations of the report  The report was conducted only analyze the IUBAT SGHIS policy agreement.  Lack of time & records.  Large-scale research was not possible due to time constraints.  Due to the lack of experience.  Another limitation was that the data gathered could not be verified for correctness. 10
  • 11. Methodology  Primary source and Secondary sources: For doing this report class lectures, IUBAT SGHIS agreement paper, our main book “Insurance principles and practice” and face to face consult with our honorable faculty those are both primary and secondary information . 11
  • 12. A brief description of the SGHIS Health insurance requires sufficient information and data for development of a good scheme, proper pricing, and health management. IUBAT is committed to enhancing the academic success of their students by helping them to achieve and maintain the highest levels of health, reduce risks and well being as possible. It’s a welfare plan for the students of IUBAT. 12
  • 13. Characteristics  All students are covered.  Acute sickness or accidental medical bills are paid by the insurer.  Gives peace of mind to both students and parents.  Direct payment if hospitalization in: 1. Ayesha Memorial Hospital 2. Apollo Hospital 3. Samorita Hospital 4. Uttara Crescent Hospital  For other hospital, bills are paid by the insurer after providing the valid documents. 13
  • 14. The benefit of this policy 14 Students aged up to 30 years For Hospitalization Up to the amount Tk.100,000/year Daily room rent Tk. 2,000 In patient treatment expense Tk. 50,000 ICU/CCU Tk.40,000 Students Pay Premium Tk.130/ semester (390 /annum)
  • 15. Action on injury or sickness Accident & Injury:  Take admission to a hospital immediately  Inform Mrs. Momena Akter- IUBAT at 01711111155 within 24 hours of hospitalization.  Alternatively e-mail them momena@iubat.edu & progress@bdcom.com For sickness:  Consult a registered doctor in chamber, clinic or hospital.  If admission needed inform Mrs. Momena first. 15
  • 16. Claim procedure of the IUBAT SGHIS among the students Direct payment:  Apollo, Ayesha Memorial, Samorita & Crescent Hospital bill will be paid directly by PLIC.  Up to the Limit. Indirect payment or compensation:  For other hospital, the medical bill will be paid by PLIC.  In a Prescribed form.  With other supporting documents.  Submitted to Mrs. Momena Akter.  Within 15 days of discharge from the hospital. 16
  • 17. Supporting documents for Claim  Consultants recommendation for hospitalization.  Discharge certificate.  Bill of consultants(physician/surgeon) fee  Bills relating to room charges, investigations and any other service  Bill of medicine supported by doctors prescription and vouchers  Bill relating to surgical operation charges(where applicable)  Bill relating to secondary charges. 17
  • 18. Analysis of the agreement paper General Elements of Contract Special Elements of Contract Policy conditions 18
  • 19. General Elements of Contract 19 • Offer and Acceptance (agreement) • Legal consideration • Competent to make contract • Free consent • Legal object
  • 20. Special Elements of Contract Insurable Interest Utmost Good Faith Indemnity Subrogation Warranties Proximate Cause Assignment and Return of premium 20
  • 21. Policy conditions • Commencement of risks • Premium • Continuation of policy • Lapse Condition • Claims Settlement 21
  • 22. Findings  A student up to the age of 30 years shall be qualified for membership of the scheme on the date of admitting the university.  PLIC don’t pay any benefit for unregistered hospital.  No benefit for dental treatment.  Extra premium charged for students the ages of 31 & 45 years enrolled for any semester.  We have to pay premium quarterly in advance at the time of registration for each semester.  No benefit is payable for pregnancy & childbirth.  No benefit for HIV & AIDS related diseases.  No benefit for dangerous game such as wrestling, boxing, hinting etc. 22
  • 23. Findings (cont..)  For withdrawal the claim amount students have to submit a lot of documents .  The students who are emotional or psychiatric disorders they don’t get any benefit.  Plastic surgery of an injury due to accident or burn don’t paid benefit  No seminar, program regarding IUBAT SGHIS was held in our campus.  PLIC don’t provide any benefit for surgery within the first 12 months of the effective date of the policy for abdominal.  No benefit for expenses in respect of outdoor or domiciliary treatment . 23
  • 24. Recommendations  Up to the age of 45 years should be qualified for the membership without any condition imposed by the insurer.  PLIC should be pay benefit for unregistered hospital.  More seminar, program regarding IUBAT SGHIS Should be held in our campus.  Expenses in respect of dental treatment should be included.  The students who are emotional or psychiatric disorders they should be paid the benefit.  Cosmetic or plastic treatment/surgery of an injury due to accident or burn shall be paid the benefit.  Expenses in respect of outdoor or domiciliary treatment should be included. 24
  • 25. Recommendations (cont…)  Injury sustained while practicing or actively taking part in any hobby should be included.  Successive confinements due to the same illness not separated at least 90 days shall not be considered as a single confinement.  We strongly recommend that expenses for confinement in excess of twenty one days must be covered. It may be covered for 30 days or 1 month.  Benefit shall be payable for surgery within the first 12 months of the effective date of the policy for abdominal or inguinal hernia, hemorrhoid/tonsil.  If the age of membership attains at 30 then his/her membership should not be ceased. 25
  • 26. Conclusions SGHIS is very essential for the students of IUBAT and as a student’s we are very lucky that they (IUBAT) has introduced this policy first time in a Non-Government University in Bangladesh. Finally we are insured on our health risk by taking the ‘IUBAT Group Health Insurance Scheme (SGHIS). 26
  • 27. 27
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