COMPLETE HEALTH SOLUTION AT JUST Rs 30000 PER YEAR AT AGE 79
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The presentation discusses the decline of family doctors and the complexities of health management, emphasizing the need for family health insurance and systematic health processes. It outlines systematic business solutions' comprehensive healthcare offerings, including emergency care and wellness services, as well as comparisons with existing mediclaim policies. The document details eligibility criteria and the process for obtaining health insurance and highlights the importance of proper coordination and support in healthcare management.
COMPLETE HEALTH SOLUTION AT JUST Rs 30000 PER YEAR AT AGE 79
- 1. Complete Healthcare SolutionsComplete Healthcare Solutions This presentation is solely for the use of client personnel and contains SBS Intellectual Property. No part of it may be circulated, quoted or reproduced for distribution outside of the client organization without prior written approval of Systematic Business Solutions Nerul NAVI MUMBAI.
- 2. Scenario In Health ManagementScenario In Health Management •• Decline of the family doctor,Decline of the family doctor, –– who we always depended on for all routine care, gatekeeper to higher care, nonwho we always depended on for all routine care, gatekeeper to higher care, non--commercial;commercial; friend, philosopher, guidefriend, philosopher, guide •• Too much medical complexityToo much medical complexity for single GPsfor single GPs –– many not wellmany not well--qualified, and governed byqualified, and governed by commercial compulsionscommercial compulsions •• Rapidly rising costsRapidly rising costs, for individuals, driven by, for individuals, driven by high rates of hospitalizationhigh rates of hospitalization,, diagnosticdiagnostic referralsreferrals and lack of negotiating power with the medical systemand lack of negotiating power with the medical system •• NoNo--one to coordinateone to coordinate carecare –– leaving you alone in time of emergency, or hospitalleaving you alone in time of emergency, or hospital •• PoorPoor ““customer servicecustomer service”” –– no respect for your time, no focus on your convenienceno respect for your time, no focus on your convenience
- 3. Need of hour in Family Health ManagementNeed of hour in Family Health Management •• You NeedYou Need –– First & Foremost thing for your family is aFirst & Foremost thing for your family is a Health /Mediclaim Insurance PolicyHealth /Mediclaim Insurance Policy •• You NeedYou Need Regular & Systematic Health Management Process in PlaceRegular & Systematic Health Management Process in PlaceRegular & Systematic Health Management Process in PlaceRegular & Systematic Health Management Process in Place •• You NeedYou Need Emergency /disaster Management Process in PlaceEmergency /disaster Management Process in Place •• You NeedYou Need A professional process & implementer in placeA professional process & implementer in place Systematic Business Solutions
- 4. But what Our Agents generally offered to us is Mediclaim or Health Insurance Cover/PolicyMediclaim or Health Insurance Cover/PolicyMediclaim or Health Insurance Cover/PolicyMediclaim or Health Insurance Cover/Policy
- 5. QUESTIONS you must ask your self taking Mediclaim / Health Insurance Policy QUESTIONS you must ask your self taking Mediclaim / Health Insurance Policy 1. What are my objectives in providing healthcare for my family 2. Are they of value to my family ? Do I find these benefits meaningful? 3. Am I keeping my family safe? In a medical emergency (at work, or at home), or even routine care, do I suggest a plan in place? Systematic Business Solutions
- 6. Our approach to Healthcare Single window for all your concerns Our approach to Healthcare Single window for all your concerns 24x7 Emergency Response Integrated Health Program – More than a health check! Single window for all 6 Health Insurance From proper advise to all out for claims settlement Wellness at the Home Single window for all medical care and wellness
- 7. What we are offering is a combination of Mediclaim / Health Insurance PolicyMediclaim / Health Insurance Policy Plus A complete heath care SolutionA complete heath care SolutionA complete heath care SolutionA complete heath care Solution with RegularRegular as well as anas well as an EmergencyEmergency carecare with a human toucha human touch
- 8. Comparison with your existing Mediclaim Policy with our proposed oneComparison with your existing Mediclaim Policy with our proposed one Your existing or available Mediclaim Policy Our suggested Mediclaim Policy Family Floater or Individual Insurance Family Floater Family Self + Spouse+ max Two Children aged below 21 Yrs. Family Self + Spouse+ max Two Children aged below 21 Yrs. Cap on Room Rent No Cap on Room Rent Benefits for pre existing diseases will be available only after the completion of 48 Benefits for pre existing diseases will be available only after the completion of 36available only after the completion of 48 months of continuous coverage since inception available only after the completion of 36 months of continuous coverage since inception If in case Porting your existing policy you will get the continuity impact. In fact the 48 months will be counted from the first date of taking your first policy If in case Porting your existing policy you will get the continuity impact. In fact the 36 months will be counted from the first date of taking your first policy Proportionate Deduction in all the expenses All the admissible expenses are payable Maternity Expenses are not payable Maternity expenses Payable with fixed amount with waiting period 9 months
- 9. Comparison with your existing Mediclaim Policy with our proposed oneComparison with your existing Mediclaim Policy with our proposed one Your existing or available Mediclaim Policy Our suggested Mediclaim Policy Premium is dependent on Number of family members Premium remains the same even if member varies in family No health check up Free health check up available with health card Age at entry restrictions & Medical examination varies with age at entry No Medical examination required up to Entry age of 79 Yrs. No value addition /services With value addition /servicesNo value addition /services With value addition /services Current services limited to insurance cover for families Current services limited to insurance cover for families with regular Health Management Services No personalise claims service help Personalised claims service help at your door step Your policy may be of any sum Insured Our Policy is Five Lakh Sum Insurance WAITING PERIOD OF 30 DAYS FROM THE DATE OF POLICY TAKEN WAITING PERIOD OF 30 DAYS FROM THE DATE OF POLICY TAKEN
- 10. One Card will cover Family of Four Members Health Card Regular Health Card Senior Physician's 30 minute Full Medical Review Yes Yes Consultations with the Family Physician, Gynecologist, Paediatrician, Dietician, Physiotherapist / other in-house specialist at any Healthspring Centre 6 (To be shared between the family) 16 (To be shared between the family) Critical Health Score (Fasting Blood Sugar, Total Cholesterol, Blood Pressure, Body Mass Index, Waist: Hip Ratio) Only for individuals above 20 years of age) Yes Yes Access to 24x7 Emergency Response- Pay per incident Yes* Yes * SBSSBS –– HEALTHSPRING CardHEALTHSPRING Card Access to 24x7 Emergency Response- Pay per incident Yes* Yes * Scheduled Doctor/Nurse Home Visit (During Centre working hours)- Charged per visit as per Centre charges Yes Yes 24x7 Tele Health- Call the Doctor Yes Yes Electronic Medical Records & Reports Yes Yes Discounts on Pathology, Pharmacy, Vaccinations 10% 10% Discounts on Radiology and Other Services 5% 5% Scheduled Doctor/Nurse Home Visits will be charged per visit @Rs.1000/- only Scheduled Only Nurse Home Visits will be charged per visit @Rs.250/- only. * The first emergency doctor visit is FREE for the first emergency that occurs within the family of 4. Thereafter, a Rs. 3000 charge will apply. A further Rs. 3000 is chargeable on hospitalization. Ambulance service is charged at Rs. 1200 . Any medication administered will always chargeable at actuals, even on the first emergency The regular card will be given to the proposer whose age is below 65 and senior card will be given to proposer above 65 yrs. at no extra cost
- 11. We guarantee the free claims servicesWe guarantee the free claims services • We are undertaking all the services related to your health claim – Cashless Approvals – Reimbursement Approval– Reimbursement Approval – Claims Processing – Convenience Services for you @ home, and on- the-go – Documents from your office – Only one phone call away
- 12. Convenience Services for you @ home, and on-the- go Convenience Services for you @ home, and on-the- go On-site conveniences Doctor-on-site Blood collections @ home Lifestyle disease management Pharmacy Order Online Travel vaccinations Doctor-on-video Phone / Email @ home On-the-go concierge services management Order Online EMR - Online prescriptions, doctor notes Home visits Doctor and Nurse Travel first-aid kit, advisories
- 13. Our Centres are designed for patient convenience, to access all routine needs under one roof 13
- 14. Age Band 0-25 26-35 36-40 41-45 46-50 51-55 56-60 61-65 66-70 71-75 76-80 Insurer # 7080 7080 7080 7080 7080 7080 7080 7080 8850 8850 8850 Allied *Services 10920 10920 10920 10920 10920 10920 10920 14920 16150 21150 21150 Total 18000 18000 18000 18000 18000 18000 18000 22000 25000 30000 30000 THE POLICY IS OF FIVE LAKH SUM INSURED WITH FAMILY FLOATERTHE POLICY IS OF FIVE LAKH SUM INSURED WITH FAMILY FLOATER Total Premium 18000 18000 18000 18000 18000 18000 18000 22000 25000 30000 30000 We need two chequesWe need two cheques Cheque 1 7080 7080 7080 7080 7080 7080 7080 7080 8850 8850 8850 Cheque 2 10920 10920 10920 10920 10920 10920 10920 14920 16150 21150 21150 Systematic Business Solutions We will deliver the policy Document & Health Card within 7 days
- 15. Who is eligibleWho is eligible • Only Savings Bank A/c Holders of – Bank of India – Bank of Baroda – Punjab National Bank • If presently you are not a account holder of any of the bank • If presently you are not a account holder of any of the bank – You can open an account in one day in any of the Bank – You need to issue two cheques – Proposal form Even if you have existing policy – you can port the existing policy before 50 days of expiry and avail continuity benefit Systematic Business Solutions
- 16. •• If the you have a bank account in any of the following bankIf the you have a bank account in any of the following bank then you need following thingsthen you need following things –– Proposal Form duly filled in along with photographProposal Form duly filled in along with photograph –– Copy of Bank PassCopy of Bank Pass--book or Bank Statementbook or Bank Statement –– Age proof for all family membersAge proof for all family members ProcessProcess –– Age proof for all family membersAge proof for all family members –– Two chequesTwo cheques •• One in the name ofOne in the name of •• If you are Bank of India or Bank of Baroda A/c Holder “ NationalIf you are Bank of India or Bank of Baroda A/c Holder “ National Insurance Co.Ltd” orInsurance Co.Ltd” or •• If you are Punjab National Bank A/c Holder then “ Oriental InsuranceIf you are Punjab National Bank A/c Holder then “ Oriental Insurance Company Ltd.”Company Ltd.” For amount mentioned after “Cheque 1”For amount mentioned after “Cheque 1” •• Second in the name of “Second in the name of “We need one cheque in the nameWe need one cheque in the name ofof “Systematic Business Solutions (P)Ltd.”“Systematic Business Solutions (P)Ltd.” For amount mentioned after “ Cheque 2“For amount mentioned after “ Cheque 2“ Systematic Business Solutions
- 17. ProcessProcess •• If you are not a account holder in any of theIf you are not a account holder in any of the mentioned bank then you need to openmentioned bank then you need to open savings account in any of the bank.savings account in any of the bank. –– Account Opening form is attachedAccount Opening form is attached–– Account Opening form is attachedAccount Opening form is attached –– Fill the same and submit it along with all KYCFill the same and submit it along with all KYC norms in the bank.norms in the bank. –– After opening the Account please follow theAfter opening the Account please follow the process.process.
- 18. Important NoteImportant Note •• Please open Bank Account inPlease open Bank Account in –– Bank of India or Bank of Baroda if your age is lessBank of India or Bank of Baroda if your age is less than 65 yrs.than 65 yrs. –– Punjab National Bank if age is more than 65 yrs.Punjab National Bank if age is more than 65 yrs.–– Punjab National Bank if age is more than 65 yrs.Punjab National Bank if age is more than 65 yrs. –– Then follow the same process as mentionedThen follow the same process as mentioned earlier.earlier.
- 19. KYC NORMS & DOCUMENTS FOR Accounts of Individuals - Legal name and any other names used (i) Passport (ii) PAN card (iii) Voter's Identity Card (iv) Driving license (v) Identity card (subject to the bank's satisfaction) (vi) Letter from a recognized public authority or public servant verifying the identity and residence of the customer to the satisfaction of bank - Correct permanent address (i) Telephone bill (ii) Bank account statement (iii) Letter from any recognized public authority (iv) Electricity bill (v) Ration card (vi) Letter from employer (subject to satisfaction of the bank) (any one document which provides customer information to the satisfaction of the bank will suffice)
- 20. PortabilityPortability •• If you wanted to take advantage on your existingIf you wanted to take advantage on your existing insurance policy the you need to giveinsurance policy the you need to give –– Intimation in the format before 50 days from the date ofIntimation in the format before 50 days from the date of expiry of policy .expiry of policy . –– If the existing policy is of Oriental Insurance Company thenIf the existing policy is of Oriental Insurance Company then we will do the portability in Oriental Insurance Companywe will do the portability in Oriental Insurance Companywe will do the portability in Oriental Insurance Companywe will do the portability in Oriental Insurance Company onlyonly –– Else all policies will be portable to National InsuranceElse all policies will be portable to National Insurance Company Ltd.Company Ltd. –– Please call us for clarity before actual filling up of thePlease call us for clarity before actual filling up of the Application for avoiding confusionApplication for avoiding confusion –– Other process remains the same for Account &Other process remains the same for Account & ApplicationApplication
- 21. Operational Process • The following documents are required – For Policy • Proposal Form • Photograph of all the family member who are covered in the proposal (TWO COPIES EACH) • Date of Birth Certificates of all the family member who are• Date of Birth Certificates of all the family member who are covered in the proposal (Self Attested ) • Address Proof • Bank Passbook /statement copy • Two cheques – One for Insurance premium – One for Health Card & allied services – For Health Card • Form
- 22. Handling of claims process • We will give all the relevant names and number of the persons who will handle the claims process. • Process will be as follows;• Process will be as follows; – You can call our executive 24X7 . » For cashless approval » For Reimbursement » For any explanations
- 23. For any Clarification & HelpFor any Clarification & Help YouYou •• Wanted to complete the process for buying ofWanted to complete the process for buying of the cover please write or speak tothe cover please write or speak to •• JairamJairam GopalanGopalan AiyerAiyer•• JairamJairam GopalanGopalan AiyerAiyer •• 9223391469 / 81497453159223391469 / 8149745315 •• ajvmmcs@gmail.comajvmmcs@gmail.com