Complete Healthcare Solutions Complete 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.

Scenario In Health Management Scenario 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 GPs for single GPs –– many not wellmany not well--qualified, and governed by qualified, 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, , diagnostic diagnostic

referralsreferrals and lack of negotiating power with the medical systemand lack of negotiating power with the medical system

•• NoNo--one to coordinate one to coordinate care care –– 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

Need of hour in Family Health Management Need of hour in Family Health Management

•• You Need You Need

–– First & Foremost thing for your family is a First & Foremost thing for your family is a

Health /Mediclaim Insurance Policy Health /Mediclaim Insurance Policy

•• You Need You Need

Regular & Systematic Health Management Process in Place Regular & Systematic Health Management Process in Place Regular & Systematic Health Management Process in Place Regular & Systematic Health Management Process in Place

•• You Need You Need

Emergency /disaster Management Process in Place Emergency /disaster Management Process in Place

•• You Need You Need

A professional process & implementer in placeA professional process & implementer in place

Systematic Business Solutions

But

what Our Agents generally offered

to us

is

Mediclaim or Health Insurance Cover/Policy Mediclaim or Health Insurance Cover/Policy Mediclaim or Health Insurance Cover/Policy Mediclaim or Health Insurance Cover/Policy

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

Our approach to HealthcareSingle window for all your concerns

Our approach to HealthcareSingle 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

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

Regular Regular as well as an as well as an Emergency Emergency care care

with

a human touch a human touch

Comparison with your existing Mediclaim Policy with our proposed one Comparison 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 36 available 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

Comparison with your existing Mediclaim Policy with our proposed one Comparison 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 /services No 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

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 *

SBS SBS –– 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

We guarantee the free claims services We 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

Convenience Services for you @ home, and on-the-goConvenience Services for you @ home, and on-the-go

On-site conveniences

Doctor-on-site Blood collections

@ homeLifestyle 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

Our Centres are designed for patient convenience, to access all routine needs under one roof

13

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 FLOATER THE 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 cheques We 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

Who is eligible Who 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

•• If the you have a bank account in any of the following bank If the you have a bank account in any of the following bank then you need following things then 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 members Age proof for all family members

Process Process

–– Age proof for all family members Age proof for all family members

–– Two cheques Two cheques •• One in the name of One in the name of

•• If you are Bank of India or Bank of Baroda A/c Holder “ National If you are Bank of India or Bank of Baroda A/c Holder “ National Insurance Co.Ltd” or Insurance Co.Ltd” or

•• If you are Punjab National Bank A/c Holder then “ Oriental Insurance If 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 name We need one cheque in the name of of “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

Process Process

•• If you are not a account holder in any of the If you are not a account holder in any of the

mentioned bank then you need to open mentioned bank then you need to open

savings account in any of the bank.savings account in any of the bank.

–– Account Opening form is attached Account Opening form is attached –– Account Opening form is attached Account Opening form is attached

–– Fill the same and submit it along with all KYC Fill the same and submit it along with all KYC

norms in the bank.norms in the bank.

–– After opening the Account please follow the After opening the Account please follow the

process.process.

Important NoteImportant Note

•• Please open Bank Account in Please open Bank Account in

–– Bank of India or Bank of Baroda if your age is less Bank 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 mentioned Then follow the same process as mentioned

earlier.earlier.

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)

Portability Portability

•• If you wanted to take advantage on your existing If 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 of Intimation 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 then If the existing policy is of Oriental Insurance Company then we will do the portability in Oriental Insurance Company we will do the portability in Oriental Insurance Company we will do the portability in Oriental Insurance Company we will do the portability in Oriental Insurance Company onlyonly

–– Else all policies will be portable to National Insurance Else all policies will be portable to National Insurance Company Ltd.Company Ltd.

–– Please call us for clarity before actual filling up of the Please call us for clarity before actual filling up of the Application for avoiding confusion Application for avoiding confusion

–– Other process remains the same for Account & Other process remains the same for Account & Application Application

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

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

For any Clarification & HelpFor any Clarification & Help

You You

•• Wanted to complete the process for buying of Wanted 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