Download - S YSLIFT A M ANAGEMENT I NFORMATION S YSTEM F OR M ICRO I NSURANCE Designed by Health Developed by
SYSLIFT A MANAGEMENT INFORMATION SYSTEMFOR MICRO INSURANCE
Designed by
Health
Developed by
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Software developed by Tieto Enator for Micro-Insurance Units
Meant for community based organizations/branches gathered together under a Federation
Can be used by any Micro insurance model (mutual or partner agent)
Syslift
Syslift - MIS
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MicroInsurance Management Information System.
Reporting customized for various levels of decision.
Strong capacity for Health Insurance. Comprehensive Database for statistical
research. Tracking & understanding of contributions
and members’ data. Risk management indicators for managing
Insurance Management. Capacity to handle infinite products under
3 categories : Health - Accident – Property User Friendly : Fully open to Development
specification suggestions.
SYSLIFT IS A
Freeware
offered to micro insurance units
sharing their database with all other user-MIUs.
1. To maintain information about products, policyholders, dependants, policies and claims.
2. To monitor Micro-Insurance portfolios.
3. To monitor quality data encoding.
4. To faster the claim settlement process – cashless systems.
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To Provide MIU’s with data from a Centralized Database for easing their activities management, and helping their clients/members to have a better behavior related to the concerned risk.
Syslift Objectives
Operational Processes
Syslift Software for Policy Making Portfolio management Claims Processing & Decision Makings Statistics and reporting
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Community A
Community B
Reporting
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Syslift Overview
Syslift
Security Roles & Database Support
Functionalities Data Models
Pl click on buttons
Complete DB security Complete User Configuration User Logins & Roles Physically data deletion not
possible, logically possible to hide or unhide – Administrator Right
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Security Roles
Back End – Database - SQL Server
Front End – Application - Visual Basics
Client Server
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DB supportUser Role
Limited access Purpose / Work
Printer No Field Editable To read any data.
Encoder Right of Policy/ Claims Creation before validations
To do all type of encoding only.
Claim Adjuster
Limited Fields editable on Claims
For Claim Trials.
Controller
Finalized Decisions can’t be changed /edited.
Right of Decision making
Administrator
Works thru different User Roles.
Responsible for Data security & quality.
User Operate through its limited User Property
Use Me
Policy Category - 3 Types of Insurance Policies
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Syslift Functionalities Policies & Products
Health Insurance Policies
Accidental – Life Insurance Policies
Property – Asset Insurance Policies
Products - Possible to handle
Infinite no of Products under Policy Category Called as “Policy Products”.
Policy Factor Catalog Fixed Factors & Variable Factors –
Formula Writing possible
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Product Definitions
Product Definitions – Includes Factors. Responsible for
Automatic Premium Calculations.
Partner/Policy Search Names or Branch Name or Policy Nr etc.
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Policy Management
Partner/Policy Creation
Policy Information available at a glance - One Policy Holder (or family) with Many types of Policies or Products.
Policy Shift/ Selection from One policy to other Possible.
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Policy Selection
Policy Details like Policy Number, Categories, Products, Start dates, End dates etc.
For Balance Payments / Premiums Warning message for
balance of premium not paid
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Policy Validations
Policy Validations For Factors Value Checking Contribution Details
& Encoded Data should match
Information of Multiple Claims on One policy – available on One Window.
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Claims Management
Claims Details – family or Individual
Claim Benefit Category & Max Limit - Doesn’t allow Claim amt higher than its Max Limit
Extensive Data of Expenses Billed
Inter-National Classification of Diseases (ICD) by WHO – Upto 3rd level
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Claims Management
Amounts Related to Claims -
Total Expenses Billed - Amt. Claimed
Amt Claimable Amt Disbursed Additional
Benefit Amt.
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Reporting From Syslift
No Limited In-built reports
Reports Development using Crystal Reports
Report Association Possible
Choice of Filters – Parameters Settings
Export Facility – Excel, Crystal Reports, DIF, CSV
All Quantitative & Qualitative reports possible.
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Reporting From Syslift
Technical Report with – Important Ratios –
Claim Ratio Frequency Ratio etc.
Fund balances Claim Paid Amount Insured Members Claims to be processed Health Insurance
Indicators Use Me
Data Model Features
Security: Login with password and various possible user roles.
3 Types of policy Categories and an infinite number of possible policy Products.
5 Levels of portfolio consolidation (Community – Fed). Extensive Claim Information Management:
Health Events chosen from the ICD (WHO) Any Bill or Expenses are sorted per Hospital
Data Model including Policies, Persons, Families, Socio economic and personal health information, International Diseases Catalogs (WHO).
Various reports and Wide potential for statistical studies.
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Data Model – Data TablesPartner: Contains Partner’s Data
Partner No, First_Name, Middle_Name, Last_Name, Area, Branch, Income, Birth_Date, Religion, Address Etc.
Program: Contains Federations Structure, (E.g. FederationDistrict VillageGroup)
Business_Code: Contains Business codes, and description, (E.g. Self Employed, business name, Govt. Employed, type of work, etc)
Policy Table: Contains All Information about Policy of partner like Policy Number, Type, Policy Holder, Premium, Start Date, End Date, Enrollment Date.
Policy Receipt
Table: Has Information about Policy Receipts. Receipt SrNo. Receipt_Date, Encode_Date, Encoder, Collector.
Policy Dependents
Table: Stores info about all dependents of policy. Like Policy ID, Policy holder, Relation, etc
Policy Claim Table: Holds Claims Information about Policy claims of partners like Claim_Number, Start Date, End Date, Enrollment Date.
Policy Claim Details: Has details about Claims. Claim_Number, Bill Date, Claim_Expense Details, Hospital Name, Doctor In Charge, Normal Market Price, Expenses billed, Amount Claimable, Indemnity
Data Model – Catalogues
Kat_ICD: Contains ICD List (International Classification of Diseases)
ICD Code, Description, Kat_Policy_Type: Contains Policy Types (Personal, Accidental, Property)
Kat_Medical
condition: Contains Business codes, and description, (E.g. Self Employed, business name, Govt. Employed, type of work, etc)Kat_Relation: Contains All
relations in it
Father, Mother, Brother, Sister, Spouse, Father In-Law. etc
Kat_Claim_Statu
s: Stores Status of Claim (Opened, encoded, enquiry, Ready for Settlement, Settled.
Kat_Document_Type: Has details about document types needed for claims.
Member ID Card, Claim application document Doctor’s Checking Report, prescription. etc
Kat_Expenses: Stores Status of Expenses for claims : (Expense Code, Policy Type).
Partner Information – Partner Window
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Partner & Policy Windows
Family Information – Policy Details Window Policy Details Personal Details Medical Conditions Relations etc
Status of Processing of Claims Opened Encoded Enquiry & Ready for Settlement.
Decision Making Status – Settled Unpaid Settled Paid & Settled Guidance Only
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Policy & Claims Status
Expire Status – Expired Policy
Cancel Status – Cancelled Policy
Open Status – Ongoing Policy
Portfolio levels upto 5th level are available.
Helps to study closely the smallest possible unit
Also, useful for Consolidated studies & Analytical studies
Study of regional differences
Health trends & parameters etc.
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Data Models – 5 Levels
User Creation Shift to Community –
Easy shift of partners from one Branch to other
Report association Policy receipts Policy Expiration Contribution Statistics.. –
Technical Report with Health Insurance Indicators
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Administrative Catalogs
Catalog Editor - Organizational Structure – levels of Portfolio Medical Condition – Attached to Partner Business types and Relations Expenses types & Expenses – For Claims Document type & Claim Benefit Category – Attached to
claims Policy factor & Product – Product Definition
Plans For 2007
To configure the software for Cash less claim settlement.
Online download – Web based software. Licensing of Software To develop Centralize DB systems. Health care pricing lists and Hospitals’
agreement stored and comparable. Multi Scripts Multi lingual
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How to get the Software?
Pl Contact us at:
UpLift India AssociationPhone: 020-26051013/ 9225528127
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THANK YOU!
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