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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