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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
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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?
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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
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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