Final Final Insurance

8/13/2019 Final Final Insurance

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Presented byDeepali Jukar (PA-04)Rachana Shetty (PA-14)Sagar Patel (PA-17)


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Commenced operations on 18thMay2006 with an unique distinction of being thefirst Standalone Health Insurer of India

Had a humble beginning with Rs. 18 crs of premium during the first year, grewleaps and bounds by registering GDP of Rs. 860 crs during FY 2012-13

Operating through 224 Branch offices and 512 SMS with more than 5000employees in the service of the insuring public

Has handled 3 mega schemes

Rajiv Aarogyasree in AP Chief Ministers Health Insurance Scheme in TN

Govt. Employees Scheme in TN

Has been maintaining growth rate consistently more than the industry average


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Paid up capital : INR 326.95 Crs

Promoters: Oman Insurance Company, UAE

Leading NRIs

Indian Business Houses

Investors: ICICI Ventures Funds

Sequoia Capital

Tata Capital Growth Fund


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Corporate Office

Zonal Offices

Area Offices

Branch Offices

SM Station SM CorporateAgents/Brokers

Agents MTs


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Source

GIC

SL No Insurers Health

1 New India 2757.71

2 United India 2642.81

3 National 2372.22

4 ICICI-lombard 1665.17

5 Oriental 1491.94

6 Star Health 843.80

7 Apollo Munich 598.75

8 Bajaj Allianz 594.85

9 HDFC ERGO 521.5010 Reliance General 295.53

11 Cholamandalam MS 287.00

12 IFFCO-Tokio 210.79

13 Royal Sundaram 209.23

14 Max Bupa 206.52

15 Bharti AXA 195.49

Grand Total OF 22 15340.78

Rs. In Crores

Ranking 6thamongst all General Insurers in garnering Healthinsurance Premium

Ranking 2ndamongst Private Insurers in securing Health Premium Ranking 1stamongst the Standalone Health Insurers in premium

base


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Gross Direct Premium Underwritten upto November 2013

INSURERS APRIL NOVEMBER(yoy)

GROWTH OVER THEPERIOD OF PREVIOUSYEAR( )

TATA-AIG 1353.92 16.62

ICICI LOMBARD 3967.67 16.87

BAJAJ ALLIANZ 2505.62 16.87

HDFC ERGO 1601.18 16.70

BHARAT AXAGENERAL

772.87 20.94

MAX BUPA 104.68 68.91

STAR HEALTH 512.78 24.43


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INSURERS MARKET SHARE( ) ANNUAL RANKINGTATA-AIG 3.14 11

ICICI LOMBARD 9.01 5

BAJAJ ALLIANZ 5.82 6

HDFC ERGO 3.71 9

BHARAT AXAGENERAL

1.86 15

MAX BUPA 0.35 23

STAR HEALTH 1.27 19

HEALTH INSURANCE MARKET OVERVIEW (APRIL 2013- NOV 2013)


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0

200

400600

800

1000

1200

1400

No. of Policies

Premium

Performance - Retail


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product for Senior Citizens

top up plan Star Super Surplus

Health + Life combi product

coverage for HIV +ve groups.

coverage for cardiac patientsStar Cardiac Care

Innovations by STAR


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2006 - 07 2007 - 08 2008 - 09 2009 - 10

24689112119

264725

493531

6.4 32.1 82.1164.4

no.of policies Premium (in crore)

Portfolio wise Performance

HEALTH

2006

- 07

2007

- 08

2008

- 09

2009

- 10

2010

- 11

2011

- 12

2012

- 13

32998

178481

227847 247579292242226474

131282

1.3 7.6 9.1 10.9 15.2 17.4 16.6

ACCIDENT


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First company to have in house settlement of claims with qualified medical professionals

Cashless with TAT less than 2 hours in 90% of cases

Cashless Claims settlement decentralized at zone level with prescribed limits.

Re-imbursement claims settled within 10 days on receipt of documents

We service our customers through 2056 Agreed network hospitals, 5431 Empanelled

hospitals and 724 empanelled diagnostic centers.

Hospital Relationship Managers in each zone to strengthen relationship with our network

hospitals

24 X 7 In house Toll Free Call Centre for claims facilitation and claims assistance center at

Zonal level

Field visit by our Doctors to verify authenticity of claims

Regional vigilance officers in every zone for market intelligence and monitoring offices


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0

50000

100000

150000

200000

250000

PA

HEALTH

OMP

Claims Handled (retail)


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Treatment of illness/disease/sickness contracted by the insured person during the

first 30 days from the commencement date of the policy

First Two Years Exclusions: Cataract, Hysterectomy for Menorrhagia or Fibromyoma, Replacement surgery for knee and/or joint (other than caused by an accident), Prolapse of intervertebral disc (other than caused by accident), varicose veins and varicose ulcers

First Year Exclusions Benign Prostate Hypertrophy, Hernia, Hydrocele, Fistula in anus, Piles, Sinusitis and related disorders, congenital internal disease/defects, removal of gallstones and renal stone

Naturopathy treatment

Exclusions


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Medical Examination Necessity for persons above 50 yrs of agecost of medical check up will be pickedby our Co

The test to be done in one of our empanelled laboratories only. The type of test tobe conducted is available with the net-work diagnostic clinics

Company will issue a form with the photo of the insured which needs to bepresented at our network diagnostic centre who will carry out the medical tests and

submit the report to us.

The report will be seen by the doctors on our rolls and based on theirrecommendation, proposals need to be accepted and policy issued.

If the insured has not turned up for medical examination up to 30 days from thedate of receipt of advance premium, then the premium received shall be refunded infull.

The cover is granted from the date of the advance receipt. In the event of any shortcollection of the premium, cover can be granted only from the date of collection of

balance/full premium


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Acceptance of proposals Persons above 50 or up to 50 yrs of age, where the medical reports/history, indicate

that the insured had suffered in the past or suffering from any heart disease orcancer, avoid acceptance of such risks.

Will not grant cover for persons beyond the age of 60 yrs under our following healthpolicies i.e. Medi Classic, FHO, Super Surplus, Medi premier & Health Gain.

The maximum age limit of 60 yrs for acceptance of business is not applicable to ourown renewals and Sr. Citizen Red Carpet insurance Policy

As for as the cover for persons above 60 yrs for Medi Classic, the proposal need not tobe considered generally and they can be covered under Sr. Citizen Red Carpet Policy.

No premium cheque to be collected nor the proposer shall be asked to undergomedical examination.

On receipt of the acceptance of the proposal from the Corporate Office, the premiumto be collected, persons to be asked to go for medical examination

Then the proposal and medical report shall be referred to the company doctor. Based

on the scrutiny report, the proposal has to be considered for underwriting


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All the officers in charge of operating officers are empowered to issue policies up to80 yrs of age & up to US $ of 5 lakhs sum insured.

Also note that all special exclusions/conditions/loading/co-pay & PED applicable tovarious age groups and sum insured is incorporated. However in respect of personsabove 80 yrs, proposal form along with medical reports to be referred to Corporate

Office for their approval.

Overseas Medical Policies

Break In insurance All the officers in-charge of operating offices (BM/AM/ZM) are empowered to

grant continuity of benefits in respect of their own renewals done within 15 daysfrom the date of expiry of the policy.

No cover will be available for the period (15 days) for which no premium isreceived.


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Transfer from other companies

Allowed only in cases where the age of the proposer is less than 45 yrs and also with

NIL Claim history. Even then based on the number of years, the policy has run with other/earlier

insurer, waiver of 30 days, 1year and 2 years are allowed excluding cover for PED. Cover for PED will be given only after completion of continuous policy with us for

four years. Whenever a proposal is received for covering only one individual of above 50 years

and not covering other younger members of the family, the proposer has to bedecided after satisfying our self, that there is no intention to cover a person withimpending problems

General The proposal form should be duly filled in all respect and signed by the

insured/proposer properly. Answering the questions with a mere dash shall not be accepted and

proposer/insured has to specifically answer with YES or NO.


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Level 1

Contact our Grievance Coordinator for your Region.Grievance Coordinator's contact information

Level 2

If not satisfied with our Zonal Grievance Coordinator's response thencall at toll free number 1 800 425 2255 / 1 800 102 4477 or landline number 044-28319100 (Register your complaint online.

Level 3

Contact Mr.V.Vasudevan,Grievance Redressal Officer,Corporate Grievance Department,

Level 4

If all the above steps do not meet your expectations or your issue is still unresolved or you are unhappy withour decision then escalate to: Insurance Regulatory Authority by registering your complaint in their website at http://www.irda.gov.in OR Insurance Ombudsman of your region

GRIEVANCE REDRESSAL


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Uses brochures for information forevery policy

Easy customer understanding

24x7 helpline for claims inquiries

Customer support

Online availability of brochures

Well designed web content

List of network hospitals

Clearly distinguished policies

featuring key benefits of each policy

Marketing collateral


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INTEGRATED

MARKETINGCOMMUNICATION


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PRINT ADVERTISEMENTS


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Star health undertook an innovative approach on World Diabetes

Day,2011in Thiruvananthpuram,Kerala by organising a flash mobwhere all officials including the senior ones held a rally withplacards and wearing t-shirts with World Diabetes Dayprintedonthem.

They were walking around several high traffic areas of the city andhanding over pamphlets to passers- ysmaking them aware aboutthe disease.

This approach of Star Health showed the potential clients howmuch concerned it is about their health and their readiness to holdtheir back in times of need.

This gesture can win customer buying intention which if properlynurtured through hassle free claims service and renewal notices

can achieve customer loyalty too.

INITIATIVE TAKEN BY STAR HEALTH


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INITIATIVE TAKEN BY STAR HEALTH


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OTHER COMMUNICATION MEDIA

Radio

Word Of Mouth

Newspapers

Walk-ins andCold Walk-ins


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Final Final Insurance

Documents

Transcript of Final Final Insurance