Syslift A Management Information System For Micro Insurance

1. Health Designed by Syslift A Management Information SystemFor Micro Insurance Developed by

2. Syslift • 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) 2

3. Syslift - MIS • 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. 3

4. Syslift Objectives • 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. • To maintain information about products, policyholders, dependants, policies and claims. • To monitor Micro-Insurance portfolios. • To monitor quality data encoding. • To faster the claim settlement process – cashless systems.

5. Community A Reporting Community B Operational Processes • Syslift Software for Policy Making • Portfolio management • Claims Processing & Decision Makings • Statistics and reporting

6. Syslift Overview Syslift Functionalities Data Models Security Roles & Database Support 6 • Pl click on buttons

7. Security Roles • Complete DB security • Complete User Configuration • User Logins & Roles • Physically data deletion not possible, logically possible to hide or unhide – Administrator Right

8. DB support • User Operate through its limited User Property • Back End – Database - SQL Server • Front End – Application - Visual Basics • Client Server 8 Use Me

9. Syslift Functionalities Policies & Products • Policy Category - 3 Types of Insurance Policies • 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”.

10. Product Definitions • Policy Factor Catalog • Fixed Factors & • Variable Factors – • Formula Writing possible • Product Definitions – • Includes Factors. • Responsible for Automatic Premium Calculations. 10

11. Policy Management • Partner/Policy Search • Names or • Branch Name or • Policy Nr etc. • Partner/Policy Creation 11

12. Policy Selection • 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. • Policy Details like Policy Number, Categories, Products, Start dates, End dates etc.

13. Policy Validations • For Balance Payments / Premiums • Warning message for balance of premium not paid • Policy Validations For Factors Value Checking • Contribution Details & Encoded Data should match 13

14. Claims Management • Information of Multiple Claims on One policy – available on One Window. • Claims Details – family or Individual • Claim Benefit Category & Max Limit - Doesn’tallow Claim amt higher than its Max Limit • Extensive Data of Expenses Billed

15. ClaimsManagement • Inter-National Classification of Diseases (ICD) by WHO – Upto 3rd level • Amounts Related to Claims - • Total Expenses Billed - Amt. Claimed • Amt Claimable • Amt Disbursed • Additional Benefit Amt. 15

16. 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

17. Reporting From Syslift • All Quantitative & Qualitative reports possible. • 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 17

18. 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.

19. Data Model – Data Tables Partner: Contains Partner’s Data Partner No, First_Name, Middle_Name, Last_Name, Area, Branch, Income, Birth_Date, Religion, Address Etc. Business_Code: Contains Business codes, and description, (E.g. Self Employed, business name, Govt. Employed, type of work, etc) Program: Contains Federations Structure, (E.g. FederationDistrict  VillageGroup) 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 19 19

20. Data Model – Catalogues Kat_ICD: Contains ICD List (International Classification of Diseases) ICD Code, Description, Kat_Medical condition: Contains Business codes, and description, (E.g. Self Employed, business name, Govt. Employed, type of work, etc) Kat_Policy_Type: Contains Policy Types (Personal, Accidental, Property) Kat_Relation: Contains All relations in it Father, Mother, Brother, Sister, Spouse, Father In-Law. etc Kat_Claim_Status: Stores Status of Claim (Opened, encoded, enquiry, Ready for Settlement, Settled. Kat_Expenses: Stores Status of Expenses for claims : (Expense Code, Policy Type). Kat_Document_Type: Has details about document types needed for claims. Member ID Card, Claim application document Doctor’s Checking Report, prescription. etc

21. Partner & Policy Windows • Partner Information – Partner Window • Family Information – Policy Details Window • Policy Details • Personal Details • Medical Conditions • Relations etc 21

22. Policy & Claims Status • Open Status – Ongoing Policy • Cancel Status – Cancelled Policy • Status of Processing of Claims • Opened • Encoded • Enquiry & • Ready for Settlement. • Decision Making Status – • Settled Unpaid • Settled Paid & • Settled Guidance Only • Expire Status – Expired Policy 22

23. Data Models – 5 Levels • 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.

24. Administrative Catalogs • 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 • 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 24

25. 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

26. How to get the Software? Pl Contact us at: UpLift India Association Phone: 020-26051013/ 9225528127

27. THANK YOU! 27