GMC By
• Pioneer Investcorp (PINC) is an India-focused integrated financial services company specializing in insurance advisory services
• A decade of experience in serving the needs of corporates across several industries such as
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Pharma, Healthcare, IT, Liability & BFSI.
• Registered
Broker
• PINC Group has a professional team of over 250+ members with a strong entrepreneurial mindset
• Presence across 8 cities – Mumbai | Delhi | Chennai | Bengaluru | Kolkata | Pune | Coimbatore | Ahmedabad
Full-Service Spectrum of the PINC Group Service Offerings
Investment Banking
Institutional Securities
Insurance Advisory and Intermediation
Debt Syndication & Advisory Bond Trading PE Advisory
M&A Advisory
Institutional Equities
Direct Insurance Broking
Global Reinsuranc e Broking
Direct Insurance Comprehensive understanding of an array of product options and extensive risk analysis of the client with advisory services.
8. Credit Insurance 7. Liability & Specie Insurance
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Classes Handled
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Recent Transactions Structured , designed and placed a comprehensive Marine Stock through put insurance for a Retail conglomerate .
1.Property & Project Insurance
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2. Marine Comprehensive Insurance
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3.Oil & Energy Insurance
This involved extensive analysis of existing risk profile of the corporate and ensuring a through the value chain
4. Aviation Insurance
Our Approach
Understandin g Client Business Strategies
Risk Evaluation & Management
Structuring Insurance Programs
Seeking Quotes & Placement
Claims Handling
Value proposition VS Competitors HOW DO WE DIFFRENTIATE? Employee Based
Corporate Based
• Single window settlement 24/7
• Data Analysis and findings
• 24*7 support
• Improving ratio
cashless/Reimbursement
• Technology platform • Cashless TAT • Wellness program • Communication with employees
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Employee benefit practice CORE EMPLOYEE BENEFITS Benefit Management • Employee Benefit policy Design • Procuring best coverage from market at competitive rate • Training of employees for availing benefits • Dedicated relationship manager
INSURANCE COVERS • • • • • • • • •
Medical Plans Personal Accident and Life EDLI Disability Travel Medical Self Insurance/ Stop Loss covers Voluntary Benefits Key man Insurance Top Up plan
WELLNESS PROGRAMME
• Benefits Administration
Retiral Issues
• 24* 7 claim assistance
• Health camps
• Review and Analysis
• Health Talks • Employee engagement programme • Counseling sessions
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Quote Quote & & Services Services comparison comparison from from different different insurers insurers as as per per the the specified specified requirements requirements
EMPLOYEE HEALTH INSURANC E
Benchmarking Benchmarking of of the the costs costs and and services services for for each each of of the the carriers carriers for for different different options options
Suggestion Suggestion and and recommendations recommendations on on basis basis of of the the quotes quotes and and comparative comparative statements statements
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Employee Communication • Benefits Highlights, Handbook, Folders • Summary Plan Description • Benefit Presentation for employees • Enrollment Kits • Online Web portal for all Employee benefit process • Mobile App for HR & employee login
Employee benefit package – Core services cont. Dedicated Discounts on person for medicines and cashless diagnostics management
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Mobile Apps
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Monthly MIS • Deployment of a process, generating the monthly MIS wherein key parameters are captured like demographics, additions, attritions, ID card TAT, claim status, amount reimbursed etc. • This helps in monitoring the smooth running of operations where problems and glitches are identified and communicated to the client, insurer and TPA. • Along with it, rectification plans are provided to make the program more effective and useful. These reports forms the base for quarterly and yearly reviews.
Claim Support PINC has its predefined processes and formats which are agreed mutually between the client, insurer and TPA in the service level agreements wherein processes for claim registration, preauthorization, claim settlement and other required end to end solutions for claims settlement and amount reimbursement. PINC negotiates on behalf of the employers for the legitimate claims which are either rejected or partly reimbursed. It also helps in monitoring the claim settlement TAT as agreed in the SLA and helps in quick and smooth settlement.
PreAuthorization
Claim Registration
Verification
Adjudicatio n
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Cashless Hospitalization Cashless hospitalization means the Administrator may authorize upon a Policyholder’s request for direct settlement of eligible services and its according charges between a Network Hospital and the Administrator.
Planned Hospitalization
Emergency Hospitalization
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Non cashless hospitalization process Member intimates PINC before or as soon as hospitalization occurs
Ye s
Is claim liable (coverag e/ applicabil ity)
Claim registered by TPA after receipt of claim intimation
TPA performs medical scrutiny of the documents
Insured admitted as per hospital norms. All payments made by member
Ye s
Is documenta tion complete No
Ye s
Claims processing done within 15-20 days
Send mail about deficiency and document requirement
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•Insured will create the summary of Bills (2 copies) and attach it with the bills •The envelope should contain clearly the Employee ID & Employee e-mail Claim Rejected
If document recieved within 30days from discharge
No
No
Insurer checks document sufficiency
Insured sends relevant documents to designated regional office within 30 days of discharge
AA
Payment to be directly made to HR. The same will be disbursed to claimant by Controllership.
ROGRAM DETAILS – ONSITE & VIRTUAL HEALTH SCREENINGS
EVENT BASED QUIZZES/TOOLS
HEALTH SESSIONS/TALKS
HEALTH SESSIONS/TALKS
COUNSELLING SESSIONS
HEALTH ARTICLES/TIPS
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WELLNESS PROGRAMS • Basic Health Check-up Camp (BP, BMI, RBS, Dr’s Consultation) • Eye Check-up Camp • Dental Check-up Camp • Hair & Scalp Analysis Camp • Skin Analysis Camp • First Aid responder program • Save the life through CPR training • Onsite Foot reflexology camp • HRA (by EAV machine) with consultation • Angiodefender test (Assess heart attack risk & your Vascular age) • Bone mineral density camp • Audiometry camp
• • • • • • • • • • • • • • •
Spirometry camp Deep venous thrombosis test camp Drum circle session Sound healing session Peripheral neuropathy test camp Laughter session Yoga/Desktop yoga/Meditation Depression assessment test Self Defence program Zumba/ Bollywood Zumba Catharsis and inner cleansing Tai-chi and core muscle strengthening Dance Aerobics for Cardio fitness Onsite Medical room set up Onsite Gym/Fitness room set up & many more 16
Our Clients
Maini Materials
NTPC
NDTV
Nuclear Power Corporation
BPCL
Aurion Pro
Raymond's
BHEL
Wilhelmsen Maritime services ltd
MRPL
SAIL
Tata Housing
Essel Infra
Hathway Cables
Ashok Piramal Group
Purvankara
Tata Infra
JSW Severfeild
Valecha Group
MEP Infra
HCC Vizag Steel
Capri Global. Anunta technologies
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Thank You
Disclaimer The information and material provided in this presentation do not constitute an offer or solicitation for the purchase or sale of any security and financial instrument. The information may be obtained from various sources and PINC and/or its affiliates do not represent that the information is accurate or complete, and it should not be relied upon as such. PINC accepts no liability whatsoever for any direct or consequential loss arising from the use of this material or its contents. All estimates and opinions provided herein constitute the original researcher’s judgment as of the date of the report and may be subject to change without notice. PINC will not be responsible for the consequences of reliance upon any opinion or statement contained herein. The returns on the products discussed in this material are not guaranteed by any bank unless specifically stated and are subject to investment risks, including possible loss of the principal amount invested. An investment in any product should be made only after careful study of the most recent sales prospectus, term sheets, relevant fund regulations and basic legal information contained therein. Furthermore, investments in foreign currencies are subject to exchange rate fluctuations. Before entering into any transaction, you should consider the suitability of the transaction to your particular circumstances and independently review (with your professional advisors as necessary) the specific financial risks as well as legal, regulatory, credit, tax and accounting consequences.