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BRILife Health Insurance Proposal Created Specifically For: Mei 14, 2020 PT. Asuransi BRIlife CORPORATE BUSINESS 02
BRILife Health Insurance Proposal
Created Specifically For:
Mei 14, 2020PT. Asuransi BRIlife CORPORATE BUSINESS 02
➲ Company Profile
➲ Benefit of Health Insurance
➲ Service procedure
➲ Health Care Management
➲ PremiumGraha Irama Lt. 9 Jl. H.R.Rasuna Said Blok X-1 Kav 1&2 Jakarta 12950
PRESENTATION POINT
Company Profile
COMPANY PROFILE
A Brief History of BRI Life
1987 1993 2003
20132015
BEGINNING STARTINGEstablished by the BRI Pension Fund to meet needs and complete services.
BUSINESS EXPANSIONSales office to serve sales force to all major cities in Indonesia.
POTENTIAL EXPANSIONBRI Life expands its services by opening the Syariah Insurance business unit.
DYNAMIC AND RECENTBRI Life together with Bank BRI conducts channel developmentBancaasurance business.
ROBUST AND RELIABLEBRI Life was acquired by PT. Bank Rakyat Indonesia (Persero) Tbk. BRI Life has more than 25 sales offices.
91,001% 8,999%
Shareholders Composition
COMPANY PROFILE
Important Financial Statements Overview &
RBC
COMPANY PROFILE
The Finance The Best CFO & Performing
Life Insurance 2019
Indonesia Trusted Companies Based on Coorporate
Governance Perception Index (CGPI)
Media Asuransi Awards Market Leader 2019
IT Works Top Leader on Digital Implementations 2019
IT Works Top Digital
Implementations 2019
Warta Ekonomi Awards 2019 Perusahaan Asuransi Inovatif
dalam pengembangan Bancassurance dan Produk
Link Berbasis Syariah
Info Bank Awards 2019 Asuransi Berpredikat “Sangat Bagus” Atas kinerja keuangan
selama 2018Indonesia Financial Top Leader Award
2019 Katergori Asuransi Jiwa
Media Asuransi Awards 2019 Best Life Insurance 2019
Kategori Ekuitas Rp. 1,25-4 Trilliun
Majalah Investor Awards Asuransi Jiwa Terbaik 2019 Kategori Asuransi Jiwa Aset
5-10 Trilliun
Indonesia Insurance Innovation Award 2019
As Top Most Trusted Insurance Companies
Trusted Company Base on Corporate
Governance Index 2018
AWARD 2019COMPANY PROFILE
Danakarya
COMPANY PROFILE
Benefit Of Health Insurance
Rawat Inap
Rawat Jalan
Dental Care
Kacamata
Improvement BRI Life untuk benefit RI & RJ dari kondisi eksisting:
1. Biaya Kamar dan Makan menjadi 365 hari, sebelumnya hanya 180 Hari.2. Biaya Perawatan Intermediate & Biaya Unit Perawatan Intensif menjadi 365 hari, sebelumnya hanya 20 Hari.3. Biaya pembedahan menjadi singgle limit, sebelumnya di klasifikasi menjadi 4 (Kompleks, Besar, Sedang, dan Kecil.4. Biaya Kunjungan dokter dan Spesialist menjadi 365 Hari, sebelumnya hanya 180 Hari.5. Biaya Rawat Jalan & Gigi Darurat akibat Kecelakaan menjadi single limit yang sebelumya dipisah dengan manfaat
Gigi Darurat akibat Kecelakaan sangat kecil.6. Penambahan Biaya Paket Penyakit Kongenital yang sebelumnya tidak ada.7. Santunan Dana Tunai Harian menjadi 365 Hari, sebelumnya Tanya Maksimal 60 Hari.8. Biaya Santunan Dana Tunai Harian menjadi Rp. 600.000,-/ Hari, sebelumnya Rp. 500.000,-/Hari.9. Penambaham Manfaat Biaya Imunisasi Dasar pada rawat jalan, sebelumnya tidak ada.
Syarat dan Ketentuan Umum
1. Menjamin klaim dari seluruh dunia. 2. Penjaminan 24 Jam. 3. Tanpa masa tunggu penyakit tertentu untuk peserta baru atau peserta tambahan. 4. Menjamin peserta s.d usia 65 Thn dan Anak 0–25 Thn. 5. Claim System Cashless (Swipe Card) di Provider BRI Life dan Reimburs di luar provider BRI
Life. 6. Menjamin semua penyakit kristis. 7. Menjamin akupuntur, (dengan rekomendasi dokter dan berhubungan dengan diagnosa
utama sakit), tanpa limit berdiri sendiri, dijaminkan sebagai diagnosa penyakit umum. 8. Menjamin keputihan, flour albus, vaginitis, cervicitis, abses bartholini, selama tidak
berhubungan dengan penyakit menular seksual. 9. Menjamin Vitamin dan Multivitamin dan Food suplemen yang diresepkan dokter selama
bukan produk MLM. 10.Mengakomodir COB dengan BPJS atau dengan Asuransi Swasta Lainnya. 11.Peserta tambah backdate 30 hari klaim dicover. 12.Kondisi detail lain tertuang dalam Lampiran term dan condition.
ServiceProcedure
SERVICE PROCEDURE
Card for VIP
1Participants headed to BRI Life
Hospital / Clinic
2Confirm guarantee /
Card in Swipe
3Guaranteed or not guaranteed
4Preparation for home
and final medical expenses
5Excess Amount
6Excess is paid by participant
in the place / Participant Goes Home
BRI Life Provider Not in the BRI Life Provider1
Participants headed Hospital / Clinic Non Provider
2All treatment documents provided by the hospital
3All documents are given to BRI Life.
4Claim payment to Employee's
account 10 working days.
KLINIK ADMEDIKA Jl.Jend. Sudirman, Jakarta
Term # 12345678 April 15, 2006 8.30 pm APP CODE 15160 CARD NO. 8000 1815 0001 5095 ALEXANDRA PENDAFTARAN PASIEN ************************************************* ASURANSI XYZ PT. ABCD BENEFIT : RAWAT JALAN
B. Dr. UMUM 25.000 B. Dr. SPEC 50.000 B. OBAT/VITAMIN 775.000 B.TES DIAG 550.000 B. FISIOTERAPI 300.000 B.VAKSINASI + DOKTER 175.000 B.KONSULTASI & OBAT 50.000
Limit tahunan 2.250.000 --------------------------------------------------------- EKSES KLAIM DIJAMIN DAHULU OLEH ASURANSI
KLINIK ADMEDIKA Jl.Jend. Sudirman, Jakarta
Term # 12345678 April 15, 2006 8.30 pm APP CODE 15160
CARD NO. 8000 1815 0001 5095 ALEXANDRA
PENGESAHAN & TAGIHAN ******************************************* ASURANSI XYZ PT. ABCD BENEFIT : RAWAT JALAN DIAG : J02 B. Dr. UMUM 0.00 B. Dr. SPEC 50000.00 B. OBAT 100000.00 B.TES DIAG 0.00 B. FISIOTERAPI 0.00 KB 0.00 IMUNISASI 0.00 JUM. BIAYA 200.000.00 JUM. DIBYR ASS. 150.000.00 JUM DIBYR PASIEN 50.000.00 -------------------------------------------------
Registration
Ratification
Proof of registration BRI Life AdMedika
Kuitansi Asli
Salinan Kartu Peserta Askes
Diagnosa Dokter/ Resume
(Berstempel)Berkas
Tambahan
Rawat Inap √ √ √
Rawat Jalan √ √ √
Rawat Gigi √ √ √
Kontrol Kehamilan √ √ √
Pembelian Obat Di Apotik Tanpa Pemeriksaan Dokter (Pengulangan Resep)
√ √ ▪ Salinan resep dokter, indikasi pembelian obat-obatan/ Diagnosa
▪ Rincian dan harga masing-masing obat
Pemeriksaan Laboratorium √ √ Salinan Surat Pengantar pemeriksaan Laboratorium dari dokter yang merawat dengan disertai cap/stempel klinik, praktek dokter, Rumah Sakit, RSIA, disertai indikasi pemeriksaan laboratorium/ diagnosa
Kacamata √ √ • Salinan resep Dokter Spesialis Mata untuk pembelian pertama kali atau Copy Resep dari Reffraksionist Optician jika sudah pernah klaim sebelumnya
• Rincian biaya frame dan biaya Lensa/Lensa Kontak
Formulir Rawat Jalan dapat digunakan untuk :Rawat Gigi, Kacamata dan Kontrol Kehamilan
PENGAJUAN KLAIM REIMBURSEMENT
CORDINATION OF BENEFIT (COB)
BPJS ft BRI Life The requirementsFile as usual claim (Resume, Diagnosis, Prescription drugs, results of supporting labs) in the form of legalized FC: 1. Letters of eligibility (BPJS verifiers at hospitals)2. INA c’bgs letter (BPJS Verifier at the hospital)3. Cover letter from the local BPJS
BRI Life ft Other InsuranceFile as usual claim (Resume, Diagnosis, Prescription drugs, results of supporting labs) in the form of legalized FC1. Cover letter from the first guarantor, which explains the total cost of care and the total cost
guaranteed.2. Claim acceptance from the first guarantor, which contains information on guaranteed and
unsecured costs of any benefits (claim details).3. Photocopy of billing of hospital bill legalized by the first guarantor (including photocopies of
medical resumes and other supporting results).
BRILIFE HEALTHCARE MANAGEMENT
PENGECUALIAN
Transplantasi Organ
CuciDarah
PerawatanPercobaan
GangguanJiwa
TerapiHormonal
Kesuburan/ketidak-suburan
PerawatanKosmetik / Estetika
PenyakitBawaan
Lahir
Medical Check-Up
Sunat Penyakit Kotor, HIV/AIDS,
Aborsi Ilegal
Terapi Bicara
Perang OlahragaBerbahaya
BunuhDiri
Alat Bantu Seperti Alat
Bantu Dengar, Kursi Roda
Tidak Diperlukan
Secara Medis
BRILIFE HEALTHCARE MANAGEMENT
There is no need to choose just one hospital / clinic
which means that participants are free to use all
hospitals / network clinics at BRI Life.
The BRI Life Card can be
received well at hospitals / BRI Life Network
Clinics throughout Indonesia.
BRI Life Clinic hospitals / clinics are
located throughout Indonesia
Participants do not need to pay when seeking treatment in this network, simply swipe
the card on the available IDC
machine.
BRI Life can add hospitals / network clinics according to the client's request
whenever possible.
3000 BRI Life Hospital / Clinic networks
Hospital Partner Overseas
National University Hospital
Mount Elizabeth Novena
Raffles Hospital
Mount Elizabeth Orchard
Singapore National Eye Center
SINGAPURA 1.National University Hospital 2.Tan Tock Seng Hospital 3.Raffles Hospital 4.Singapore Pain Care Center 5.Mount Elizabeth Novena 6.Mount Elizabeth Orchard 7.Gleneagles Hospital 8.Singapore General Hospital 9.Singapore National Eye Center
MALAYSIA 1. Island Hospital 2. Gleneagles Penang 3. Mahkota Medical Centre 4. Sunway Medical Centre 5. Gleneagles Kuala Lumpur 6. Pantai Hospital Kuala Lumpur 7. Institut Jantung Negara 8. Loh Guan Lye Specialist Centre 9. Mount Miriam Cancer Hospital
Island Hospital
Gleneagles Penang
Mahkota Medical Centre
Gleneagles Kuala Lumpur
Pantai Hospital Kuala Lumpur
Accommodate claims from several other countries such as: Africa, AUS, NZ, Caribbean, Middle East, North America, Europe, South America and Central America.
BRI Life Mobile Apps :Health Insurance Policy Information
Benefit of Health Insurance
Information of Partner Hospital With Directions
Claim History
Virtual Card
SERVICE ADVANTAGES
MY MEDICAL •Services that provide information
- Benefit Information- Product- Claim history- Hospital Information Provider
PERIODIC MEETING✓ Between BRI Life and the Company
to evaluate the health services that have been provided.
✓ Performed every 3 months or 6 months, depending on needs.
HEALTH TALK SERVICE✓ To establish health
communication between BRI Life and participants.
✓ Contains important information and health tips.
✓ Every Year 1x.
HEALTH CARE SERVICE✓ 24/7 service for clients✓ Person In Charge of each
company
PAYMENT OF CLAIMS ✓ Submit using softcopy is paid
after the file is received complete.✓ Paid a maximum of 10 working
days.
VIRTUAL ACCOUNT ✓ A service that makes it easy for
Policyholders to make payments
PROVIDER BRI LIFE ✓ Participants are served in 3,000 BRI
Life swipe card provider networks.✓ Providers consist of private and
government providers.✓ There are Providers in several
countries abroad.
BRILIFE HEALTHCARE MANAGEMENT
HOTLINE SERVICES 24 / 7
Customer Services 24 hours BRILIFE dan AdMEDIKA :
021 - 29647555 Email Operation :
[email protected] [email protected]
Claim Verification via Whatsapp (Tc Apply) :
0859.744.33023
www.brilife.co.id
@brilifeid
MEDIA INFORMATION and PUBLICATION
Contact Person :
Costantein Johanes Geruh (Jojo)082298597488
PREMIUM
Peserta & Premi
Peserta & Premi
TOTAL PREMI
Keterangan:Mekanisme Pembayaran Premi adalah TahunanPremi dapat berubah sesuai dengan sebaran demografi peserta
