Sghis final.pptx anik

WELCOMETO

OUR PRESENTATION

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ent of Insurance Business - Black & White

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2 Presentation topic

Analysis of the IUBAT Student Group Health

Insurance Scheme (SGHIS)Agreement paper

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3Prepared by: Black & White

Promiz Roy AnikID# 13102229

Silvy Bhuyian ID# 13102058

Samsun NaharID# 13102056

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Milia Rahman ID# 13102101

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4Prepared for :

Instructor: Abdullah Al Yousuf Khan

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5Aim

The aim of our presentation is to provide clear idea about the IUBAT students group health insurance scheme.

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6SequencesIntroductio

n Objectives

Scope of the report

Limitations of the report

Methodology

A brief description of

the SGHIS

Analysis of the agreement

paper Findings

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7 Introduction of SGHIS

Introduced: in May15, 2011 Between

International university of Business Progressive Life Insurance Agriculture & Technology Company Limited

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And

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8Objectives

Broad Objective: The broad objective of this report is to analyze the policy contract of the IUBAT student

group health insurance scheme .

Specific Objective:

To gain knowledge of the IUBAT student group health insurance scheme .

To identify what are the benefits we are going to get from SGHIS.

To know what will be our premium.

To know how we get claim amount.

To know the elements & condition of the contract.

To identify the overall Procedure & immediate support (SGHIS) of IUBAT and PLIC.

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9Scope of the report

The report is only based on our critical analysis of SGHIS

in IUBAT. This analysis will focus on giving the highest priority upon student for protecting their physical and morale hazards.

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10Limitations of the report

The report was conducted only analyze the IUBAT SGHIS policy agreement.

Lack of time & records. Large-scale research was not possible due to time constraints. Due to the lack of experience. Another limitation was that the data gathered could not be verified

for correctness.

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11Methodology

Primary source and Secondary sources:

For doing this report class lectures, IUBAT SGHIS agreement

paper, our main book “Insurance principles and practice” and face

to face consult with our honorable faculty those are both primary

and secondary information .

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12A brief description of the SGHIS

Health insurance requires sufficient information and data for development of a good scheme, proper pricing, and health management.

IUBAT is committed to enhancing the academic success of their students by helping them to achieve and maintain the highest levels of health, reduce risks and well being as possible.

It’s a welfare plan for the students of IUBAT.

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13Characteristics All students are covered. Acute sickness or accidental medical bills are paid by the insurer. Gives peace of mind to both students and parents. Direct payment if hospitalization in: 1. Ayesha Memorial Hospital 2. Apollo Hospital 3. Samorita Hospital 4. Uttara Crescent Hospital For other hospital, bills are paid by the insurer after providing the

valid documents.

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14The benefit of this policyStudents aged up to 30 years

For Hospitalization Up to the amount

Tk.100,000/year

Daily room rent Tk. 2,000

In patient treatment expense Tk. 50,000

ICU/CCU Tk.40,000

Students Pay Premium Tk.130/ semester (390 /annum)

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15Action on injury or sickness

Accident & Injury: Take admission to a hospital immediately Inform Mrs. Momena Akter- IUBAT at 01711111155 within 24

hours of hospitalization. Alternatively e-mail them [email protected] &

[email protected] sickness: Consult a registered doctor in chamber, clinic or hospital. If admission needed inform Mrs. Momena first.

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16Claim procedure of the IUBAT SGHIS

among the studentsDirect payment: Apollo, Ayesha Memorial, Samorita & Crescent Hospital bill will

be paid directly by PLIC. Up to the Limit.Indirect payment or compensation: For other hospital, the medical bill will be paid by PLIC. In a Prescribed form. With other supporting documents. Submitted to Mrs. Momena Akter. Within 15 days of discharge from the hospital.

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17Supporting documents for Claim

Consultants recommendation for hospitalization. Discharge certificate. Bill of consultants(physician/surgeon) fee Bills relating to room charges, investigations and any other service Bill of medicine supported by doctors prescription and vouchers Bill relating to surgical operation charges(where applicable) Bill relating to secondary charges.

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18Analysis of the agreement paper

General Elements of Contract

Special Elements of Contract

Policy conditions

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19General Elements of Contract• Offer and Acceptance

(agreement)

• Legal consideration

• Competent to make contract

• Free consent

• Legal object

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20Special Elements of Contract

Insurable

Interest

Utmost

Good

Faith

Indemnity

Subrogation

Warranties

Proximate Cause

Assignment and Return of premium

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21Policy conditions• Commencement of risks

• Premium

• Continuation of policy

• Lapse Condition

• Claims Settlement

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22Findings

A student up to the age of 30 years shall be qualified for membership of the scheme on the date of admitting the university.

PLIC don’t pay any benefit for unregistered hospital. No benefit for dental treatment. Extra premium charged for students the ages of 31 & 45 years enrolled for any

semester. We have to pay premium quarterly in advance at the time of registration for each

semester. No benefit is payable for pregnancy & childbirth. No benefit for HIV & AIDS related diseases. No benefit for dangerous game such as wrestling, boxing, hinting etc.

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23Findings (cont..)

For withdrawal the claim amount students have to submit a lot of documents .

The students who are emotional or psychiatric disorders they don’t get any benefit.

Plastic surgery of an injury due to accident or burn don’t paid benefit

No seminar, program regarding IUBAT SGHIS was held in our campus.

PLIC don’t provide any benefit for surgery within the first 12 months of the

effective date of the policy for abdominal.

No benefit for expenses in respect of outdoor or domiciliary treatment .

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24Recommendations Up to the age of 45 years should be qualified for the membership without any

condition imposed by the insurer. PLIC should be pay benefit for unregistered hospital. More seminar, program regarding IUBAT SGHIS Should be held in our

campus. Expenses in respect of dental treatment should be included. The students who are emotional or psychiatric disorders they should be paid

the benefit. Cosmetic or plastic treatment/surgery of an injury due to accident or burn shall

be paid the benefit. Expenses in respect of outdoor or domiciliary treatment should be included.

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25Recommendations (cont…)

Injury sustained while practicing or actively taking part in any hobby should be included.

Successive confinements due to the same illness not separated at least 90 days shall not be considered as a single confinement.

We strongly recommend that expenses for confinement in excess of twenty one days must be covered. It may be covered for 30 days or 1 month.

Benefit shall be payable for surgery within the first 12 months of the effective date of the policy for abdominal or inguinal hernia, hemorrhoid/tonsil.

If the age of membership attains at 30 then his/her membership should not be ceased.

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26Conclusions

SGHIS is very essential for the students of IUBAT and as a student’s we are very lucky that they (IUBAT) has introduced this policy first time in a Non-Government University in Bangladesh. Finally we are insured on our health risk by taking the ‘IUBAT Group Health Insurance Scheme (SGHIS).

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2726/11/2015

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2826/11/2015

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