K. M. Dastur Reinsurance Brokers...Mumbai Aviation Fuel Farm Facility. ... taken at a clinic or hospital registered by the Central or State Government. ... Surrogacy Maternity Cover

K. M. Dastur Reinsurance Brokers Private Limited

About Us

K.M. Dastur Reinsurance Brokers Private Limited was founded in 1973, by the late Mr. K. M. Dastur, the erstwhile Country Head of Norwich Union Insurance Company.

Group operations includes 11 offices abroad & 16 offices in India.

K.M. Dastur & Company Ltd - London is a Registered Lloyd’s Broker. In the UK, KMD is authorized by the Financial Conduct Authority (FCA).

As a Group, we have over four decades of experience in all classes of Insurance & Reinsurance brokerage, with a highly experienced & skilled team of over 400 professionals.

An ISO 9001 : 2015 Company -Certified by TUV Germany.

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Corporate Clients

TATA Group

Jindal Steel & Power

Reliance Industries

Hindustan Aeronautics

ONGC Petro Additions

GVK Group

Larsen & Toubro

Vardhman Textiles

Star Union Dai-Chi Life

Sandoz

Nagarjuna Fertilizers

Go Air

Firmenich Aromatics

Lemuir Group

Gujarat Paguthan Energy

Shriram Fibres

HDFC Limited

Mumbai Monorail

Sun Pharmaceuticals

Novartis India

Bombay Dyeing

Berger Becker

Cosmos Films

Warburg Pincus India

Great Ship India

Jeena & Co

TUV India

Ashapura Industries

Greaves Cotton

Plasten India

CLP India

PI Industries

Banking Clients

Indian Bankers Association

State Bank of India

Axis Bank

Indian Overseas Bank

Punjab National Bank

Abhudhaya Bank

Saraswat Co-Operative Bank

DCB Bank

Public Sector Clients

Indian Tourism Development Corporation

Agriculture Finance Corporation

Mahanagar Gas Limited

Gujarat Paguthan Energy

The Gem & Jewellery Promotion Council

CIDCO : City & Industries Development Corporation

BSC CC JV & Chief Engineer : PWD Highway Meghalaya

Bihar State Hydro-Electric Corporation

CLP Power India Private Limited

Goods & Services Tax Network Limited

Odisha Power Generation Corporation

Vizag Steel Plant

National Seeds Corporation Limited

School Education & Sports Department : Government Of Maharashtra

Mumbai Aviation Fuel Farm Facility

Achievements

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Conceptualized, designed & implemented the largest Group Health Insurance Policy in India, for the Indian Banks Association, covering 40 banks, 33 lakh lives & with an annual premium of over INR 1200 CR.

Reinsurance of the very first independent power project in India was placed by us in 1995. We are the first to develop manuscript wordings for mega projects in India. This saw the development of project finance in India, with the support of Insurance & Reinsurance.

Major contributors in Foreign Inward Business, in excess of USD 300 Million with the Indian markets. We consistently remain the highest contributors of Foreign Inward Business to GIC RE, for the past 18 years.

Developed in 1997 & leads till date, the very first Indian General Aviation Treaty in India, which has grown into a Market Treaty including all SAARC countries. This Treaty earns for GIC RE INR 700 CR (USD 120 Million) annually.

Introduced for the very first time in the Indian markets the Directors & Officers Liability Policy in 1997, Machinery Loss of Profit for the fertilizer industry in 1998, the Extended Warranty Policy for motor-cars & the Port Package Policy in 1999.

Introduced for the very first time in the Indian markets, various health insurance products, in particular mortgage-related Critical Illness products. This product has generated new premium in the markets, currently amounting to INR 2000 CR

Introduced the very first Structured Reinsurance Solution for the Indian markets in 2002.

Introduced for the very first time Non-Physical Damage & Liquidated Damages Insurance & War on Land Quota Share Treaty for Domicile Assets in 2001 - the first of its kind permitted by Lloyd’s.

Major Programs Implemented In Health Insurance

Indian Bank Associations

Regional Rural Banks

Secure CreditMunicipal Corporation

Of Greater Mumbai

KMD was instrumental inconceptualizing, designing&implementing the GroupHealth Policy for 40-memberPSU Banks.

The Policy is the largestsingle Group HealthInsurance Policy everdesigned & implemented inIndia.

Total annual premium is INR1200 CR, covering 33 lakhlives.

Total number of claimssettled over a 3-year periodwas INR 20.5 lakhsamounting to INR 3710 CR.

Post the success of the IBAHealth Insurance Scheme,the Finance Ministry issued adirective that the RRBs mayfollow the same program.

Currently 19 Regional RuralBanks have appointed us asbrokers for their healthinsurance program.

Total annual premium is INR41 CR.

KMD conceptualized &launched the “Secure CreditInsurance” for protecting thelenders against any default inre-payment of personal loansbecause of critical illness,permanently disability orinvoluntary loss of job.

The product was launched in2003 and 11 insurers & 50commercial banks andfinancial institutions marketthe same to their loancustomers.

Total annual premium is INR1500 CR.

Municipal Corporation ofGreater Mumbai was thevery first municipality in Indiathat moved from the self-funded scheme to a GroupHealth Insurance Coverage.

KMD helped in designing thebenefits as per the needs ofthe management & theUnions.

The policy covered over 1.10lakh employees & 12000retirees, with an annualpremium of over INR 100 CR.

Other Ongoing Initiatives In Health Insurance

USA Students’ Policy

A Unique Students’ Overseas HealthInsurance Policy mapped to 5000USA-based universities for the 2lakh Indian students who takeadmission to USA universities everyyear, at 30 % to 40 % lower cost,compared to the coverage offeredby these universities.

Student Policy

A comprehensive hospitalization &accident coverage which coverspsychiatric ailments, geneticdisorders, congenital anomalies &minor injuries. It also provideseducational grant in case of death ofthe earning parent.

Pimpri Chinchwad

Municipal Corporation

KMD is the advisor for PCMC forconverting their current self-insuredhealth benefit scheme to a healthinsurance program. Currently in theprocess of finalizing the plan design& floating an RFQ with the insurers.

Policy For Differently-Abled Persons

A comprehensive health, accident &critical illness cover for differently-abled persons. Various physical &mental disability conditions likeblindness, loco-motor disability,cerebral palsy & autism are coveredunder the policy.

Juvenile Critical Illness

& Accident PolicyLong-Term Care

Health Coverage For Rural Population

Policy For

Co-Operative Banks

A Unique Critical Illness &Accident Policy for children uptothe age of 18 years. It pays alump-sum in case of diagnosis ofany of the listed critical illnesses.The policy also covers accident,death & disability with accidentalmedical extension.

A long-term care coverage isneeded for persons who cannotperform 2 of the 6 activities ofdaily living : dressing, bathing,eating, toileting, continence &transferring. The coverage isfunded through reversemortgaging.

The health & accident coverage isfor the rural population, who areabove the poverty line (& hencenot covered by the governmenthealth insurance schemes), but areunable to pay for a regular healthinsurance policy.

Based upon the success with theIBA & Regional Rural Banks, weare now working with various co-operative banks for designing &launching their health insuranceprograms.

Policy T&Cs*

EEMA : Policy Coverages Of Various Plans

Sum Insured Plan A Plan B Plan C

I : Health Insurance Cover 500000 300000 100000

II : Personal Accident Benefit 300000 200000 100000

III : Critical Illness Benefit 200000 100000 50000

Coverages Plan A Plan B Plan C

Family Definition

Self, spouse, dependent children upto the ageof 25.

(Handicapped children to be covered withoutage limit).





Ex-Gratia to be decided by EEMA, in case the cost of the treatment exceeds the Sum

Insured

If the expenditure exceeds the Sum Insured,the Association may give an additionalamount, equivalent to the Sum Insured.




Part I : Health Insurance Cover


Pre & Post Hospitalization Coverage

Pre-Hospitalization : 30 days. Post-Hospitalization : 60 days.



Room Rent Limit : Room Eligibility

Single AC room, room rent shall be restricted @1.5 % of the Sum Insured per day.

ICU charges @ 2.5 % of the Sum Insured per day.

Single Non-AC room, room rent shall berestricted @ 1.5 % of the Sum Insured per day.


Twin-sharing room, room rent shall be restricted@ 1.5 % of the Sum Insured per day.


All Other Expenses As per the room eligibility. As per the room eligibility. As per the room eligibility.

Expenses On Outside Surgeon

Or Consultant

Outside surgeon or consultant shall be paid anamount equivalent to the hospital rates, on thebasis of room eligibility.



Ambulance Charges

Ambulance charges are payable up to INR 2500/-or 1 % of the Sum Insured, which-ever is less,per trip to the hospital or transfer to anotherhospital or transfer from the hospital to home, ifmedically advised.



Pre-Existing Ailments OrDiseases Or Injury

Covered from Day 1 Covered from Day 1 Covered from Day 1



Waiting Periods No waiting periods. No waiting periods. No waiting periods.

Day-Care Treatment Covered. Covered. Covered.

Alternative Therapy

Reimbursement of expenses due tohospitalization under the recognized system ofmedicines, viz. Ayurveda, Unani, Siddha,Homeopathy, Naturopathy, if such treatment istaken at a clinic or hospital registered by theCentral or State Government.



Maternity

Normal delivery : INR 40000/-LSCS : INR 65000/-

9 months waiting period waived.





Surrogacy Maternity Cover Within Maternity Limit

Covered. Covered. Covered.

Infertility (Male & Female)

Covered upto INR 100000/- subject tohospitalization.





Baby Day 1 Cover

New-born dependent is covered from Day 1within the Family Floater Sum Insured.Expenses for well-baby is included in theMaternity Sum Insured. In case the babycontracts any life-threatening illness, full SumInsured to be given.

New-born dependent is covered from Day 1 withinthe Family Floater Sum Insured. Expenses for well-baby is included in the Maternity Sum Insured. Incase the baby contracts any life-threateningillness, full Sum Insured to be given.

New-born dependent is covered from Day 1within the Family Floater Sum Insured.Expenses for well-baby is included in theMaternity Sum Insured. In case the babycontracts any life-threatening illness, full SumInsured to be given.

Congenital Anomalies

Congenital Internal are covered. CongenitalExternal Ailments shall be covered, providedthey are life-threatening in nature.

Congenital Internal are covered. CongenitalExternal Ailments shall be covered, provided theyare life-threatening in nature.

Congenital Internal are covered. CongenitalExternal Ailments shall be covered, providedthey are life-threatening in nature.

Psychiatric Diseases

Psychiatric Ailments covered onhospitalization, with a limit of INR 100000/-

Psychiatric Ailments covered on hospitalization,with a limit of INR 100000/-

Psychiatric Ailments covered on hospitalization,with a limit of INR 50000/-

Advanced Medical Treatment

All new kinds of approved advanced medicalprocedures, eg : laser surgery, stem-celltherapy for treatment of a disease is payableupon hospitalization or day-care surgery.

All new kinds of approved advanced medicalprocedures, eg : laser surgery, stem-cell therapy fortreatment of a disease is payable uponhospitalization or day-care surgery.

All new kinds of approved advanced medicalprocedures, eg : laser surgery, stem-cell therapyfor treatment of a disease is payable uponhospitalization or day-care surgery.

Cyber Knife, Robotic Surgery are payable uptoan amount of INR 250000/-

Cyber Knife, Robotic Surgery are payable upto anamount of INR 200000/-

Cyber Knife, Robotic Surgery are payable uptoan amount of INR 75000/-

Lasik Surgery Covered if refractive error of eye is beyond + or-7.5

Covered if refractive error of eye is beyond + or -7.5

Covered if refractive error of eye is beyond + or-7.5



Treatment For Accidents

Accidents covered even on OPD basis, iftreatment is taken at a hospital, upto INR100000/- except for burns.



Other Medical Treatments

Treatment for Age-Related MacularDegeneration (ARMD), treatment such asRotational Field Quantum Magnetic Resonance(RFQMR), Enhanced External Counter Pulsation(EECP), Injection Avastin for RheumatoidArthritis & other de-generative conditionscovered. Sub-limit upto INR 30000/-



HIV - AIDS HIV - Aids to be covered upto a limit of INR250000/-

HIV - Aids to be covered upto a limit of INR150000/-

HIV - Aids to be covered upto a limit of INR50000/-

Physio-Therapy Charges

Physio-therapy payable, even if taken at home,during the post-hospitalization period, on therecommendation of the treating doctor.

Limit per session : INR 600/- per session upto 60days.


Limit per session : INR 500/- per session upto 60days.


Limit per session : INR 300/-per session upto 60days.

Registration Or Admission Charges

Covered. (This is normally an exclusion under the policy).



Hospitalization On Account Of Injuries Due To Riots &

Terrorism




EEMA : Policy Coverages Of Various Plans : Part II

Part II : Personal Accident Coverage


Accidental Death Coverage

100 % of the Sum Insured. 100 % of the Sum Insured. 100 % of the Sum Insured.

Permanent Total Disability

If an insured person meets with an accident,which leads to permanent impairment of theInsured's mental or physical capabilities, thenthe company will pay, depending upon thedegree of disablement.



Permanent Partial Disability

If an insured person meets with an accident,which leads to permanent partialdisablement, then the company will pay,depending upon the degree of disablement.





Burns Benefit

If an insured person sustains burns, then thecompany shall pay an amount, depending uponthe degree of burns suffered.

If an insured person sustains burns , thenthe company shall pay an amount,depending upon the degree of burnssuffered.

If an insured person sustains burns , then thecompany shall pay an amount, dependingupon the degree of burns suffered.

Education Grant

If the employee dies or is permanently totallydisabled following an accident, a lump-sum ofINR 50000 towards the Education Grant ispayable, for the dependent children.

If the employee dies or is permanentlytotally disabled following an accident, alump-sum of INR 30000 towards theEducation Grant is payable, for thedependent children.

If the employee dies or is permanently totallydisabled following an accident, a lump-sumof INR 15000 towards the Education Grant ispayable, for the dependent children.

Funeral Expenses

A one-time lump-sum payment of an amount of INR 10000/- towards :



A : Expenses incurred for preparing the body ofthat insured person for burial or cremation &transportation.

A : Expenses incurred for preparing thebody of that insured person for burial orcremation & transportation.

A : Expenses incurred for preparing the bodyof that insured person for burial or cremation& transportation.

B : Funeral or cremation expenses, in respect ofthat insured person.

B : Funeral or cremation expenses, inrespect of that insured person.

B : Funeral or cremation expenses, in respectof that insured person.

Riots & Terrorism Covered. Covered. Covered.


Part III : Critical Illness


Critical Illness

The Association will consider Critical IllnessBenefit for the members.



Critical Illness is to be provided to theemployee, subject to a Sum Insured of INR200000/-

Cover starts upon inception of the policy. Incase an employee contracts a Critical Illness aslisted below, the Total Sum Insured of INR200000/- is paid, as a benefit. This benefit isprovided on the first detection or diagnosis ofthe Critical Illness.

Critical Illness is to be provided to the employee,subject to a Sum Insured of INR 100000/-

Cover starts upon inception of the policy. In casean employee contracts a Critical Illness as listedbelow, the Total Sum Insured of INR 100000/- ispaid, as a benefit. This benefit is provided on thefirst detection or diagnosis of the Critical Illness.

Critical Illness is to be provided to theemployee, subject to a Sum Insured of INR50000/-

Cover starts upon inception of the policy. Incase an employee contracts a CriticalIllness as listed below, the Total SumInsured of INR 50000/- is paid, as a benefit.This benefit is provided on the firstdetection or diagnosis of the Critical Illness.

• Cancer including Leukaemia. • Cancer including Leukaemia. • Cancer including Leukaemia.

• Stroke. • Stroke. • Stroke.

• Paralysis. • Paralysis. • Paralysis.

• By-pass surgery. • By-pass surgery. • By-pass surgery.

• Major organ transplant. • Major organ transplant. • Major organ transplant.

• End-stage liver disease. • End-stage liver disease. • End-stage liver disease.

• Heart attack. • Heart attack. • Heart attack.

• Kidney failure. • Kidney failure. • Kidney failure.

• Heart valve replacement surgery. • Heart valve replacement surgery. • Heart valve replacement surgery.



Critical Illness

Hospitalization is not required to claim thisbenefit. Further, the employee can claim thecost of hospitalization on the same, from theGroup Mediclaim Policy as cashless orreimbursement of expenses, for the treatmenttaken by him.

Hospitalization is not required to claim thisbenefit. Further, the employee can claim thecost of hospitalization on the same, from theGroup Mediclaim Policy as cashless orreimbursement of expenses, for the treatmenttaken by him.

Hospitalization is not required to claimthis benefit. Further, the employee canclaim the cost of hospitalization on thesame, from the Group Mediclaim Policyas cashless or reimbursement ofexpenses, for the treatment taken by him.

Under this policy, there would be no waitingperiod for the payment of the claim on theinception of the policy, nor any survival periodfor the payment of the claim on the individualcontracting any of the above mentioned CriticalIllnesses.

Under this policy, there would be no waitingperiod for the payment of the claim on theinception of the policy, nor any survival periodfor the payment of the claim on the individualcontracting any of the above mentioned CriticalIllnesses.

Under this policy, there would be nowaiting period for the payment of theclaim on the inception of the policy, norany survival period for the payment ofthe claim on the individual contractingany of the above mentioned CriticalIllnesses.

Benefit Administration Capabilities

Benefit Design Data Analytics Benefit Administration Employee Engagement Health Management

Data Analytics Model

Organizational Physical Risk

Analysis

Claim Utilization Data

Organizational Psychographic Risk

Analysis

Personal Health Data

Organizational Health Data

Market Healthcare Tech Data

Market Healthcare Cost Data

Market Health Management Program Data

Market Morbidity Risk Data

Market Health Data

Employee & Dependent Feedback

Socio-Economic Profile Data

Psychographic Profile Data

Demographic Profile Data

Profile & Feedback Data

Organizational Morbidity Risk & Healthcare Cost

Analysis Report

Morbidity Risk & Healthcare Cost Variance Report

3-Year Projection Report Of Medical, Life & Accident Claim Cost & Employee

Productivity Loss

Identification Of Appropriate Health Management

Programs

3-Year Projected Impact Of HRM Program On Claims

Cost & Employee Productivity & ROI Of The

Program

Data Analytics

Benefit AdministrationKMD shall provide an Exclusive Backend Operations Team for managing all operations & support functions.

Database Management

Collection of data.

Checking & formatting as per insurer requirement.

Calculation & collection of premium.

Checking the policy document with agreed T&Cs.

Ensuring issuance of pocket-cards, for crucial emergency details.

Management of monthly endorsement.

Management of premium deposit balances.

Claim Management

Review of repudiation claims.

Monitor services by the insurers & TPA, as per agreed TATs.

Support in choosing a network hospital, arrangement of second opinion & more.

Support in understanding deficiency requirements, interpreting policy conditions.

Support in documentation & processing of claims of policies, other than GMC.

Employee Support Services

Call support.

Mobile & web platform for member support for all benefit programs (shall be implemented in a month).

A centralized grievance response & resolution team.

Periodic employee feedback process.

A dedicated support system for answering queries, TPA & insurer co-ordination & dispute resolution.


Health & Wellness Activities

Employee driven health awareness programme.

Health Management Programme based upon data analytics & employees health assessment.

Formulate a calendar on Health and wellness Programmes for the year across all companies

Design and organize discounted packages for Health Check ups on a PAN India basis

Case Management Programme

Reporting & Review

Comprehensive review of claims on a defined periodic basis & preparation of a weekly report.

Preparation of a weekly outstanding & TAT report & a monthly policy update report.

Participate in a monthly review with the customer.

Conduct a quarterly review meeting with the client, insurer, TPA & other service providers. The meetings are audio-video recorded & a detailed report is prepared & presented to all stake-holders.

Service At Renewal

Report on benefit utilization & claims data.

Analysis of incidence & claims ratio.

Organizational Morbidity Risk & Healthcare Cost Analysis Report.

Benefit bench-marking.

Suggestions for changes in the benefit structure.

Performance Monitoring

Dashboards with monitoring of KPIs at

member & group level.

Group & Member Enrolment

On-board corporate clients, group policies & members.

Policy Administration

Policy Administration Tools including managing members, claims & policy benefits.

Benefit Administration

Automated email for member on-boarding & enrolment.

Single page for enrolment & benefits visualization.

Simplified dashboard for policy management.

Easy explanation of benefits.

All benefits, members & claims related information at a

single place.

Easily accessible from mobile or web.


Key Features :


Policy & benefits management is a key advantage of the Policy Wallet Tool.

Policy administrative tasks are enabled directly via the Policy Wallet.

Linking of accounts across family members, to allow sharing of benefits.

Dashboard provides access to directory features such as network hospitals.

Access to community forum allows members the access to financial & insurance related advice.

Digital

Policy Wallet

Digital

Insurance Advisor

Coverage

Gap Analysis

Benefit

Sharing

Policy

Management

Affiliate

Services

Community

Support

Single unified insurance dashboard linked with other eco-system players, to provide a SPOC to meet all consumer requirements : Simplified

Insurance Dashboard

FAQs Intuitive Search Query Fine-Print

Giving A True Picture Of Existing Risk

Coverage & Gaps

Policy Sharing With Family Members, Minimize Over-

laps.

Policy Admin Nominee Change Claims Support

Renewal Reminder

Point Of Care Directory Wellness

Programme Loyalty Rewards

Risk Management

Share & Contact Message Board

Discussion Forum Referrals


Employee Engagement

Mobile & web platform for member support for all benefit programs.

On-site help desk for answering queries, TPA & insurer co-ordination, and dispute resolution.

24 X 7 call center support.

Pocket-cards for crucial emergency details.

Employee driven health awareness programs.

Employee survey & focus groups.

Periodic employee feedback process.

Employee participation in benefit review meetings.

Pre-Authorization.

Claims Settlement.

Answering Queries.

Dispute Resolution.

Appropriate benefit bench-marking.

Appropriate wellness activities.

Health Management Program.

Case Management Program.


We have a highly experienced back-end operations team, which is beyond what is ordinarily offered by any insurer or broker.

We strive for value-additions that will benefit the client, in all our structured programmes.

We do not accept a proto-type insurance product available in the markets. We design & structure a product which is best-suited & is favoring our client.

IBA was one such unique policy structured specifically for the bankers. We have structured similar products for students, teachers, farmers & even widows.

We have now structured a policy which is best-suited to an events & hospitality company.

A Cut Above The Rest

Lets Raise The Bar !!

Shazman Shroff

98203-71701

[email protected]

Priyadarshan Kakodkar

98678-22557

[email protected]

Anahita Daver

98678-22557

[email protected]

Board Line

022-6617-7600

Thank You !!

Documents

K. M. Dastur Reinsurance Brokers...Mumbai Aviation Fuel Farm Facility. ... taken at a clinic or hospital registered by the Central or State Government. ... Surrogacy Maternity Cover