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Presentation to :. Local protection, global connection. Who We Are…. The Generali Group is a leading player in the global insurance and financial markets. 68 countries worldwide 60 million clients Over 70 billion Euro of premiums 85,000 employees - PowerPoint PPT Presentation
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Local protection, global connection
Presentation to:
2
Who We Are…..
The Generali Group is a leading player in the global insurance and financial markets
• 68 countries worldwide • 60 million clients• Over 70 billion Euro of
premiums• 85,000 employees• Over 1.3 billion Euro of net profit
It all began in 1831 in Trieste where Assicurazioni Generali S.p.A. was founded. Today Assicurazioni Generali S.p.A. is::
1st insurer in Italy The biggest Life Insurer in Europe
It has strong financial rating: S&P AA-
Spain4.7%
French7.6%
Germany8.7%
Austria15%
Italy24.9%
Switzerland4.7%
CEE6.9%
China5.8%
Geographic Expansion: Continental Europe and Asia
Indonesia
5
What we offerWhat do they say about us….
China Life
CNP Assurance
Zurich Financial Services
Nippon Life
Munich Re
Prudential
Aviva
AIG
Allianz
Generali
ING Group
AXA
- 50,000 100,000 150,000 200,000
126,012
Fortune Global 500 – Year 2010: Worldwide Insurance Ranking
Based on Revenue (in USD Bio)
GENERALI
Forbes Global 2000 – Year 2010: Worldwide Insurance Ranking
Based on Sales (in USD Bio)
China Life Insurance
Travelers Cos
Prudential Financial
Manulife Financial
CNP Assurances
Munich Re
Zurich Financial Services
Prudential
Aviva
Generali
Allianz
AXA
- 20.00 40.00 60.00 80.00 100.00 120.00 140.00 160.00
123.14 GENERALI
Global Employee Benefit Market Share
GENERALI
Source: Ernst & Young 2009 Market share survey
2005 2006 2007 2008 20090.00%
5.00%
10.00%
15.00%
20.00%
25.00%
30.00%
19.61% 19.19%
23.13% 23.57%25.70%
Column4 Column3 Column2 GENERALI Column1
9
What we offer
Generali Indonesia
Head Office
PT. Asuransi Jiwa Generali Indonesia
Cyber 2 Tower 30th FloorJl. H.R. Rasuna Said Blok X - 5 /13
Jakarta 12950
Key Development Milestone
• Started Operations in January 2009
Strong Risk Based Capital(481% per Juni 2010)
• 153 companies (world best known)• Over 50,000 member
• 570 hospitals in Indonesia• 30 international hospitals
(REVIEWED)• 90 employee (4 doctors)
Active Members
-
5,000
10,000
15,000
20,000
25,000
30,000
35,000
40,000
45,000
50,000
2,442
34,545
49,600
(3)Proactive Claim
Management
(2)Speed
ProcessingLong Term
Relationship
Our Business Model
Healthier and Productive
Employees(1) Customized
Solutions
+GEBSupport
Group Medical
Group Term Life
QUALITY OF
SERVICE
Capacity
Free Cover Limit
Serving you better…
3. Easy Tracking Process
1. Easy and Convenience Claim Process
2. Easy and FasterRegistration Process
CashlessSwipe Card
Easy and Convenience Claim Process
Provider Network
Reimbursement to Generali Indonesia
Non Provider Network
Customer Paid to Hospital
Claim Business Process
Verify ID card & Swipe the card
Provide Medical ServicesAdmission Process
Patient Hospital/Clinic Hospital/Clinic
Submit the complete
documentsPayment ProcessVerify documents
14 Working Days 14 Working Days
Hospital/Clinic Generali Indonesia Generali Indonesia
Claim Business Process
Easy and Faster Registration & Tracking Process
Regional Office
Regional Office
Regional Office
HO Insurance Company
Common Practice
Regional Office
Regional Office
Regional Office
DIRECT REGISTRATION (Through Generali Indonesia Web - CLICK)
Generali Indonesia
Serving you better…
User id
Password
Generali CLICK
xxxxxxxx
ACCEPTED
CLAIM
POLICY
BILLING
CASH
Regional Office
Regional Office
Regional Office
DIRECT REGISTRATION (Through Generali Indonesia Web - CLICK)
Generali Indonesia
CLAIM
Serving you better…
POLICY
BILLING
CASH
Policy Inquiry Member Registration
Claim Inquiry Claim History
Billing Due Date Billing Tracking
Payment Status Cash Receipt
Serving you better…
Claim & Payment Status email to member
Wide provider network 7x24 Hour Call center & Emergency Mobile Phone
Regional Processing Center
Service
Wider Provider Network (570 local and 30 overseas)
Jabotabek : 260
Provider
West Java : 55
Provider
Bali/NTT/NTB : 25 Provider East Java : 64
Provider Middle java : 45 Provider
Papua : 1
Provider
Maluku : 2
Provider
Kalimantan : 16 Provider
NAD : 1
Provider
Riau /Batam : 15
Provider Sulawesi : 10
Provider
Other Sumatera : 18 Provider
Singapore : 8 Provider (Review)
Malaysia : 22 Provider
(Review)
MANFAAT RAWAT INAP & PEMBEDAHANNO BENEFIT PLAN 1 PLAN 2 PLAN 3 PLAN 4
250 350 500 13501 Biaya kamar Rumah Sakit per hari (Maks 365 hari) 250,000 350,000 500,000 1,350,000
2 Biaya Unit Perawatan Intensif (Maks 180 hari) 500,000 700,000 1,000,000 2,650,000
3 Biaya Pembedahan - Pembedahan A 22,000,000 29,000,000 40,000,000 80,000,000 - Pembedahan B 11,000,000 14,000,000 18,000,000 52,000,000 - Pembedahan C 5,600,000 7,500,000 9,000,000 25,000,000 - Pembedahan D 2,800,000 3,630,000 4,500,000 12,500,0004 Biaya Perawatan Rumah Sakit lainnya (obat-obatan, x-ray, lab) 6,250,000 8,750,000 12,500,000 30,000,000
5 kunjungan dokter di rumah sakit per hari (Maks 365 hari) 200,000 280,000 400,000 600,000
6 Biaya konsultasi dokter spesialis di rumah sakit (Maks 365 hari) 300,000 320,000 500,000 1,000,000
7 Perawatan Gawat Darurat per ketidakmampuan 2,000,000 3,000,000 4,000,000 10,000,0008 Biaya perawat pribadi (Maks 90 hari) 150,000 200,000 300,000 600,0009 Biaya Ambulan per kasus 200,000 280,000 400,000 1,000,000
10 Biaya sebelum (30 hari) & setelah (30 hari) perawatan 750,000 1,050,000 1,500,000 3,500,000
Batasan Tahunan Tidak terbatasTidak terbatas Tidak terbatas Tidak terbatas
11 Santunan kematian 2,500,000 2,500,000 2,500,000 2,500,000
MANFAAT PERSALINAN
NO MANFAAT PLAN 1 PLAN 2 PLAN 3 PLAN 4
2,500 3,500 5,000 8,000
1 Persalinan normal 2,500,000
3,500,000 5,000,000
8,000,000
2 Persalinan dengan Pembedahan 3,125,000
4,500,000
6,500,000
10,000,000
3 Komplikasi kehamilan 1,700,000
2,500,000
3,500,000
5,500,000
4 Perawatan sebelum & sesudah melahirkan 500,000 700,000 1,000,000 1,600,000
MANFAAT RAWAT JALAN
NO MANFAAT PLAN 1 PLAN 2 PLAN 3 PLAN 4
1 Biaya konsultasi Dokter Umum (per kunjungan/hari) 40,000 50,000 70,000 150,000
2 Biaya konsultasi Dokter Spesialis (per kunjungan/hari) 120,000 150,000 210,000 450,000
3 Biaya obat-obatan sesuai resep dokter / tahun 900,000 1,250,000 1,400,000 3,250,000
4 Biaya Diagnostik/laboratorium / tahun 675,000 825,000 1,200,000 2,325,000
5 Biaya Fisioterapi per tahun 200,000 300,000 500,000 600,000
BATAS TAHUNAN PER ORANG 3,500,000 4,250,000 5,900,000 12,000,000
PENGGANTIAN 100% 100% 100% 100%
MANFAAT RAWAT GIGI
NO MANFAAT PLAN 1 PLAN 2 PLAN 3 P-LAN 4
1 Perawatan dasar (per tahun) 400,000 500,000 700,000 1,000,000
2 Perawatan pencegahan (per tahun) 200,000 250,000 350,000 500,000
3 Perawatan kompleks (per tahun) 600,000 750,000 1,050,000 1,500,000
4 Gigi palsu (per tahun) 400,000 500,000 700,000 1,000,000
BATAS TAHUNAN PER ORANG 1,600,000 2,000,000 2,800,000 4,000,000PENGGANTIAN 100% 100% 100% 100%
MANFAAT KACA MATA
NO MANFAAT PLAN 1 PLAN 2 PLAN 3 P-LAN 4
1 Penggantian Kacamata
a. Frame (batas dua tahunan) 210,000 300,000 600,000 700,000
b. Lensa atau lensa kontak (batas tahunan) 140,000 200,000 400,000 500,000
2 Biaya Dokter Mata per tahun 35,000 50,000 100,000 200,000
PENGGANTIAN 100% 100% 100% 100%
Kelebihan Program Asuransi Kesehatan Rawat Inap & Rawat Jalan, Persalinan & Kacamata dari Generali
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1. Limit Tahunan Rawat Inap “Tidak terbatas” dengan Biaya Rawat Inap, Kunjungan Dokter, Konsultasi Dokter Spesialist dicover sampai 365 hari, Biaya Unit perwatan intensif dicover sampai 180 hari
2. Perawatan gawat darurat rawat jalan dan gigi dijadikan satu, dan disediakan per ketidakmampuan, bukan per tahun.
3. Biaya operasi : dokter bedah, dokter anestesi, & kamar operasi dijadikan satu4. Biaya Fisioterapi di Rawat Jalan terpisah dari biaya dokter spesialis.5. Untuk rawat jalan langsung ke dokter spesialis tanpa rujukan dari dokter umum.6. Tidak ada masa tunggu untuk PRE-EXISTING CONDITION.7. Untuk rawat jalan penggantian bisa 100% untuk reimbursement.8. Pada program Persalinan, penggantian biaya dokter dan bidan sama besar.9. Pada program Persalinan, biaya perawatan sebelum & sesudah melahirkan terpisah.10. Biaya pemeriksaan dokter mata pada program kacamata terpisah dari biaya pembelian kacamata dan
bingkai.11. Proses klaim reimbursement adalah 14 hari kerja (dibayarkan ke rekening karyawan/perusahaan)
Mengapa memilih Generali Indonesia ?
1. Kekuatan keuangan : a. Bagian dari Generali Group, terbesar di Itali, 3 terbesar di Eropa, 30 besar di Dunia b. RBC 481% (per Juni 2010)
2. Registrasi dan Inquiry : Sistem IT yang teruji : Sistem Click a. Policy inquiry : Melihat informasi data peserta aktif b. Claim inquiry : Melihat informasi detail claim status klaim reimbursement/provider c. Billing inquiry : Melihat informasi tagihan/pengembalian premi/ekses klaim d. Form Changes : Penambahan/pengurangan/perubahan Data Peserta
3. Standar kepatuhan : Etika Bisnis, Acuan Perlindungan Data.
4. Jaringan Provider Rawat Inap dan Rawat Jalan dengan teknologi terkini : a. Teknologi swipe card b. Jaringan provider yang sangat luas - 570 Rumah Sakit rawat inap & Klinik rawat jalan
- 24 jam, Worldwide coverage
5. Pengembalian Premi (Profit Sharing) :Minimum Premi Rp. 15,000,000 dan Jumlah karyawan 25 orang
50% (60% Premi – Klaim – 1,500,000), apabila polis diperbarui untuk tahun berikutnya
6. Customer Service : a. 7 x 24 jam : (021) 57933290 b. Emergency Mobile Phone : 081586401117 c. Customer service : (021) 29963737 (Office Hour)
31
Thank You
Terima Kasih