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 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-
Geographic Expansion: Continental Europe and Asia Indonesia Spain 4.7% French 7.6% Germany 8.7% Italy 24.9% Austria 15% Switzerland 4.7% CEE 6.9% China 5.8%
What do they say about us…. What we offer What do they say about us….
Fortune Global 500 – Year 2010: Worldwide Insurance Ranking GENERALI Based on Revenue (in USD Bio)
Forbes Global 2000 – Year 2010: Worldwide Insurance Ranking GENERALI Based on Sales (in USD Bio)
Global Employee Benefit Market Share GENERALI Source: Ernst & Young 2009 Market share survey
What we offer Generali Indonesia
Head Office PT. Asuransi Jiwa Generali Indonesia Cyber 2 Tower 30th Floor Jl. H.R. Rasuna Said Blok X - 5 /13 Jakarta 12950
Key Development Milestone Strong Risk Based Capital 570 hospitals in Indonesia 30 international hospitals (REVIEWED) 90 employee (4 doctors) 153 companies (world best known) Over 50,000 member Strong Risk Based Capital (481% per Juni 2010) Started Operations in January 2009
Active Companies
Active Members
and Productive Employees Long Term Relationship Our Business Model Group Medical Healthier and Productive Employees (1) Customized Solutions QUALITY OF SERVICE (3) Proactive Claim Management (2) Speed Processing Long Term Relationship Group Term Life Capacity GEB Support + Free Cover Limit
Speed Processing Serving you better… 1. Easy and Convenience Claim Process Speed Processing 3. Easy Tracking Process 2. Easy and Faster Registration Process
Easy and Convenience Claim Process Provider Network Non Provider Network Cashless Swipe Card Customer Paid to Hospital Reimbursement to Generali Indonesia
Verify ID card & Swipe the card Claim Business Process Patient Hospital/Clinic Hospital/Clinic Verify ID card & Swipe the card Admission Process Provide Medical Services
Submit the complete documents Claim Business Process Hospital/Clinic Generali Indonesia Generali Indonesia Submit the complete documents Verify documents Payment Process 14 Working Days 14 Working Days
Easy and Faster Registration & Tracking Process Common Practice Regional Office Regional Office HO Insurance Company Regional Office Generali Indonesia Regional Office CLICK Regional Office DIRECT REGISTRATION (Through Generali Indonesia Web - CLICK) Regional Office
CLICK Serving you better… ACCEPTED xxxxxxxx CLICK POLICY CLAIM User id Generali CLICK BILLING Password xxxxxxxx ACCEPTED CASH Generali Indonesia Regional Office CLICK Regional Office DIRECT REGISTRATION (Through Generali Indonesia Web - CLICK) Regional Office
CLICK Serving you better… POLICY Policy Inquiry Member Registration CLAIM Claim Inquiry Claim History BILLING Billing Due Date Billing Tracking CASH Payment Status Cash Receipt CLICK
Service Serving you better… Regional Processing Center Wide provider network 7x24 Hour Call center & Emergency Mobile Phone Service Claim & Payment Status email to member
Wider Provider Network (570 local and 30 overseas) Singapore : 8 Provider (Review) Kalimantan : 16 Provider Malaysia : 22 Provider (Review) Maluku : 2 Provider Riau /Batam : 15 Provider Sulawesi : 10 Provider NAD : 1 Provider Papua : 1 Provider Other Sumatera : 18 Provider Jabotabek : 260 Provider Bali/NTT/NTB : 25 Provider West Java : 55 Provider East Java : 64 Provider Middle java : 45 Provider
MANFAAT RAWAT INAP & PEMBEDAHAN NO BENEFIT PLAN 1 PLAN 2 PLAN 3 PLAN 4 250 350 500 1350 1 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) 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 12,500,000 4 Biaya Perawatan Rumah Sakit lainnya (obat-obatan, x-ray, lab) 6,250,000 8,750,000 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 7 Perawatan Gawat Darurat per ketidakmampuan 2,000,000 3,000,000 4,000,000 10,000,000 8 Biaya perawat pribadi (Maks 90 hari) 150,000 9 Biaya Ambulan per kasus 10 Biaya sebelum (30 hari) & setelah (30 hari) perawatan 750,000 1,050,000 1,500,000 3,500,000 Batasan Tahunan Tidak terbatas 11 Santunan kematian 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 5,500,000 4 Perawatan sebelum & sesudah melahirkan 500,000 700,000 1,000,000 1,600,000
BATAS TAHUNAN PER ORANG 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) 120,000 210,000 450,000 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%
BATAS TAHUNAN PER ORANG 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 3 Perawatan kompleks (per tahun) 600,000 750,000 1,050,000 1,500,000 4 Gigi palsu (per tahun) BATAS TAHUNAN PER ORANG 1,600,000 2,000,000 2,800,000 4,000,000 PENGGANTIAN 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 PENGGANTIAN 100%
Kelebihan Program Asuransi Kesehatan Rawat Inap & Rawat Jalan, Persalinan & Kacamata dari Generali 08/04/2017 07:38:38 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 Perawatan gawat darurat rawat jalan dan gigi dijadikan satu, dan disediakan per ketidakmampuan, bukan per tahun. Biaya operasi : dokter bedah, dokter anestesi, & kamar operasi dijadikan satu 4. Biaya Fisioterapi di Rawat Jalan terpisah dari biaya dokter spesialis. Untuk rawat jalan langsung ke dokter spesialis tanpa rujukan dari dokter umum. Tidak ada masa tunggu untuk PRE-EXISTING CONDITION. Untuk rawat jalan penggantian bisa 100% untuk reimbursement. Pada program Persalinan, penggantian biaya dokter dan bidan sama besar. Pada program Persalinan, biaya perawatan sebelum & sesudah melahirkan terpisah. Biaya pemeriksaan dokter mata pada program kacamata terpisah dari biaya pembelian kacamata dan bingkai. 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)
08/04/2017 07:38:38 Thank You Terima Kasih 31