april, 2010
DESCRIPTION
POLICY ADMIN. April, 2010. Policy Admin. POS – CC - Claim Not taken / Call out / Claim. Policy Admin. UW + SC Incomplete ME / Declined CFS return. PREMIUM TIA checking Renewal premium collection. INCOMPLETE RATIO. ANALYSIS_Incomplete Ratio. FILLING APPLICATION FORM TEST. - PowerPoint PPT PresentationTRANSCRIPT
1
April, 2010
Policy AdminPolicy Admin
UW + SCUW + SCIncomplete
ME / DeclinedCFS return
PREMIUMPREMIUMTIA checking
Renewal premium collection
POS – CC - ClaimPOS – CC - ClaimNot taken / Call out / Claim
Policy Admin
INCOMPLETE RATIOINCOMPLETE RATIO
Year 2009 2010Month Jul Aug Sep Oct Nov Dec 1st 2nd 3rd
Incomplete
7.05%
6.19%
10.04%
27.92%
10.66%
8.18%
11.6%
9.30%
8.06%
IMPROVEMENT
ANALYSIS_Incomplete RatioANALYSIS_Incomplete Ratio
Region
Non - UW factor
UW
factor
Total
Received
case
Non
UW
%
Gran
d total %
Wrong client's
information/ contract
Lack of healthy
declaration
Lack of client's
signature
Lack of ID card
Su
btotal
Ho Chi Minh 4 1 0 1 6 4 10 138 4.3% 7.2%
Ha Noi 6 4 7 1 18 6 24 291 6.2% 8.2%
Da Nang 0 0 1 0 1 2 3 68 1.5% 4.4%
Can Tho 2 5 1 1 9 6 15 148 4.1% 10.1%
Grand Total 12 10 9 3 34 18 52 645 5.3% 8.06%
FILLING APPLICATION FORM TEST
CS STRICTLY RECEIVE APPLICATION FORM
UPDATE FREQUENT REQUEST TO TRAINING DEPT
ME- DECLINED RATIOME- DECLINED RATIOME reason Cases Ratio
Auto ME 26 47.3%
Diabetes 1 1.8%
Hematuria 4 7.3%
Hepatitis B 2 3.6%
Hypertension 11 20.0%
Overweight 3 5.5%
Underweight 1 1.8%
Other 7 12.7%
Total 55 100%
UW decision to ME cases
Reason Case %
ME 55 8.5%
Non ME 590 91.5%
Total 645 100%
Special insurance 0 0 %
Cancel 0 0 %
Issued 41 74.5 %
Pending 6 10.9 %
Postpone 3 5.5 %
Decline 5 9.1 %
Total 55 100%
ME- DECLINED RATIOME- DECLINED RATIO
Year
2009 2010Jul Aug Sep Oct Nov Dec 1st 2nd 3rd
within 14 days 93.7% 90.4% 91.8% 91.9% 94.0% 91.4% 95.0% 87.0% 98.1%over 14 days 6.3% 9.6% 8.2% 8.1% 5.8% 8.6% 5.0% 15.1% 1.9%
CFS RETURN RATIOCFS RETURN RATIO
POS_NOT TAKEN RATIOPOS_NOT TAKEN RATIO
Area 1st
2nd - 2010
+/-Issues cases Not-takenRatio
Cases Premium Cases Premium
HCMC 2.46% 94
392,362,000 4
8,023,000
3.2% 0.69%
HN 1.66% 399
1,361,726,000 13
66,609,000
4.1% 2.41%
DN 6.46% 57
238,668,000 14
64,897,000
25.9% 19.42%
CT 1.29% 95
314,986,000 3
13,526,000
3.73% 2.44%
Total 2.2% 645 2,307,742,000 34 153,055,000 6.0% 3.73%
POS_NOT TAKEN RATIOPOS_NOT TAKEN RATIO
ANALYSISANALYSIS IMPROVEMENTIMPROVEMENT
- The not taken value is triple than last month
- The not taken value is triple than last month- The issued cases in this working month is only 645 cases so it effects to the ratio
- The issued cases in this working month is only 645 cases so it effects to the ratio
- SC pay attention to convince client keep policy still effective
- SC pay attention to convince client keep policy still effective - RD/ BM get experiences to improve it
- RD/ BM get experiences to improve it
86.3%
92.7%95.10%
93.76%
93.93%
94%91.18%93.2%
80.0%82.0%84.0%86.0%88.0%90.0%92.0%94.0%96.0%
Aug Sep Oct Nov Dec Jan Feb Mar
Area Jan Feb
Mar +/-
Accept case
Incomplete case Ratio
HCMC 98.40% 98.75% 88 0 100.00% 1.25%
HN 94.43% 93.41% 177 13 93.16% -0.25%
DN 95.29% 98.44% 44 1 97.78% -0.66%
CT 93.50% 89.09% 82 12 87.23% -1.86%
Total 95.10% 93.93% 391 26 93.76% -0.17%
CALL CENTERCALL CENTER
89.9%
80.9%
84.5%
80.4%
80.5%
79.8%
76.1%
79.7%
80.7%
75.2%
73.4%
67.8%
78.7%
0.0%
10.0%
20.0%
30.0%
40.0%
50.0%
60.0%
70.0%
80.0%
90.0%
100.0%
Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan-10verif ication %
PREMIUM COLLECTIONPREMIUM COLLECTION
Area Dec
Jan
% +/-Receivable Actual
CasePremium (M)
Case
Premium (M)
HCMC71.0
% 437 717.331 364 602.80483.7% 12.7%
HN64.6
% 341 828.699 248 622.77073.9% 9.3%
DN68.2
% 55 79.720 40 60.19674.1% 5.9%
CT86.6
% 30 22.11125 18.716 84.0% -2.6%
Company67.8
% 865 1.651.066 678 1.304.60878.7% 10.9%
TIA CHECKINGTIA CHECKING
97.0%
96.0%
99.0%
95.0%
98.3%
93.0%
96.0%
97.8% 97.8%
97.0%
90.0%
91.0%
92.0%
93.0%
94.0%
95.0%
96.0%
97.0%
98.0%
99.0%
100.0%
8th 9th 10th 11th 12th 13th 1st 2010 2nd 2010 3rd 2010 4th 2010
WKM
1st 2nd 3rd
4th
+/-RegionCheckable
CaseUnchecked
Case Ratio
HCM 1 96% 96% 97.3% 477 32 93.0% -4.30%
HCM 2 100.0% 86 0 100.0% 0
HN1 91.3% 96.9% 93.5% 226 12 95.0% 1.50%
HN2 96.2% 99.5% 99.6% 219 0 100.0% 0.40%
HN3 89.2% 100.0% 97.8% 187 0 100.0% 2.20%
Danang 99.2% 100.0% 99.7% 362 8 98.0% -1.70%
Cantho 94.9% 97.7% 100.0% 236 0 100.0% 0
TIA CHECKINGTIA CHECKING
UNCHECKED TIAARE POSTED
IN NEWSPAPER
THE UNCHECKED REASONS NEEDED
TO REPORT
DEDUCTING AGENT’S INCOME
100.000VND/TIA
UW CSPREMIUMPOSCLAIM
-Testing new products- BDO Exam- Modify Agent’s Investigation Right- Prepare documents for MOF audit- Authority Table- Shorten time for pending cases
ACTIVITIESACTIVITIES
- Auto-pay regulation
- Process & investigation for pending claim cases
- Training & Support opening Dongnai SC- Testing new products (A03, R04 & R05)- Implement BDO/SM/Pre-BM Exam
UW
CONTINUE FOLLOW-UP SPLITTING CASES
BDO/SM/PRE-BM TESTING RESULT
UW SKILL TRAININGRATING AGENT ON THE JOB
TRAINING
SC
SUPPORT DONG NAI SC OPERATION TESTING SYSTEMBDO/SM/PRE-BM EXAM
PLAN FOR NEXT MONTHPLAN FOR NEXT MONTHPOS
INTEREST OF LOAN AS REPAY PLAN TO DEDUCT MEDICAL FEE BANK TRANSFER & ID CARD PAYMENT
CC
DRAFT QUESTIONAIRE & STATEMENT CALL OUT RESULT IN PRODUCTION SYSTEM
CLAIM
SIGN HOSPITAL CONTRACT IN CENTRAL AREA INVESTIGATOR SYSTEM
PREM.
AUTO-PAY
RECRUITING COLLECTORS & SUPERVISOR IN HANOI
PLAN FOR NEXT MONTHPLAN FOR NEXT MONTH
17