• Document: Health Insurance Orientation Module. Future Generali Health
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Health Insurance Orientation Module Future Generali Health Introduction 9 Future Generali is an insurance joint venture between the Italy-based Generali Group and the India-based Future Group. 9 Future Generali operates Life and Non-Life insurance businesses through ‘Future Generali India Life Insurance Co. Ltd.’ and ‘Future Generali India Insurance Co. Ltd.’ 9 Future Group holds 74% each in both the companies. 9 Future Generali received license from the Insurance Regulatory Development Authority (IRDA) in Sept 2007 and launched operations from Nov 2007. Future Generali Health Introducing Future Generali Health How we are different: • Future Generali Health (FGH) is an internal unit of Future Generali India Insurance. • No Third Party Administrator (TPA) involved between the insurer and FGH. • Claim settlement is faster due to single point clearance – no exchange of claim documents between insurer and TPA. • Preferred services extended as FGH provides service only to clients insured by Future Generali. Future Generali Health Future Generali Health An In-house Health Management Team of Future Generali India Insurance Co. Ltd. Internal units of (FGH) Future Generali Health Team Call Centre 24 X 7 Helpline to cater to customer queries Enrolment For card issuance and member data management Cashless Management 24 X 7 services with 2 hours Turn Around Time (TAT)** Claims Processing Average TAT of 14 working days** Provider Management 1800 hospitals and 200 diagnostic centers network Research and Analysis Analysis, Feedback & monitoring Pre Policy For retail medical underwriting Underwriting Centralized Group / Retail Underwriting at hubs **All TAT’s subject to availability of complete documentation Future Generali Health Your New Wellness Card • Your New card entitles you to a host of healthcare benefits. • Photo identification is necessary whenever you use this card. • This card does not entitle you to avail cashless without pre-authorization. • This is NOT a credit card. Future Generali Health Member Enrolment Key Function: For card issuance and member data management ¾ Within how many days will I get my Wellness Card? • You will receive health cards via courier or e-mail within 7 days after your details are received by FGH from your organization. ¾ What if there is an error on my Wellness Card? • For any error in cards or correction required, you can immediately report to your HR. ¾ What is the use of the Wellness Card? • You will get a Wellness Card to utilize the Cashless facility at Network Hospitals. • This card helps only in your identification as a Future Generali Health member. Future Generali Health • Availability of Cashless and any other benefit is subject to policy Claim Process: Cashless If you are going for a Planned Hospitalization: 1. Carry your ID cards and authorization letter when you go to the hospital for admission 2. Get the Pre-authorization done in at least 7 days before hospitalization 3. Pre-authorization is done to determine whether cashless facility can be granted based on all medical information about your ailment and coverage 4. Pre-authorization forms are available at NETWORK hospitals. You can also obtain it from our call centre by e-mail or Fax 5. Your treating doctor has to fill the form and sign it 6. You will also have to sign the Pre Authorization form and provide your mobile number Future Generali Health 7. The hospital will fax this form to our Call Centre to get an authorization Claim Process: Cashless Continued…. If you are going for Planned hospitalization: 8. Our doctors will examine the form and decide on cashless availability 9. If cashless is granted, we will send an Authorization Letter to the hospital. You can also get a copy of the Authorization Letter from our Call Centre by e-mail 10. If cashless is denied, we will send a Denial Letter to the hospital and inform you 11. If cashless has been denied, you will have to pay the hospital bill and then send the claim to us Future Generali Health Customer approaches FGH Toll Free Cashless for Cashless Treatment. Future Generali coordinates with hospital for preauthorization Process Hospital verifies customer details and sends pre-auth by fax to FGH (Pune) FGH verifies pre-auth details with

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