PROFIDA for Medical Assurance
The PROFIDA® Administrator Edition is a totally integrated policy administration system for administrating medical assurance like hospital cash plans.
Its high-sophisticated design makes it possible that any hospital cash plans for individual, families, or group schemes is supported.
The product design is entirely configurable which makes it easy to customise and configure hospital plans with different covers and premiums for main member, spouse, children, parents, as well as extended family. For Parents and extended family different age restrictions and premiums can be managed.
Value-Added-Products like Medical Emergency Evacuation, Counselling Services, Telephonic Legal Assistance, etc. can be accomodated as well.
Policies can be amended by adding family members at any time. If an additional premium applies then PROFIDA® automatically calculates the new premium from the 1st of the next month.
Schedule of Benefits
Benefits statements and/or policy schedules of each product and scheme are printed displaying logos and signatures. Schedules are issued in Afrikaans and/or English.
Benefit statements and related correspondence (welcome letter, statutory notice) can be triggered to be automatically printed or emailed based on events like 'new policy captured'.
Client accounts are maintained at client level with all transactions relating to any policy of the client being posted and aged within the client's account. Accounts are also maintained at Company/Region/Group/Branch/Agent level with all transactions relating to any policies capable of on screen display as required.
Accounts may be viewed from a Client, Broker or Underwriter, etc. perspective, showing a complete history.
For details on money collection click on Financial Accounting.
Multiple claims may be registered against one policy. User can review the history of a claim from its initial registration right through to its finalisation.
The Claims Administration Facility is seamlessly integrated with the Workflow and Document Management Functionality. Claims statistics can be generated with a wide set of group and filter options.
PROFIDA® caters for two premium increase options which can be combined with a variety of filters.
Filtering by product, cover, group scheme, broker, date ranges, payment frequencies and other variables allow a fine tuning of policies affected by the premium increase.
A full history of all increases is kept within PROFIDA.
Workflow and Diary Management
Interactions, notes and tasks are kept on the client, policy, or claim records. Tasks are automatically assigned to the current user, and can be re-assigned to another staff-member. Tasks can be prioritised according to business processes and claims activity parameters.
Tasks can be triggered to be automatically created based on events like 'new claim' (--> send out claim form) or 'change quotation status to accepted' (--> print/email: benefit statement)
Correspondence can be triggered to be automatically printed or emailed based on events like 'new business captured' (--> print/email: welcome letter) or 'policy cancelled' (--> print/email: confirmation letter)
Emails, including attachments, can be sent from and received within PROFIDA®, making it the only financial software package worldwide with the ability to act as an email program. This keeps the correspondence with clients and insurers all in one place.
Client service level reports, in the form of tasks, to-do lists and calendars, are available to any user - allowing you to maximize your client service levels.
Any supporting documentation (scanned or created) is linked to the client, policy or claim record, and is available to the user on-line, real-time. Attached documents are automatically included in the backup of PROFIDA®.
The Workflow and Document Management Facility serves also as a tool to comply with the FAIS requirements of record keeping.
Click on Features for a detailed overview of PROFIDA®'s facitilities and features.