Case of ICICI Lombard

Contents
Case highlights

Problems

Alternative solutions

Analysis of alternatives

Best solution

Roadmap for implementation

Case highlights
ICICI Lombard general insurance company has
an turnover of 2000 Cr Rs.
It deals in all kinds of insurance and most
importantly health insurance.
Clients can either go for cashless or
reimbursement.
Competitors of ICICI Lombard
Star health insurance
National Assurance
Bajaj Insurance
Case Highlights (cont.)
Departments involved
Customer Relationship Department
Health Enrollment Department
Health Claims, Mumbai

Functioning of Departments
Health
CRD Gets Third Party
Data Enrollment Data
Order Administrator
Team

In case of differences in data, data is reverted back from HET to CRD

Case Highlights (cont.)
Kaustav Dey from CRD got the order from Siyaram silk mills
Kaustuv Dey sent the data of SSM employees to the health enrollment
team
Due to difference in data, data was reverted back to CRD.
Kaustuv Dey. CRM had not looked into his system and was unaware of
the fact.
One of the director from SSM was admitted and claimed for cashless
hospitalization
The Data Didnt reached the TPA so the cashless facility was not
provided.
A blame game was evolved among the departments of CRD, HET,
HCM
Problems of the Case
There was lack of communication between the
departments

The flow of information was complex

Kaustav Dey, CRM was irresponsible in checking

his system on a daily basis.

Health enrollment team didnt contact CRM after

reverting the data due to differences.

Health claims, Mumbai didnt take course of

action when data was not with TPA
Alternative Solution
Immediate action would have been taken by following the
system if data was not with TPA.

To keep all the departments in the loop, through adding them in

CC while mailing when required.

Acknowledging the responsible heads whenever the message is

circulated.

To develop the platform in all the three departments, where all

the flow of communication and information will exist.
Analysis of Alternatives
By keeping in loop all the heads of department.
There will be prompt flow of information
There will be proper communication

By acknowledging the three heads through call, message will

lead to
Immediate response to the issues
Will provide remainders
Confirmation to the concerned parties
Analysis of Alternatives
(cont.)
If data not with TPA, Stll cashless hospitalization
could have been provided by following the
system.
Would not have resulted in a problem
Would have solved the problem then and there.

By developing the platform through a software

will lead to
Complete awareness of the work in progress.
Proper link between the departments
Proper communications
Best solution
Providing platform by developing a software and
involving the three departments, which will
facilitate flow of information and communication
It will lead to proper coordination
It will lead to proper flow of information
It will give direction to common goals to the
company
Will reduce errors in working
Better customer satisfaction.
It will link the departments
Instant solution to customer grievances.
Roadmap
Developing a single platform (Software)

Investment in Developing Infrastructure for

single platform by using Cloud Computing

Developing a system for flow of information

without loopholes

Process the data according to the system.

Thank You
Made By -

Sparsh Dipani

Sumit Assudani

Suraj Gajbhiye

Shasha Khandey

Sagar Joshi

Shubham Dhapkas
Technical assistance Mayank Sahu
Special Thanks to Mustoor Sir