Using Technology to provide an innovative sustainable model for delivery of Cashless Health Insurance                              r r r r r y y g s s v v v v v v #

AGENDA System Components About Smart Cards Enrollment Transactions Process Flow Roles & Responsibilities

System Components ystem Components

System Features About Smart Cards Unique Identification Fool proof Authentication of Beneficiary Instant Validation of Mediclaim Balance available Multiple levels of Security Claims Processing Least inconvenience to Beneficiary Reduction in administrative costs for Hospitals & Insurance agencies Enable product innovation Fast availability of MIS for analysis & fraud control Possible to Store customer’s health history Other Government Schemes for the same set of beneficiaries can make use of available Card real estate.

About Smart Cards Supports About Smart Cards Stores Data Images Codes Security Keys Algorithms Supports Authentication Validation Verification Encryption Business Logic Non Repudiation

Enrollment KIT

EOn the Field Enrollment Kit Kit in Backpack Enrollment on Tabletop

nrollment Station Enrollment Process 8

CInside the Station Enrollment Process Web Camera for Photograph Optical Biometric scanner for Fingerprints Remodelled data masters based on State’s BPL data Battery Power back-up for undisrupted enrolment Option of printing & Issuing card at Site

Enrollment Process Capturing Photograph

Enrollment process Enrollment Process Capturing Finger Prints

On the Field (contd.) Enrollment Process Enrollment Session Night Lights

Unique Identification Enrollment Process UID Customer Data Deduping An application to capture beneficiary data, Personalise Cards, Conduct transactions , Transmit Data & provide MIS Various methodologies used like demographic, Biometric (finger, face, etc.) - Fingerprint most effective from technical & cost perspective Sr no + Birth Yr + Gender + State + Location + Checksum Uniform Application Across states & Insurance Providers This number can be and should be shared across several entities Possible state of the art technology for de-duping

Unique Identification (UID) Enrollment Process Unique Identification (UID) Serial number Gender Village Code/ Location r r r r r y y g s s v v v v v v # Year of Birth State Checksum Foolproof Identity Biometric 14

Transaction Transaction

Transaction Transaction

Transaction Transaction

Process Flow - Enrollment State Server Electronic BPL List Photo, fingerprint , text details captured Card Issued Verification by Govt official, Administrative fees Rs.30 Enrolment station Insurance Co details Policy Details Personalised Card District Server Enrollment & Personalisation Details Card Activation Issuer Authority Card Keys Inserted Card Activation Details Policy Details Premium amount Insurance Company

Flow - Transactions Process Flow Authenticate Card holder BPL Desk State Server Authenticate Card holder Verify Policy Activation Display Balance Insurance cover Diagnostic Details Confirm Hospitalisation Requirement Confirm Package Freeze amount on Card Settlement Details Discharge Details Transaction Details Package modifications Hot List Card details District Server Transaction Details Insurance Company Transaction Details Claims Settlement Details

Roles & Responsibilities Roles And Responsibilities For the Government Definition of Common Specifications for Cards & Devices Setting up of a Central Key Management system (KMS) for a secure system Development of a Uniform application Availability of a Robust Backend system for data transmission & MIS Defining a process for system conformonce of Smart Card product

Requirements to Deploy Roles And Responsibilities For the Insurance Companies Designate a Central Nodal officer to deal with complete smart Card system Evaluate the various Smart Card vendors & their capabilities Ensure Tight contracts with Smart Card vendor for Seamless & Uninterrupted Operation & Maintenance of the system Set up systems of checks & balances of the smart card product to ensure conformance to Government guidelines.

Thank You