Star Health & Allied Insurance Co. Ltd. · NSE:STARHEALTH
Star Health & Allied Insurance — Investor Day (March 2023)
46 slides from Star Health & Allied Insurance's investor day presentation, Mar 29, 2023
Slide 1: Analyst meet schedule filing letter to exchanges
Date: March 29, 2023 Place: Chennai Ref: SHAI/B & S/SE/245/2022-23 To, To, The Manager The Manager Listing Department Listing Department BSE Limited National Stock Exchange of India Limited Phiroze Jeejeebhoy Tower Exchange Plaza, 5th Floor, Plot C/1, Dalal Street G Block, Bandra-Kurla Complex Mumba
Slide 2: Filing letter continued and signature
Sl. No Fund/Firm Type of Meeting 16. Motilal Oswal 17. CLSA 18. BoFa 19. B&K 20. Haitong Physical Group Meet 21. Anand Rathi 22. Axis Capital 23. Phillip Capital The presentation made to the Analyst(s)/ Institutional Investor(s) is attached herewith. The above disclosure will also be made available
Slide 3: Star Health - Analyst day, March 2023
Star Health - Analyst day March 2023
Slide 4: Health Insurance Industry - India
Health Insurance Industry - India Accounting Distribution Underwriting, Actuarial & Human resource Strategy 2
Slide 5: Health insurance industry is under-penetrated
Industry Health insurance industry is under-penetrated India has a large uninsured population The share of retail and group has been rising (Number of lives in million) Government 482 472 499 515 520 Uninsured population 22.4% 31.5% Retail 6.9% 8.9% 8.7% 10.3% 9.9% Group 18.5% 15.5% 18.8% 23.1% 31.2
Slide 6: Retail Health is the fastest growing & SAHIs have grown rapidly
Industry Retail Health is the fastest growing & SAHIs have grown rapidly Health insurance (Ex PA & Travel) industry category mix Health insurance (Ex PA & Travel) player wise mix (INR bn) (INR bn) GWP CAGR (%) 731 731 Retail Health 20.1% Group Health 19.9% 60 Government 10.5% 200 Overall Health 18.8
Slide 7: Expenses of Management – Large to Largest
Industry Expenses of Management – Large to Largest Regulations 35% for SAHI and 30% for GI players Actual EoM exceeds by =>10 percent of the projected EoM as per Business Plan, no variable pay to MD/CEO/KMP for the said FY Industry Many insurers are operating at higher cost and will have to co
Slide 8: Unit economics of Retail Health business under various scenarios
Industry Unit economics of Retail Health business under various scenarios Scenario A Scenario B Scenario C Post-tax ROE Pre-tax ROE Post-tax ROE Pre-tax ROE Post-tax ROE Pre-tax ROE 28% 38% 22% 29% 16% 21% Investment Underwriting Investment Underwriting Investment Underwriting result leverage result
Slide 9: Accounting - IGAAP and Ind AS
Accounting Accounting - IGAAP and Ind AS Assumption Indian GAAP 22% 22% 22% IND AS 22% 22% 22% Year 1 Year 2 Year 3 Year 4 Year 1 Year 2 Year 3 Year 4 GWP 100 122 149 182 GWP 100 122 149 182 NWP 95 116 141 173 NWP 95 116 141 173 NEP 40 104 127 154 NEP 40 104 127 154 Business Mix 58:42 Business Mix 5
Slide 10: Largest and Well-spread Distribution
Distribution Largest and Well-spread Distribution Retail health business is Agent driven Focused on growing ‘Agency channel’ Industry Retail health channel mix - FY2022 Star Health’s total agency force 700 14% 600 7% 500 550 400 462 8% 300 284 359 200 100 79 71% 28 59 - 40 FY2019 FY2020 FY2021 FY202
Slide 11: Renewal Retention Cell - Snapshot
Distribution Renewal Retention Cell - Snapshot Centers RRC Network 01 18 across the country 02 Callers 200+ callers across 18 centers 03 Calls volume 40K per day across India Renewal Volume- FY23 04 No of Policies: 68 lacs 9
Slide 12: RRC Key Initiatives
Distribution RRC Key Initiatives Initiatives : Well Trained & best performers identified as dedicated callers for FHO renewals CIBIL Usage- Scrub for latest contactibility & for better understanding of customer persona Moving high propensity renewals to digital platforms for conversions – Usag
Slide 13: Digitization – Renewal Retention Cell
Distribution Digitization – Renewal Retention Cell Truecaller Integration helped to increase connectivity rate from 75% to 80% Automated Renewal reminders i.e IVR/ Bot has reduced dependency on call centre Cross-sell of PA, Extra protect etc. now at the checkout page across platforms ML base
Slide 14: FHO price revision impact – Predictive Analytics
Distribution FHO price revision impact – Predictive Analytics - Analyzed Impact for period Aug-17 to Jul-18 -NOP Retention came down by 4% from 91.4% to 87.5% - Method 1 : Based on Premium Co-relation : Impact in FY24 - FHO retention expected to impact by 2-3% - Impact lower as contribution of 1st y
Slide 15: Customer Engagement calendar
Distribution Customer Engagement calendar T>180 to T< 270 T>270 to T< 365 T+90 days T>90 to T< 180 days days Renewal reminders Assurance of Wellness + VAS Cross Sell of with focus on the purchase Services like Talk to PA/OPD & Advantages of made- KYC & Star, Telemedicine Rewards renewal / early How
Slide 16: Our channel partners – Opportunity with New EoM
Distribution Our channel partners – Opportunity with New EoM PSU and Pvt Banks NBFC and Brokerages Digital & Corporate agents contribution to GWP consistently increasing 6.3% 5.7% 5.3% 3.6% 2.7% 1.9% Leading Fintechs partners FY2020 FY2021 FY2022 Digital Corporate Agents Note: Corporate agents inclu
Slide 17: Underwriting Philosophy
UW & Actuarial Underwriting Philosophy Become the most preferred insurer in the country – making Star Health synonymous with Health Insurance Introduce innovative products / covers to suit the evolving requirements of the various segments of the society Achieve Growth with quality and profitab
Slide 18: Underwriting Safeguards
UW & Actuarial Underwriting Safeguards Agent’s Confidentiality Report Tele Verification Cell Document Management System (DMS) Zonal Underwriting Audit Cell -100% audit of fresh cases Proof of age for Proposals above 45 years Surprise audit by Corporate UW cell Alert in Premia (If, Agen
Slide 19: Centralized Medical Underwriting Department - CMU
UW & Actuarial Centralized Medical Underwriting Department - CMU Medical underwriting is fully Centralized in Head office and process PAN India proposals Team of 67 doctors, Supported by Super Specialist doctors panel Team of Executives and Paramedics for supporting UW team All Fresh Proposa
Slide 20: Regulatory Actuarial Work
UW & Actuarial Regulatory Actuarial Work Product Pricing New product pricing Repricing of existing products Experience Analysis Valuation of liabilities Estimation of Incurred But Not Reported (IBNR) reserve Estimation of Premium Deficiency Reserve (PDR) estimation Analytics & Manage
Slide 21: Product Pricing
UW & Actuarial Product Pricing Products – Designed based on the market needs and evolving trends New product pricing – Internal data, Reinsurer data, Industry data and inputs from medical professionals Repricing of existing products – product’s current experience and projected future experienc
Slide 22: Actuarial Analytics
UW & Actuarial Actuarial Analytics Product sales and ICR trend analysis Asset-Liability – Duration analysis Business projections for the Company CAT exposure analysis Expense ratio analysis Others like Capital Requirement analysis, Solvency Projection etc. 20
Slide 23: Strong domain expertise - Investment in Talent Capital
Human resource Strong domain expertise - Investment in Talent Capital Employee Strong organizational culture Talent Development Dashboard • Believes in a culture of empathy, resulting in a • Focus remains on developing of key talent, recall around ‘family values’ creating a succession plan across le
Slide 24: Our Strategy
Strategy Our Strategy Large scale Technology transformation to reduce cost and increase customer delight Leveraging leading position Deepening penetration in rural areas Offering Innovative & Expanding use of alternate Customized Products distribution channels Strengthening agency Robust and efficie
Slide 25: THANK YOU !
THANK YOU ! 23
Slide 26: Claims Capabilities-Our Strengths
Claims Capabilities-Our Strengths Wednesday 29th March 2023
Slide 27: Our Strengths
• Over 8.8 Million Claims handled Loss Minimization since inception - In-house First to implement Hospital Scoring • 37037 crores Paid since 1671 Hospitals Actioned,1711 cautioned,452 Flagged FY 23 • Inception 300 + Medically Qualified resources 436 Error Proven Channel Identified for claims T
Slide 28: Claims Initiatives | Wider Coverage | Innovative Products
Claims Initiatives | Wider Coverage | Innovative Products Cancer Care Cover for people diagnosed & recovered from Cancer, Cancer Care Lump sum benefit, Indemnity cover, Hospice care Diabetic Safe Diabetic Safe Day 1 Cover for Diabetes Cover for people who have CardiacCare Cardiac Care undergone PTCA
Slide 29: Claims Delivery
Claims Delivery Geography based More than 300 Claims coordinators Coordination Battery of with Hospitals • 3 Commands • Medical • Specialist doctors • ZOCA CFM • 12 Divisions Professionals • Investigators • ZCC HRM Specialized in FVO various Disciplines
Slide 30: Our Enablers, Facilitators & Accelerators
Our Enablers, Facilitators & Accelerators Pricing with Hospitals Empanelment Fraud Mitigation Disciplinary Action Telemedicine | Wellness • ANH • Transparent & Online • SAS Platform • Hospitals - 3834 > 8.5 Lac benefitted • Mini SOC 14,808 NWH • DTI • Channel- 436 Fever / COVID Help line • Dis
Slide 31: Claims Verticals
Verticals CHAIR | Fraud Mitigation Tele-Medicine | Wellness Channel wise, Hospital wise, Analyze, Investigate & Report EPPM | BPC | SEEDS Training EPPM : Empanelment, Provider & Pricing Management BPC : Best Pricing Committee Star Empanelment and Engagement of Doctors SEEDS : and Specialists CMU Cla
Slide 32: Claim Intimation Process
Claim Intimation Process Omni Channel – Intimation of Claims STAR Health Website STAR Provider Portal Toll-Free number for Intimation/ Twinkle Chatbot 18004255522 submission 24 * 7 Helpline Claims Intimation Agent’s STAR Atom 2.0 Beta Portal | App | Customer Portal mail Support@ Customer Care 24x7 S
Slide 33: Cashless Claim Processing
Cashless Claim Processing Communication and Documents received Document Processing Medical Processing Settlement to from the Hospital Hospital Documents received from Imports Data from Documents Enhancement documents Hospital through Portal/ Customer satisfaction team into system(Galaxy) received Em
Slide 34: Reimbursement Claim Processing
Reimbursement Claim Processing Receipt of Documents Medical Processing Bill Processing Financial Processing (ROD) Medical Team inputs/ decision to Documents Received Medical Verification of Claim Billing team- highlighting areas of Financial Approval of the Claim Non-Payables Billing calculated based
Slide 35: Treatment in Network Hospital
Treatment in Network Hospital Cashless Pan India TAT- 90% <2 hours Hub and Spoke Model Claims Processed by a dedicated team of Doctors and specialists Turn around Time (TAT) Preauthorization form must be Complete in all respects Complete medical history of the insured, whether or not related
Slide 36: Pre Authorization – Digitization
Pre Authorization – Digitization • Health ID Card No • Date of admission • Room Type • Claimed Amount • Signature Availability • Proposed Line of Treatment • Provisional diagnosis • Past History • Treating Doctor Name • Qualification
Slide 37: Why Auto adjudication?
Why Auto adjudication? Rise in Cashless claims Preauthorisation Auto Mode Out of Scope & Enhancement Reduce Claim Processing time from minutes to seconds Scale up without Manpower • Hospital enters key data points • Hospital enters key data points limitations in the Adjudication Portal in the
Slide 38: Auto Adjudication Progress
Auto Adjudication Progress 14482 13998 (25.4%) (27%) 13510 14000 (26.1%) 12209 (26%) 11058 12000 (23%) 10000 8072 (23%) 8000 6000 4000 2613 1714 (11%) (15%) 2000 302 165 (3%) (4%) 0 Oct '21 Dec '21 Feb '22 Apr '22 Jun '22 Aug '22 Oct '22 Dec '22 Jan '23 Feb '23 2800 + Hospitals onboarded into Adju
Slide 39: Checks and Counter checks
Checks and Counter checks Pricing Audit Claims | Hospital Audit Existing Pricing arrangement Expert Panel of doctors with Hospitals Billing Parameters across various Healthy dialogue line items, ALOS, Average Paid, Pricing Committee Mortality & Morbidity studied CHAIR Verification Intern
Slide 40: CHAIR (Channel wise, Hospital wise - Analyse, Investigate and Report)
CHAIR (Channel wise , Hospital wise - Analyse, Investigate and Report) Identify the Track the Hospital All Referrals –One Point Channel -Source of linked to the (Hospitals & Channel) Fraud Channel Triage (triage.chair@starhealth.in) Alert & Focussed Enable System Training given to Alerts/Arrest the
Slide 41: Engagement With Hospitals To Promote Topline and Protect Bottom line
Engagement With Hospitals To Promote Topline and Protect Bottom line • VSP Valuable Service Provider (712 Hospitals) VSP • PTS Progress Through Synergy (87 Sessions ) PTS | Round CFM Table • CFM Claims Facilitation Managers (200) Engagement with Hospitals Centralized Online Verification of Infrastru
Slide 42: Progress Through Synergy-Provider Engagement Platform
Progress Through Synergy-Provider Engagement Platform Pune Mumbai Delhi Bangalore
Slide 43: Hospital Front Desk Training
Hospital Front Desk Training DELHI PUNE MUMBAI
Slide 44: OPD-SEEDS Preventive Health Check Facility
OPD-SEEDS Total No. Of Doctors : 1,05,748 Preventive Health Check Facility • PHC benefit Can be availed at Existing Network Hospitals and To create a Network by 2518 Diagnostic centers Empanelling individual General Practioners, Specialist Consultants • PHC cashless Benefit can be and Individual c
Slide 45: Telemedicine Service Highlights
Telemedicine Service Highlights Primary Care + Specialists Consultations offered Launched 14/02/2020-USP of STAR 6 Channels 7676905905, Direct, App (Audio + Video), Chat, 8.5 lakhs+ Total consultations as of now Appointment 80,000+ Specialist consultations 1000+ customers treated under Home
Slide 46: Thank You
Thank You
Star Health and Allied Insurance Company — Investor Day (March 2023) on 6ix