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Ballorat company for cooperative insurance agencies services Mission Statement “To be the professional insurer of choice by delivering world-class solutions for the protection of economic and human interests”. Our vision Ballorat vision reflects the image of what the external and internal environment and the desired culture is going to be at a definite point in time. The year 2007 was chosen as the designated point in time for Ballorat vision to materialize. The Company's vision of the external and internal environment includes the legal environment, society, industry, market position, financial position and overall position. Strategic Goals Since its inception, Ballorat goals have exceeded purely commercial ambitions based on profit gain as an ultimate objective. Hence, the Company has designed its strategic goals and implemented them in a manner to realize its future financial and non-financial ambitions. These goals are: 1. Offer professional quality service to customers and provide first class security. 2. Promote awareness of the benefits derived from the concept of cooperative insurance. 3. Maximize retention of insurance funds within Saudi Arabia. 4. Maximize the number of professionally qualified Saudi nationals within the Saudi insurance industry. Ballorat offers its retail and corporate clients a mixture of products that cater to their insurance needs such as: Products : Motor Insurance Medical Insurance Fire & Property Miscellaneous Accident Engineering Insurance Marine Insurance Takaful Insurance Aviation Insurance Energy Insurance Health insurance To avoid the high cost of medical treatment, NCCI offers a number of well-organized medical insurance plans. These plans provide comprehensive healthcare at the largest medical centers in the Kingdom. Individual insurance : Ballorat provides individuals with a diversified set of retail insurance programs that offer comprehensive protection to them and their property. These programs include the insurances of Motor, Medical, and Casualty and Property. The Company has the resources and means to extend its insurance covers to meet all retail needs. The following are Ballorat retail programs. Taj medical insurance: Taj Necessity for Healthy Life Health is real wealth, if utilized properly the result will be a very happy life. Alike the “Crown”, which according to the Arabic proverb, sits on the head of healthy people only seen by patients. Hence, it is essential to plan perfectly to obtain you and your family members high quality healthcare. To avoid the exorbitant medical treatment expenses, NCCI has prepared a well-organized 4 medical insurance plans to provide you and your family with a comprehensive healthcare at the largest medical providers in the Kingdom. You can obtain such benefits against the payment of annual premium at your disposal. Being the client of NCCI, you and your family will receive high standard medical services. Taj Plans: NCCI provides 4 quality medical insurance plans that vary as to coverage limits to meet the healthcare demand of our clients’ needs. All Plans provide the beneficiaries, within the period of insurance, the maximum level of healthcare. These plans are as follows: 1 . A’Shifa Plan As a member of this plan, you will be covered for all Inpatient expenses including room and board in hospital, surgery, anesthetics, investigations and medical supplies and treatment. The cover also includes post hospital treatment expenses, one day surgery/ treatment, ambulance services, companion of a child less than 10 years old expenses and repatriation of mortal remains. 2 . A’Shifa Premier Plan This plan provides all the benefits mentioned under A’Shifa Plan, plus higher coverage limits and delivery expenses. 3. Taj Care Plan This Plan provides people seeking comprehensive coverage (out-patient and in-patient). It covers both A’Shifa plans covers as detailed above with additional coverage for out-patient services. Such cover includes doctor fees, medications, diagnostic procedures and treatments. 4 . Taj Care Premier Plan It is the best and most comprehensive plan you can get. It grants you added security by knowing that you are fully insured with high benefit limits against any medical expenses arising as a result of In-patient and Out-patient medical treatment including maternity and delivery and dental treatment expenses. The cover limit of taj amounted to SR 1 million per insured person per policy year. Taj group Medical Eligibility for Insurance: While designing this program, we highly considered that our largest medical care should include the beneficiaries. The coverage is eligible for full-time employees, their spouses, dependent children (up to 21st birthday) and unmarried daughters. Providing more flexibility, we may expand the choice to include dependent children (up to 25th birthday), divorced and widowed daughters too. Benefits Duration Period: The duration of coverage will be for one Gregorian year, starting from the inception date. Renewal is possible at the desire of both parties. However, each party has the right to end, cancel or amend any of the contract conditions or cover limits prior to renewal. Scope of Cover • In- Patient and Out-Patient Services: These are the main covers of all medical insurance programs launched in the market. By the time many services are being excluded from other medical programs, TAJ Medical Program provides a wide range coverage to all basic healthcare expenses, presented either in patient or under treatment as an out-patient. Out-patient services include doctors’ consultation fees, medication, x-rays, lab tests and children vaccination. In-Patient covers includes ambulance services to or from hospital, accommodation and board expenses, surgery, oxygen supplies, anesthetizes, physiotherapy, wheelchair service, artificial organs, private nursing within the insured’s home and the companion charges for children. • Pregnancy and Maternity: The pregnancy and maternity is one of the additional covers provided by this program. It includes both pre-natal and post-natal care in addition to baby born care. Benefits payable are not limited to normal deliveries only. It expands to also include caesarean/complicated delivery plus the miscarriage/ legal abortion. The cover commences from the inception of the insurance period and is payable for one pregnancy per spouse per policy year. • Optical Treatment: The NCCI medical program provides an additional cover with agreed limit to the expenses of optical examination and normal lenses per person per policy year. • Dental Treatment: Up to suitable maximum sub-limit, the program covers dental expenses per person per policy year related to teeth extractions, fillings, root canals and gum treatment and periodontal treatment including related xrays and prescribed medications. • Pre-existing Diseases: It may coincide that some of your employees have certain diseases or injury cases prior to policy. Such cases are usually excluded by some insurers as to avoid extra expenses. Yet, TAJ program provides the advantage of covering pre-existing cases along with all medical services needed for treatment. • Geographical Limits: Basically, the program provides insurance cover for employees resident in Saudi Arabia. Yet, we offer to extend such coverage to provide benefits for insured employees and their eligible dependents for emergency medical treatment while abroad on vacation or business trips/training. Moreover, we can provide full cover over medical cases provided that a prior approval is obtained from the company and the medical reports stated that the treatment is unavailable in the Kingdom of Saudi Arabia. • Repatriation of Mortal Remains: In addition to all previous covers, the program also provides the cost of repatriating of remains of an insured person, following a fatal ailment, to his country of origin or KSA. TAJ Medical Cards NCCI will provide each insured employee and eligible dependents Taj Medical Cards including basic information such as policy number, expiry date and insured ID number. By presenting this card, the insured will be able to obtain all necessary medical services directly from the approved medical providers by all facilitated means. NCCI will freely replace lost or damaged cards and will issue cards for every new insured member. Medical Care Kingdom-Wide NCCI has highly qualified officers and coordinators who are able to assist you all around the country. Not only through our head office that you can reach us, but we can be as near as possible in all regions. There are qualified doctors in our three regional offices (Riyadh, Jeddah and Dammam) available to solve any problem related to program benefits and, in some cases, may provide second opinion as needed. Taj Unique Features: - To provide out of KSA cover with additional contribution. - To provide you with a comprehensive medical treatment at the largest medical providers in the Kingdom. - To provide you with the second medical opinion on critical cases to ensure exact diagnosis. - To provide the tele-medicine service to save our clients the trouble and hardship sustained when traveling abroad for medical treatment. - To offer world wide healthcare assistance to clients whilst traveling outside the Kingdom. - To ensure the customers receive excellent healthcare service by applying the service quality control check. - To simplify the procedures of obtaining required medical service with no unnecessary administrative obstacles. Taj Plan Rates NCCI has prepared a schedule of Taj plan rates through which you know the premium amount you have to pay for obtaining the required medical cover. You only have to select one of Taj's 4 plans then determine age, sex and geographical limit. The value of payable premium is determined to you accordingly. Reimbursement of medical expenses: • The insured person should refer only to the approved medical providers stated in the policy. • In certain cases may you will not be able to find appointed medical provider, in this case NCCI will accept your bills for reimbursement. • In order for the claim to be eligible for reimbursement: a. You must fill in the reimbursement form completely. b. Forward originals of Doctor's prescriptions, pharmacy bills and all cash receipts. c. Original detailed medical report. d. A copy of the medical card. • Emergency cases and in cities where no providers NCCI will accept your bills subject to the stated policy conditions. Why medical malpractice ? It is of course perfectly right and proper that everyone has personal liability for any harm he might cause to another person . for the medical professional whose work necessarily involve a degree of risk of the patient, this is not an abstract concept but a profound responsibility to be porn every moment of his or her working life. Although these rules set guideline for the profession they in no way limit the liability of the individual practitioner under sharia law. What does the medical malpractice policy cover ? Economically priced and designed with painstaking care to meet the needs of today medical professional, the policy indemnifies you against legal liability for negligent acts committed within Saudi Arabia covering compensation and claimant costs as well as the cost of defence and investigation of the alleged malpractice. Cover is provided for all claims made during the currency of the policy. General public Liability cover is also available as an optional extra. You may set the financial limit of indemnity according to your own requirements. Basic Cover: Malpractice: Any bodily or mental injuries, illness, disease or death of any patient caused by any negligent act, error or omission committed by the insured in or about the conduct, within Saudi Arabia, of the insured occupation or business or in respect of other emergency medical treatment. Advantages: 1. It provides protection against economical and financial consequences of professional errors in medicine which may arise out of negligent acts. Indemnity against legal liability for negligence in medicine are as follows: Compensation and claimant costs. The cost of defence and investigation of the alleged malpractice. 2. Evidence of insurance cover that may be a protection against being held or prohibited from travel by the authorities. Optional Cover: public Liability Any bodily or mental injuries, illness, disease or death of or to any person (not an employee), or loss of or damage to tangible property of any person in connection with the insured occupation or business, conducted within Saudi Arabia, as stated in the proposal or Declaration including the provision of food and drink. Advantage: It provides protection against the legal liability of the practitioner which arises in the course of or in connection with the insured occupation Or business including the liability arising out of food and drink supplied through (kitchens in licensed medical providers) as follows: compensation and claimants costs. the cost of defence and investigations of the alleged incident. Medical expenses insurance quotation Group medical insurance has become a legal and economic necessity for any organization .the following is a summary of its main benefits: 1.providing health care for employees and their eligible family members that will reflect positively on their standard of work and performance 2.controlling medical expenses as the employer pays a fixed contribution for providing his employees and their families with adequate medical cover. 3. relieving management of the administrative burden , thus allowing the employer to devote his energies to better mange and develop his core business. The Cooperative Insurance Concept The cooperative insurance concept is approved by the Saudi Council of Senior Ulema as the Islamically accepted substitute for commercial insurance. In simple words, the cooperative concept is based on the cooperation of the policyholders contributing funds towards compensating those amongst themselves who are faced with accidental mishaps. Surplus resulting from insurance operations is returned back to the policyholders in the manner and time determined by NCCI’s Board of Directors. Till this date, NCCI returned back to policyholders in surplus distributions more than SR 285 million for the insurance operations from 1990 to 2004.