Micro Insurance :: Social Security Unit :: Process :: Roles & Responsibilites

Project Staff and Call Centre Staff

Director(Social Security )

Overall Coordination of micro-insurance and other social security interventions across the State
Empanelment of Micro-insurance service providers
Designing the policies by contacting the insurers
Placing the products/schemes for approval of the Government / SERP
Anchoring / representing State / National level and International level Micro-Insurance events on behalf of SERP/Government of Andhra Pradesh.
Facilitating the Government with regard to policy decisions governing operationalization of systems that are favorable, affordable and accessible to the community

State Project Manager (SPM)

Micro-Insurance Unit Management at SPMU , with regard to its administration /affairs
Dealing with day to day correspondence / file processing / proceedings etc
Processing payment of claim amount to the ZS accounts as soon as the LIC remits the amount to SERP-Insurance Account
Liaisoning with LIC, United India Insurance and other Insurance service providers.
Strengthening Call Centers, by keeping in touch with the DPMUs on regular basis.
Anchoring / representing State / National level Micro-Insurance events on behalf on SERP/Government of Andhra Pradesh.
Facilitate conducting of State Level Monitoring Committee Meetings regularly.

Project Executive / Manager (PE /PM)

Supporting the Director / SPM with regard to designing, implementing and monitoring of the schemes / products,
Liaisoning with LIC, United India Insurance with regard to processing and settlement of Claims , as instructed by the RPD /SPM
Liaisoning with Soft-ware service providers / updating the web portal on a regular basis, in consonance with RPD /SPM
Supporting the SPM for processing of Claim amount to the ZS accounts through online system.
Conducting Capacity Building events for Anchor Persons (DPMs/APMs), Call Center Operators, Accountants, Bima Mithras and Zilla Samakhya Insurance Sub-Committee Members in respect of quick and quality service delivery systems.
Formulating operational manuals, guidelines for each product /scheme
Documentation of progress and process reports
Providing handholding support at Call Centers by conducting field visits, review of ZS Sub-Committees, management and field functionaries, Bima Mithras.
Conducting evaluation and impact studies, sample surveys with regard to evolution of micro insurance operations for the benefit of the community as well as SERP.

DPMU Level

DPM ( Abhaya Hastham & Micro-Insurance)

Coordinating District level Abhaya Hastham & Micro insurance interventions including enrollment, data entry, computerization, and verification etc at the time of enrollment of Schemes.
Ensuring pension payments to the eligible pensioner regularly
Conducting capacity building events to all the stakeholders as per AWFP / directions by the SERP from time to time.
Apprising the Project Director and Zilla Samakhya regularly on the developments of Abhaya Hastham & insurance activities in the districts, like enrollment, transfer of funds, payment of pensions, call center operations, claim settlements, etc.
Facilitating ZS with regard to identification, training and positioning of Bima Mithras.
Supporting sub-committee in their efforts to shoulder the responsibility of insurance operations.
Checking e-mails daily three times (at 10.00 AM, 2.00 PM and at the time of leaving the office) place them before PD /ZS and ensure the compliance
Circulating all the GOs, Circulars, guidelines or any literature pertaining insurance activities sent by Govt / SERP to all the ACs/ APMs for necessary action and response.
Attending District level Revenue Officers meetings once in a month with specific issues along with ZS
Documenting progress and process reports as per the instructions of SERP

And any other responsibilities in respect of Abhaya Hastham and Insurance as directed by PD/ SERP from time to time

APM (ABH & Insurance)

Day to day management of Call Centers, particularly ensuring its functioning 365 days (from 6.00 AM to 8.00 PM) attended by the Operator/ any other alternative person regularly to receive the calls, registration, directing Bima Mithra.
Ensuring providing facilities like Cell Phone, SB A/c with ATM facility, kit etc to Bima Mithras including availability of an advance amount of Rs.10,000/- round the clock sufficient for two claims
Facilitating ZS to conduct Bima Mithras Reviews, addressing their problems, ensuring their payments.
Final verification of Claim Documents as per Check list
Filling the Claim –Discharge form and placing it for verification and signature of ZS.
Submission of UCs like Claims, Scholarships etc of all the schemes
Assessing payment of incentives to Bima Mithras, VO sub-committee members
Ensuring the following activities through Telephone Operators;
Attending / remaining in the Call Center Daily at 6.00 Am to 8..00 PM for receiving the calls, registering, verifying ( in two shifts)
Confirmation of enrollment of the particular person
Confirmation of death by calling back to the village
Confirmation of availability of amount in the account of respective Bima Mithra.
Intimation to Bima Mithra to visit the bereaved family with Rs.5000/- along with MS sub-committee members
Intimation of the death to concerned AC / APM / MS
Confirmation that the Bima Mithra is going to the village.
Receiving the Claim forms from Bima Mithras Ensuring the following functions by Call Centre Computer Operators:
Verification of Claim Documents and placing them for further verification before DPM /APM
Scanning the documents
Quality uploading the Claim documents to web portal Ensuring the following functions by Accountant:
Writing daily cash books, ledgers and vouchers
Ensuring deposit of advance amount in the accounts of Bima Mithras
Preparing Cheques for final payment to the nominees
Preparing trail balances and placing before ZS /PD
Facilitation of internal and external Audits

And any other responsibilities in respect of Abhaya Hastham and Insurance as directed by PD/ SERP from time to time

Area Coordinators:

Responsible for coordination of insurance interventions in his/ her respective cluster (Mandals) as per the GOs, Circulars, guidelines circulated by the DPMU including, awareness, enrollment, data entry, computerization, Collection and submission of premium as per the list of members to ZS
Ensuring distribution of bonds to the insured members.
Identification of Bima Mithras as per the requirement of the cluster (i.e 2-3 per each cluster providing services to minimum 2 Mandals ) from the mandal where ATM facility is available. Facilitating & Ensuring payment of immediate assistance of Rs.5000/- to the bereaved nominees without unwarranted delay.
Facilitating & final payment of Rs.25,000/- or 70,000/ to the bereaved nominees without unwarranted delay
Conducting impact studies and documenting case studies and submitting them to DPMU / SERP

Assistant Project Manager(APM) /Mandal Coordinator

Responsible for coordination of insurance interventions in his/ her respective Mandal as per the GOs, Circulars, guidelines circulated by the DPMU including, awareness, enrollment, data entry, computerization, Collection, submission of premium as per the list of members to ZS and distribution of bonds to the insured members.
Ensuring conducting the awareness among the community by the field functionaries, CRPs, CAs etc to inform at Call Centers in the event of any adversity / causality as soon as the it occurs for immediate financial assistance.
Facilitating & Ensuring payment of immediate assistance of Rs.5000/- to the bereaved nominees without unwarranted delay.
Facilitating & final payment of Rs.25,000/- or 70,000/ to the bereaved nominees without unwarranted delay at MS and taking acknowledgements
Formation of Mandal Samakhya level Insurance Sub-committees –consisting of 3- 5 members.
Facilitating and ensuring one MS Sub-Committee member accompany Bima Mithra while she visits the bereaved family for payment of Rs.5000/-
Facilitating and ensuring the bereaved family to get required Certificates for age proof , death Certificates from the VRO etc.
Responsible for thorough verification of the documents, age proof certificates - particularly age, name of the policy holder, name of the nominee tally or not as per the check list provided by SERP. if not tallied the documents shall be returned then and there to the concerned village and get rectified or fresh documents may be obtained. It is the ultimate responsibility of APM and concerned CC / CV.
Finally after satisfaction, the documents shall be sent to Call Centre.

Community Coordinator /Community Volunteers

Conducting awareness programs at the villages on the schemes in detailed manner as per the guidelines with regards, premium, risk coverage, service delivery system.
Popularizing the Call Centre Phone Number among the community to inform as soon as any members dies in the village.
Educating the VO to inform call centre as soon as the member dies for immediate assistance.
Visiting the bereaved family, even before Bima Mithra visits the family
Support the family to get death certificates as early as possible and to hand over them to APM.
Ensuring the final payment to the nominees at the earliest.

Telephone Operators – 2 Nos. 1st Operator - 8.00 AM to 2.00 PM 2nd Operator - 1.00 PM to 8.00 PM

Telephone Operators Responsibilities:

Opening of Call Center in all 365 days
Lifting of Telephone with in 4 rings
Noting of all Claims details and grievances in Base Register
Verification of policy details in the web site for registration of claim
Enquiry with APM-MS / CC & VO representatives about the claims
Register the Claim in the web site
Verification of balance amount available in Bima Mitra SB A/c
Informing to Bima Mitra for verifying claim and to pay immediate assistance
Informing to APM-MS, GP-Secretary about the visit of Bima Mitra for payment of immediate assistance
Confirmation of payment of immediate assistance with Nominee and updation of payment details in the web. Follow up over phone:
Follow up of for submit the claim documents with nominee, Bima Mitra, APM, AC
Follow up of nominees to furnish SB A/c details nominee, Bima Mitra, APM, AC
Inform to nominee about payment of final claim amount
Post claim payment follow up - Updation of final amount usage details in the web

Computer Operator – 1

Receipt of Claim documents from Bima Mitras
Verification of claim documents
Issuing online acknowledgement for receipt of claim documents
Preparing discharge receipts for claim documents
Verifying deceased members Age details with online data
Verifying signature of the registrar of Births & Deaths of concerned body issued Death certificate with online data
Updating nominee SB A/c details in the web.
Scanning & uploading of claim documents
Download the Settled claim proceedings from web, prepare the file for transfer of final claim amount to the nominees
Generate letters from web site in case of rejected claims to inform to the nominees about requirements
Post the letters to nominees

Computer Operator – 2:

Call Centre correspondence
Updation of Abhaya Hastham pension acquittances
Updation of Scholarship acquittances
Support to MS Computer operators for updating renewal data, scholarship data under various policies

Accountant

Online updation of Call Centre accounts on day to day basis
Ensuring minimum balance of 11000/- in all the Bima Mitra Accounts for payment of immediate assistance
Ensuring online transfer of final claim amount to the concerned nominees within 3 days after settlement of claim
BRS on fortnightly / monthly basis
Payment of Bima Mitra TA & DAs on monthly basis

Call Center Operator

Attending / remaining in the Call Center Daily at 9.30 Am to 6.00 PM for receiving the calls, registering, verifying
Confirmation of enrollment of that particular person
Confirmation of death by calling back to the village
Confirmation of availability of amount in the account of respective Bima Mithra.
Intimation to Bima Mithra to visit the bereaved family with Rs.5000/-
Intimation of the death to concerned AC / APM / MS
Confirmation that the Bima Mithra is going to the village.
Receiving the Claim forms from Bima Mithras
Verification of Claim Documents and placing them for further verification before Anchor Person.

Accountant:

Writing daily cash books, ledgers and vouchers
Ensuring deposit of advance amount in the accounts of Bima Mithras
Preparing Cheques for final payment to the nominees
Preparing trail balances and placing before ZS /PD
Facilitation of internal and external Audits