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Submitted By – Himanshu Saigal

SMBA13021

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Contents

Serial No. Topics Page No. 1 Acknowledgement

3

2 Completion Certificate 4

3 Executive Summary

5

4 Chapter 1 – Introduction

6

5 Chapter 2 –

Methodology

9

6 Chapter 3 – Issue

Analysis

15

7 Chapter 4 – Assessment

and Recommendation

17

8 Bibliography

18

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Acknowledgement

This company project in Neuron Llc. Dubai was a good learning experience for

me to know the working of a Health Insurance Company.

My sincere gratitude to my college mentor Dr. Arvind Seth, Professor

(Operations, IMT Dubai) for providing with his insights in the course of this

project.

As a special mention of Mrs. Sheryl Dumasia, Head HR for recruiting me &

giving her valuable advice and sharing her experiences. The successful

completion of this project would not have been possible without her constant

guidance.

I would also like to thank my parents, my team in this project and co-workers

who supported me throughout the project.

HIMANSHU SAIGAL

SMBA13021

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Company Project Completion Certificate

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Executive Summary

Neuron Llc is a Health Insurance Co & is one of the leading Third Party

Administrators (TPAs) in the MENA region. They have dynamic team of 150

members ranging from experienced medical staff to business development and

network specialists.

I was working under Total Quality Management, which helped me in

understanding how the company is trying to improve itself.

My work included comparing & evaluating the tracking records of team

division through graphs & benchmarking.

Under MIS ( Management Information System ), I used to work upon the

staff’s Call Monitoring & Training Programme which helped me in tracking

down the employee’s performance. This also included Job Descriptions Quality

Check.

This project also included me to get to know about CII ( Charted Insurance

Institute ) Certification as they asked me to present report on how a company

improves quality management through ISO ( International Organization for

Standardization ).

Altogether, it was a great learning & improving experience.

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Chapter 1 – Introduction

Dubai Health Insurance System :-

The mandatory health insurance system announced by the Dubai Health

Authority (DHA) will be known as ISAHD, Insurance System for Advancing

Healthcare in Dubai, which also means “happiness” in Arabic.

In line with the vision of His Highness Shaikh Mohammed bin Rashid Al

Maktoum, Vice-President and Prime Minister of the UAE and Ruler of Dubai,

the DHA has branded the name of the health insurance system to mean

happiness; this stems from Shaikh Mohammed’s words that the primary job of

the government sector is to provide happiness to the people of Dubai,” Essa Al

Maidoor, Director-General of the DHA.

“Health insurance is a form of security and our aim is to ensure everyone in the

emirate has access to essential healthcare in case they need it. The health

insurance system will empower patients by providing them with the right to

choose their health provider within the private or public sector.”

The roll out will take place in phases and every health insurance company that

wants to provide health insurance will have to procure a health insurance permit

from the DHA to be eligible to provide health insurance services.

Haidar Al Yousuf, Director of Health Funding at the DHA, said, “Presently, 50

companies have registered with us and we are evaluating them. To ensure we

have quality health insurance players on board, this is an essential step and this

is a procedure that is followed across several countries.

“Insurance companies interested in providing the essential health benefits

(EHB) package to resident employees with salaries below Dh 4,000 will have to

undergo further qualifying criteria to ascertain their ability to provide an

insurance package at an affordable rate. The premium for this package will

range between Dh 500-700 per person per year.”

Al Yousuf said by the end of February, the DHA will publish the final list of

approved healthcare companies. Once the list of published, the first phase of the

roll out will begin.

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In terms of the roll-out, Al Yousuf said, “ Companies with 1000 or more

employees will have to cover their staff before the end of October 2014.

Companies with 100 to 999 employees will have until the end of July 2015 and

companies below 100 employees have until end of June 2016 to cover their

employees. All spouses, dependents and domestic workers will also have to be

covered by June 2016. They can start providing cover earlier, however, these

dates are deadlines they must meet.”

Neuron LLC, Dubai :-

Neuron was established in 2000 by a strong multi-national management team

with extensive experience in the sector. Over the last decade, they have rapidly

expanded to provide a large portfolio of services and service providers. Neuron

has provided outsourced administration and management services to clients in

the Middle East for all areas of insurance administrations. They have managed

to do so through young and dynamic team of 150 members ranging from

experienced medical staff to business development and network specialists.

Vision -

Neuron, working with you, for you. Neuron continually strives to exceed client

and customer expectations by providing superior service and innovative cost

effective business solutions in the areas of healthcare and insurance services.

Mission -

We relentlessly focus on Member satisfaction, that is combined with deep

medical expertise and operational efficiency and built on a solid foundation of

advanced IT infrastructure, with the aim of achieving cost-containment via a

healthier population. We believe in approaching client needs with flexibility,

pioneering ideas in order to enable the client to lead and dominate their market

position.

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Services –

Policy Development

Medical Claim Processing

Overseas Assistance Management

24/7 Medical Authorisation & Helpline Services

Managed Care

Case Management

Eligibility Management / Card Production Service

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Chapter 2 – Methodology

This project included Total Quality Management, comparing & evaluating the

tracking records of team division through graphs & benchmarking.

Under MIS ( Management Information System ), I used to work upon the

staff’s Call Monitoring & Training Programme to monitor employee’s

performance. This also included Job Descriptions Quality Check.

This project also included me to get to know about CII ( Charted Insurance

Institute ) Certification as they asked me to present report on how a company

improves quality management through ISO ( International Organization for

Standardization ).

Total Quality Management –

TQM is a comprehensive and structured approach to

organizational management that seeks to improve the quality of products and

services through ongoing refinements in response to continuous feedback.

The Primary Elements of TQM :

Total quality management can be summarized as a management system for a

customer-focused organization that involves all employees in continual

improvement. It uses strategy, data, and effective communications to integrate

the quality discipline into the culture and activities of the organization.

Customer-focused : The customer ultimately determines the level of

quality. No matter what an organization does to foster quality

improvement—training employees, integrating quality into the design

process, upgrading computers or software, or buying new measuring tools

— the customer determines whether the efforts were worthwhile.

Total employee involvement : All employees participate in working

toward common goals. Total employee commitment can only be obtained

after fear has been driven from the workplace, when empowerment has

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occurred, and management has provided the proper environment. High-

performance work systems integrate continuous improvement efforts with

normal business operations. Self-managed work teams are one form of

empowerment.

Process - cantered :. A fundamental part of TQM is a focus on process

thinking. A process is a series of steps that take inputs from suppliers

(internal or external) and transforms them into outputs that are delivered

to customers (again, either internal or external). The steps required to

carry out the process are defined, and performance measures are

continuously monitored in order to detect unexpected variation.

Integrated system : Although an organization may consist of many

different functional specialties often organized into vertically structured

departments, it is the horizontal processes interconnecting these functions

that are the focus of TQM.

o Micro-processes add up to larger processes, and all processes

aggregate into the business processes required for defining and

implementing strategy. Everyone must understand the vision,

mission, and guiding principles as well as the quality policies,

objectives, and critical processes of the organization. Business

performance must be monitored and communicated continuously.

o An integrated business system may be modelled after the Baldrige

National Quality Program criteria and/or incorporate the ISO 9000

standards. Every organization has a unique work culture, and it is

virtually impossible to achieve excellence in its products and

services unless a good quality culture has been fostered. Thus, an

integrated system connects business improvement elements in an

attempt to continually improve and exceed the expectations of

customers, employees, and other stakeholders.

Strategic and systematic approach : A critical part of the management

of quality is the strategic and systematic approach to achieving an

organization’s vision, mission, and goals. This process, called strategic

planning or strategic management, includes the formulation of a strategic

plan that integrates quality as a core component.

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Continual improvement : A major thrust of TQM is continual process

improvement. Continual improvement drives an organization to be both

analytical and creative in finding ways to become more competitive and

more effective at meeting stakeholder expectations.

Fact-based decision making. In order to know how well an organization

is performing, data on performance measures are necessary. TQM

requires that an organization continually collect and analyze data in order

to improve decision making accuracy, achieve consensus, and allow

prediction based on past history.

Communications. During times of organizational change, as well as part

of day-to-day operation, effective communications plays a large part in

maintaining morale and in motivating employees at all levels.

Communications involve strategies, method, and timeliness.

Steps Involved in Evaluating Staff for Quality Check :-

The staff of 40 employees was evaluated based on their scoring in their

performance sheet.

Weekly call data was taken for 10 employees which included their peak 2 hr

working time. Thus including data of 15 – 20 calls per employee to evaluate in a

day, which then taken for the week to get results.

Then this data is filled according to the performance parameters which will help

the organization to do better in satisfying customers.

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The Parameters :-

1. Behavior

Patience

Cool Minded

Feedback

Gratitude

2. Knowledge

About the product

About the schemes changes

Aware of promotion

3. Listening Skills

4. Analytical Skills

5. Problem Solving skills

Rating :-

Based on the data collected from the call records of the whole week, marks are

distributed.

Bad = 0 ; Average = 1 ; Good = 2

Then, If the employee scores less than 75%, they are assigned to their training

program for the improvement.

Hence, this method facilitates the company to know who all need training.

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Sample Data :-

Hence, this data is used to calculate the % of the agent involved in calling &

thus if the % is less than 75% then the training program begins for the

particular.

Conclusion :-

As this method is not very effective, we could have used such a tool which tells

us where exactly to concentrate first.

So, I would recommend using PARETO PRINCIPLE.

For Example,

1. We collect data from all the agents.

2. Combine that data & list them to various parameters whose value represent

0 .

3. List all these parameters & make PARETO CHART.

Agent 1

PARAMETERS GRADING % = 45

BAD AVERAGE GOOD

Behaviour Patience 1

Cool Minded 1

Feedback 0

Gratitude 2

Knowledge About the Product 1

About the Schemes Change 0

Aware of Promotion 0

Listining Skills 2

Analytical Skills 1

Problem Solving Skills 1

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So now, if company concentrate on giving training into its 4 problematic areas

like Problem Solving Skills, Analytical Skills, Feedback & Gratitude then it will

be able to solve it’s 80% of the problems effectively.

Problems Count Cum Sum % Total Cum %

Problem Solving Skills 74 51 24.34211 24.34211

Analytical Skills 59 110 19.40789 43.75

Feedback 53 163 17.43421 61.18421

Gratitude 40 203 13.15789 74.34211

Listining Skills 20 223 6.578947 80.92105

About the Promotion 19 242 6.25 87.17105

Cool Mind 14 256 4.605263 91.77632

About the Schemes Change 11 267 3.618421 95.39474

Patience 8 275 2.631579 98.02632

About the Product 6 281 1.973684 100

TOTAL 304

0

10

20

30

40

50

60

70

80

90

100

0

50

100

150

200

250

300

CO

UN

T

%

Pareto Chart

Count

Cum %

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So, now we should know the agents for the training program of these four

parameters (Problem Solving Skills, Analytical Skills, Feedback & Gratitude).

So, that we can conduct training secessions separately.

We make matrix structure to understand this data better.

We have taken 10 agents record as an example.

So now we can decide who all will attend Problem Solving Training, Analytical

Skills, Feedback & Gratitude.

Parametres Problem Solving Skills Analytical Skills Feedback Gratitude

Agent 1

Agent 2

Agent 3

Agent 4

Agent 5

Agent 6

Agent 7

Agent 8

Agent 9

Agent 10

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Chapter 3 – Issue Analysis

The following are the issues faced by the company in improving itself :-

Lack of proper training to staff interacting with customers.

Communication gap between the employee & employer.

No proper marketing team in this vast growing area.

No feedbacks from customer after the services delivered.

No market research carried to get to know about their competitors.

Not able to get big contracts from organization because of lack of ISO

certification which was a huge loss to the company.

No proper organization structure, quality management was mainly run by

HR department.

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Chapter 4 – Assessment and Recommendation

The following are some recommendations :-

Go for PARETO PRINCIPLE for effective problem solving technique.

Need of proper training to staff interacting with customers.

Better communication system between the employee & employer.

Proper marketing team required in this vast growing area.

Feedbacks from customer after the services delivered.

Market research needed to get to know about their competitors.

Get ISO Certification in order to get big contracts from organization.

Proper organization structure needed for handling quality management

separately.

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Bibliography

http://www.khaleejtimes.com/kt-article-display-

1.asp?xfile=data/nationhealth/2014/January/nationhealth_January46.xml

&section=nationhealth

http://www.neuron.ae/

http://asq.org/learn-about-quality/total-quality-

management/overview/overview.html