ModrinumGroup health
Mediclaim, personal accident and term life administration: member master, sum insured and sub-limit structure, corporate buffer, e-cards, maternity and OPD handling.
Benefits and rewards administration
The 364 days between one renewal and the next
Placing a group mediclaim policy takes a fortnight. Running it takes a year: the enrolment window, the monthly endorsement file, the e-card that has to reach someone before their first cashless admission, the deficiency letter a TPA raises on day nine. Modrinum does that work for employers in Kolkata, Bhubaneswar, Guwahati and Pune, and reports back in numbers HR can use.
2018
Set up in Salt Lake Sector V, administering benefits only — we do not place the policy and then leave.
4 days
Median cashless pre-authorisation turnaround on our desk this year, down from nine when we started attaching a date-of-first-diagnosis note at intimation.
1 sitting
Enrolment, dependant declaration, top-up election and flexi choices completed together, not spread across four reminder emails.
Fixed date
Additions and deletions go to the insurer on the same day every month, reconciled against the payroll register first.
What actually breaks
A 400-person employer here typically carries group mediclaim, group personal accident and group term life across two insurers and one third-party administrator. Nothing about that arrangement is unusual. What goes wrong is administrative, and it goes wrong in the same four places every year.
- A dependant's date of birth entered from memory at joining, discovered at the pre-authorisation desk two years later.
- Mid-term additions sent whenever someone in HR remembers, so a spouse added in April is still not on the insurer's master in July.
- A room-rent sub-limit nobody explained at enrolment, met for the first time at 2 a.m. in a single-occupancy room.
- A TPA query letter sitting unread in a shared inbox while the claim clock runs.
None of these need a better policy. They need someone whose only job is the file, the follow-up and the date.
What HR usually spends the week on
Forwarding e-card requests. Re-explaining maternity waiting periods. Finding out why a claim was rejected. Rebuilding the census in Excel before renewal because three versions exist.
What we hand back instead
A clean master, a claim register with each open item and its next action, and a utilisation pack that says where the money went and what the renewal loading is likely to look like before the insurer names it.
Administration, not broking
Broking ends when the premium is agreed. Administration begins the morning after. We keep the member master, run the enrolment window, reconcile every endorsement against payroll, chase pre-authorisations and reimbursements by claim number, close TPA deficiencies, and prepare the renewal data set. If your current vendor can quote a premium but cannot show you incurred claims ratio by month, the second half of that job is not being done.
Six things we run
Each one is a page, because each one is a process with a date attached.
Top-ups and flexible benefits
Super top-up election windows, voluntary parental cover, and flexi declarations where an employee moves a defined allowance between benefit heads inside the plan year.
Enrolment
One session per employee, on the portal or in a floor session at your office, with dependant validation done live instead of corrected after a rejection.
Claims support
Intimation, cashless pre-authorisation follow-up, reimbursement tracking, query and deficiency closure, and an escalation desk that talks to the TPA so the employee does not have to.
Utilisation reporting
Incurred claims ratio by month, sub-limit dispute counts, buffer burn, top diagnosis groups, and a renewal projection you can take into a budget meeting.
The HR handover
What sits with us, what stays with you, service levels, escalation names, and how the first ninety days of a transfer are sequenced.
What employees see, what HR sees
The same event, two views. We keep both current so neither side has to ask the other.
The employee view
- An e-card with the policy number, TPA name and their own member ID, issued within two working days of the endorsement being accepted.
- A one-page plan summary in plain English: sum insured, room-rent basis, maternity limit and waiting period, what a pre-existing condition means in this policy.
- A helpline in Bengali, Hindi or English, staffed 09:30 to 18:30 Monday to Saturday, that answers with the claim status rather than a reference number.
- An SMS and email at each claim stage: intimated, pre-auth raised, query received, approved, settled.
The HR view
- A live member master reconciled to the payroll register, with the last endorsement date and the count added, deleted and pending.
- An open-claims register: claim number, employee, hospital, amount intimated, stage, days open, who the next action sits with.
- A monthly utilisation pack with incurred claims ratio, buffer consumed and the sub-limits generating disputes.
- Ticket volume by category, so you can see whether questions are about cover, cards or claims — and fix the cause.
Utilisation in this city has a shape
Across the renewals we prepared this year, Kolkata offices show a claims spike in July and August — dengue and viral admissions — and a second one in February, when people schedule planned procedures after appraisals. Employers who budget a flat monthly claim rate meet that curve as a surprise in the second quarter. We size the corporate buffer around the real curve and tell you in advance which month will look bad.
Send us your current census and last year's claims MIS
We will come back within five working days with a reconciliation of what your insurer holds against what payroll holds, the sub-limits most likely to generate disputes, and a plain estimate of your renewal position. No obligation to move the policy, and we do not need to touch your broking arrangement to do it.