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Daman insurance
A thesis submitted to Sarhad University
By
Sajjad Hussain
Dissertation submitted in partial fulfillment for the degree of BBA
Faculty of Business
Dissertation Supervisor
NOV-2013
MOST MERCIFUL
Statement of submission
This is to certify that Sajjad Hussain holding Roll No. 09-SP-23058 and SUIT
UAE Health System & Daman Insurance. At the Sarhad University of Science
& information technology, Peshawar, to fulfil the partial requirement of the degree
of Bachelors of business Administration BBA
Designation
Organization Name
Designation
I truly acknowledge the cooperation and help extended by Sir Abdul Qayyum, Supervisor of
MAS Education Center, Abu Dhabi UAE. He has been a constant source of guidance throughout
the course of this project. I am also thankful to my friends and family members whose silent
support led me to complete my project
I would like to thank the people who participated and helped me a lot from the beginning of my
research to its end. I would like to thank my father MR. Iftikhar Hussain who helped me
throughout the research and give me different references and books to refer from.
Then most importantly I am really thankful from the depth of my heart to The Sarhad University
that gave me the opportunity to make the research on motivation. I am also very thankful to the
university for the way they helped me to complete my bachelor and I am hoping to take master
degree.
I was advised and guided by different people and I want to thank all those people for helping me
successfully complete the research.
Finally I would like to thank all the companies and other professional who gave me chance to
conduct the research. I dedicate this dissertation as an excellent achievement of my educational
life to all members of my family, especially to my dearly parents and wife who were so patient
and helpful.
HAAD is the regulatory authority of health in the UAE. On the other hand Daman is the insurance
broker company that provides health insurance for its citizens in the UAE. Daman is a semi
government organization that insures individuals as well as larger organizations.
The Health Authority Abu Dhabi (HAAD) is the regulative body of the Healthcare Sector in the
Emirate of Abu Dhabi and ensures excellence in Healthcare for the community by monitoring the
health status of the population.
HAAD defines the strategy for the health system, monitors and analyses the health status of the
population and performance of the system. In addition HAAD shapes the regulatory framework
for the health system, inspects against regulations, enforce standards, and encourages adoption of
world class best practices and performance targets by all healthcare service providers in the
Emirate.
HAAD also drives programs to increase awareness and adoption of healthy living standards among
the residents of the Emirate of Abu Dhabi in addition to regulating scope of services, premiums
and reimbursement rates of the health system in the Emirate of Abu Dhabi
On the other hand Daman is the primary health insurance company in the UAE and the region of
the Middle East. We will be emphasizing on the strategy, planning and working of Daman in the
UAE. It complies and works according to the rules and regulations of HAAD (health authority
Abu Dhabi).
Daman provides health insurance facility to almost 3 million people in the UAE alone. Daman has
emerged as one of the most prominent insurance brokers not only on private personal level but
also on the organizational level of many multinational organizations. They provide insurance for
aerospace, oil and gas, energy sector, construction companies, investment companies and media.
Daman is a semi government organization where the government holds the larger share. It is a joint
stock venture. The government of Abu Dhabi owns 80% of the company whereas the remaining
20% is owned by Munich Re. the government of Abu Dhabi backs the company with reliable
support. Munich Re is the world leading reinsurers. They play an important role as reinsurers and
a valuable source of knowledge transfer.
Daman has many different types of insurance policies according to the need and requirements of
the people. They vary in price according to the age category, business category, health needs etc.
this helps Daman and the people to address their issues and get insured accordingly. Daman is the
leading health insurer in the UAE.
HAAD (health authority Abu Dhabi) is the regulatory authority for health issues in the UAE. Every
organization like pharmacies and hospitals or any other heath care unit has to abide by the laws of
the health authority.
Vision
A healthier Abu Dhabi. This is the vision of HAAD (health authority Abu Dhabi.
Mission
HAADs main and primary mission is to develop and regulate the healthcare sector to its highest
level. A world free of any disease or sickness. It aims at protecting the health of each and every
single individual by ensuring better access to services. They also aim at improving the quality of
health care continuously. Sustaining the resources is another prime mission of HAAD.
Values
Commitment to the societys needs and expectations is one the core values of HAAD
Innovation and creativity in the healthcare sector. HAAD encourages creative thinking and
continuous improvement of the services.
Accountability of each and every individual
Abiding by the laws, rules and regulations of HAAD.
Excellence in promoting and expanding the corporate performance.
All these entities regulate the laws, condition and implement rules in the healthcare industry. To
achieve this there are a lot of partnerships of the UAE with the US. This partnership includes many
entities like Cleveland clinic Abu Dhabi, GE healthcare, john Hopkins and childrens medical
center. All these entities help the UAE in moving forward in infrastructure, workforce and
integration etc. the collaboration or partnership of the government of UAE and US goes back to
the 1960s. Dr.pat and marian Kennedy were American missionaries that set up a makeshift
hospital in a mud block in Al Ain that was donated to them by Sheikh Zayed Bin Sultan Al Nahyan.
Since the independence of the United Arab Emirates in 1971, the UAE has made progress in ways
unimaginable. The country has made infrastructure, security and health available to each and every
individual that lives here. However with the passage of time and development UAE is facing
problems for its citizens that are usually found in well developed countries. These diseases include
obesity and diabetes etc. on the other hand the older people are suffering from problems like cancer
and heart attacks. The use of junk food and fast food is also becoming common among UAE
citizens. However each and every state in the UAE is working hard to fight these issues in order to
achieve a healthier society.
The UAE health sector is divided into two areas public and private sector. Public healthcare service
providers fall under the government entities like Dubai health authority, Abu Dhabi health
authority and SEHA. This means that any public healthcare service provider is governed and
maintained by the government. All of these entities have to abide by the laws, rules and regulations
that have been outlined by the authorities. Each and every company has a partnership with different
hospitals and medical centers that perform daily operations of hospitals throughout the private
healthcare sector in the UAE
The other sector is the private healthcare centers. One of the biggest private healthcare centers are
the NMC (new medical center). These sorts of healthcare centers are also obliged to follow the
rules and regulations of the health authorities but they are not managed by them. They are run
solely by themselves. These healthcare centers are providing state of the art facilities and services
to citizens of the UAE. Some of the other hospitals or health care centers are the Noor hospitals
and NMC etc. these private hospitals or health care providers are important in the overall health of
the UAE citizens.
However as a nation the UAE strives to improve its healthcare continuously. This means that all 7
states will follow the systems made by the ministry of health but each state has to play its part
individually. An example of this is the development of healthcare units in the states of Ras al
khaima and Fujairah. These two states have established themselves as the states for the best high
quality healthcare in the region. There are 8 of the best hospitals in these two states. In short
healthcare facility is an important part of the UAEs federal plan. According to the vision of UAE
UAE will invest continuously in building world class healthcare infrastructure, expertise and
services in order to fulfil its citizens expectations and needs. On the other hand the emirate of Abu
Dhabi has explained in its vision 2030 plan that the growth of the medical sector is dependent upon
large investments in technology, which Abu Dhabi is in a position to make. Abu Dhabi will have to
attract medical scientists, doctors and medical staff.
Even after the small population of UAE the government has spent a huge bulk of money on health
care. But there are still some areas that need to be addressed in the field of healthcare. Some of
them are women care, oncology, pediatrics and diabetes. These are some of the major problems
that are still to be addressed in the healthcare industry. People are visiting other countries like
Thailand and Singapore to get treated for these problems. However this doesnt mean that the UAE
has neglected or forgotten about these issues. As a result the governments of UAE and health
authorities are rapidly improving their healthcare sector in order to provide in-country treatment.
This means that their citizens will not need to travel to other countries for treatment. This means
that more and more healthcare centers from around the world will be coming to UAE in search of
partnerships and collaborations to improve health care.
Given below is a figure that will clearly help us understand the amount of expenses spent on
healthcare in the UAE:
According to the population survey conducted in the year 2010. The population of the UAE was
estimated at 9,206,000. Out if these numbers a total of 19% representation was that of the UAE
nationals. The UAE has a total of 104 hospitals as of now. According to the reports of the world
health organization there are 19.3 physicians and 40.9 nurses and midwives per 10,000 persons in
the UAE. Given below is a figure of the division of hospitals from the government and private
sector in each emirates of the UAE.
We will be discussing on the hospitals amount in the UAE cities. We shall also be mentioning the
number of beds combined in every state and how many people it services. There are government
hospitals as well as private hospitals with both having their own importance in the country.
4. Emergency preparedness
The Abu Dhabi health authority has to be prepared for any sort of major disaster or
disease outbreak
Reduce waste
Encouragement of private sector
Elimination of loss transfer for non-mandated healthcare
Effective management of funded mandates
Ensuring the appropriate reimbursement framework
Telemedicine
Tools to drive that have been discussed above
As a part of the improvements discussion we will show the commitment of the UAE towards health
care through the figure below that will show the Dubai healthcare city overview.
For this sole purpose HAAD has drawn an outline for every organization related to health. It can
be doctors, hospitals, pharmacies, clinics or insurance brokers. Each and every one has to follow
the rules made by HAAD and work accordingly. Given below are some of the public health
programs that are run by HAAD in the larger interest of the public health and awareness.
Although a lot of success has been tasted by HAAD but there is still room for improvement in its
performance. They are focused on achieving more and more goals efficiently and responsibly.
While increasing their efficiency people also have an increased level of expectation. Their
expectations rise.
HAAD (health authority Abu Dhabi) is the regulatory authority Abu Dhabi that is committed to
planning, monitoring and maintaining quality healthcare in Abu Dhabi. They are committed to the
better health of Abu Dhabi residents and citizens.
HAAD has emerged as the most important part of health in Abu Dhabi in the past decade. This is
because of their consideration towards human development in the state of Abu Dhabi. HAAD
considered human development as a pre-eminent objective for all their policies. Its highest priority
is to provide high quality healthcare to the people of Abu Dhabi. Priorities of the health care sector
are being discussed so we will have a look at a survey that will illustrate the problems faced by the
UAE citizens and the causalities caused by it.
21
Executive Committee
H.E. Prof. Maha Taysir Dr.Asma Al Mannaei Dr. Khaled Al Jaberi Dr.Omniyat Al Hajri
Barakat Director, Strategy Director, Health Director, Public Health
Director General, HAAD Division Regulation Division and Research Division
Hamed Al Hashemi
Khalid Al Hameli Director, Corporate
Director, Administration Performance &
and Finance Division Enterprise Risk
Management Division
Figure 9 executive committee of HAAD
Likewise the patients have their rights to health care. Some of the responsibilities of the patients
are mentioned below:
Patients Rights:
Treatment to the highest professional standard.
Right to be treated by the best and licensed professionals that can be held accountable for
their job as well.
Patients have the right to know and be involved in any sort of decision that is made in their
treatment and care.
Refusing any sort of treatment or accepting it on the base of the patients decision.
All patients have the right to access their medical records and history.
Informing the patient regarding admission
Safety
Second opinions according to the patients wish
Patients feedback
Patients can provide their feedback on how good or bad was the service of the healthcare facility.
Patients can make a complaint to the management of the hospital on any other health care facility
or HAAD (health authority Abu Dhabi)
Objectives
HAADs insurance laws are made to produce an effective and competitive industry of
insurance in the emirates of Abu Dhabi
Protection of the interests of all the people that are involved with the health insurance plan
One of the key objectives of HAADs laws is to ensure the complete utilization of the
Insurance policy in order to attain optimum levels of the benefits covered
Safety of all the people in the health insurance scheme
Providing optimum health care for all the participants in the insurance policy
Support for the private sector
Free choice of access
Employers obligation
Each and every employer in the state of Abu Dhabi is obliged to provide health insurance for their
employees and their families. This includes 1 spouse and 3 children. Anything after this will be
the responsibility of the employee himself. This includes the registration fees and the cost of the
policy. Any employer that does not provide a health insurance for their employees after 15 days
of arrival will face a daily fine of 10 DH. Neither will he be able to paste employment visas for the
employees without a proper health insurance card; neither will he be able to renew any other visas.
This means that the employees will be considered illegal immigrants. The law also states that no
employer is allowed to transfer the cost of insurance or registration to their employees. Who so
ever commits to doing such a thing will be party to crime and will face serious consequences and
hefty fines. Employees that are affected by this can file a complaint at GAHS complaint units.
All commercial business man and companies in the state of Abu Dhabi are expected to adhere to
the health insurance laws. As there is enough time and notice provided. HAAD has regulated a fair
and sever list of punitive measures that can be taken against anyone that fails to comply with the
laws of HAAD.
Oral health is usually taken for granted but it needs to be addressed in a far better and serious
manner. About 60 to 90 % of the children in the developing countries face dental problems. These
include several Asian and Latin American countries. In addition to pain and discomfort oral health
can also affect a childs ability to learn or communicate. Over 50 million school hours are lost
every year from all over the world in developed and developing countries due to bad oral health.
Bad oral health is associated directly to decrease school performance, poor social relationships and
less success in life. Children experience pain which leads to distraction and concentration in
school.
The WHO world health organization conducted a survey in the UAE in 2010. This global health
school survey was carried out on 2580 students from the UAE. Results shocked everyone as they
found out that 15% of the students had not brushed their teeth from the past one month. 23.3%
male students were more likely than 8.5% female students not to clean or brush their teeth.
Children
Brush your teeth twice a day
Usage of floss once a day
Dentist checkup twice a year
Brushing the teeth with only a pea sized amount of toothpaste
Avoiding sweets
Parents
Encouraging the process of teeth cleaning from the age of 2
Supervising children while they brush their teeth until they are properly trained and
comfortable with the process
Fluoride toothpaste helps prevent teeth decay
Consulting with your childrens dentist
Healthy food = healthy teeth
Given below is a figure that shows the risks involved with bad oral care
Mubadala Healthcare
Mubadala is related to healthcare in Abu Dhabi. This company builds new infrastructure and
supports UAEs strategy of economic diversification. Their assets and services are made to meet
the requirements of the emirate of Abu Dhabi. Their main focus is on diabetes, orthopedics, spine,
physiotherapy, rehabilitation, primary care, visceral medicine and medical diagnostic testing. This
shows that mubadala is focused on providing physical healthcare that is mostly growing with time.
In the pursuit of fitness it is providing with the best possible infrastructure and health options. One
of the biggest achievements of Mubadala is the Cleveland Clinic Abu Dhabi which is a state of the
art hospital with the best health care for patients.
Cleveland clinic Abu Dhabi offers a number of important health care services some of which are
mentioned below:
There are over 30 medical and surgical specialty centers in Abu Dhabi. Given below are some of
the most prominent groups associated to Mubadala
Cerner Corporation
Cerner Corporation is an IT company and healthcare technology provider. Cerner is in direct
partnership with SEHA which is the Abu Dhabi health service provider. Their partnership is aimed
at improving electronic processing, reducing cost, increasing efficiency and protecting patient
records. Their IT solutions help Abu Dhabi hospitals to perform effectively and efficiently by
meeting daily targets and requirements and data to provide better healthcare delivery on daily
purposes.
That the citizens of Abu Dhabi can have access to quality treatment without having to travel abroad.
This is a huge entity that provides almost 500 beds, 5 clinical floors, 3 diagnostics and treatments
level and thirteen floors of critical treatment.
GE healthcare
This is a collaboration that provides transformational medical technology and services in patient
care in the UAE. They specialize IT, imaging, diagnostics, patient monitoring systems,
improvement in performance and discovery of drugs. Sheikh Khalifa medical center is one of the
most prominent collaboration of GE healthcare.
CEOs Message
Dr.Michael bitzer
Daman is UAEs primary health insurance provider. We serve more than 3 million members. All
the members of Daman enjoy a vast array of healthcare services. Daman is the UAEs first and
biggest healthcare network in the UAE. It is also growing rapidly across the Middle East, Asia, Africa,
Europe and America.
Daman also offers disease prevention programs. These programs are managed by a qualified team
of individuals from Daman. We have also created our active life initiative, which aims to mobilize
the public of UAE to have a health and active lifestyle.
This is UAEs primary and national health insurance provider. It is also the leading insurance
company in the region. There are almost 3 million people that are insured by Daman in the UAE.
Hence making Daman the biggest insurance company not only in the UAE but also all over the
region.
It was established in 2006 in UAE. Its headquarters are in Abu Dhabi. They have a lot of insurance
programs according to the needs and requirements of the individuals. Daman also provides
insurance for organizations. They offer a special program for the locals of the UAE that is known
as THIQA. THIQA is an insurance plan specially made for the government and locals health.
Where THIQA is the insurance plan for UAE nationals. Daman also provides basic plans for
expatriates. Each and every individual can enjoy healthcare from the largest healthcare providing
organizations and an extensive international network of over 45 countries.
This company has been the primary choice of many multinational organizations and national
organizations that have been established in the region and UAE. Some of the most prominent
organizations include:
Daman is not a government insurance firm. It is a semi government institution where the
government has a higher percentage of stock. The government of the UAE has 80% joint stock
shares whereas on the other hand Munich Re owns the remaining 20% of the shares. But the
company is backed and supported by the government entities. They are the worlds leading
reinsurers. Reinsuring and providing a valuable source of knowledge transfer is an important role
of Munich Re.
Vision
Values
Daman values honesty and integrity. They continuously aim at setting new standards bring about
improvements in the health industry. Striving to keep their performance at the best standard to
maintain their position in the health industry.
Daman is focused on providing the best performance to its customers and members. This
means that each and every individual will have the best possible treatment weather it is
mental or physical. Each and every member will be treated appropriately. Daman sets hard
targets for itself. They strive to achieve these targets and then surpass them in order to
achieve greater heights of efficiency and performance.
Innovation
Daman is not just aimed at providing health insurance or disease prevention for the citizens.
They are innovative. Daman not only values innovation but also promotes it. Their services
and products both are a live example of damans innovation. Their innovation is not just
limited to insurance but also in the field of healthcare.
Customer focus
With each products and service that Daman is providing, they keep their customers in mind.
They strive to produce a commodity or service that is best for its members. This means that
their customers are happy and satisfied every time they benefit from Daman.
Social responsibility
At Daman people dont just think about Insurance policies. They believe that they have a
huge social responsibility of health and humanity at first. They have the responsibility of
providing a good healthcare for every individual.
Trust
Trust is one of the strongest traits of Daman. Their outstanding service and consumer
friendly policy makes people trust it and come back again and again. Daman values
honesty and goodwill. They strive to be a trusted ally rather than a trusted company.
Daman offers a dedicated number to its customer that answers any queries of customers
through a 24 hour call center which is handled by multiple representatives.
Daman has an amazing system that approves any demands for a specific treatment that
needs to have pre authorization. This helps prevent any severe problem.
Members can make in-house claims within 15 working days.
Daman also provides direct billing
Daman has an online service website that provides a track for members to submit online
claims or request or complaints and track endorsements. Members can also take advantage
of many more services.
Case management is another service provided by Daman. This service guides members
through the medical services that are provided and ensures that the people are receiving the
best possible service and care.
Daman also offers disease management programs. It helps its consumers to manage chronic
conditions with the help of well trained personal. They help the patients by motivating and
educating the patients to lead a healthier lifestyle and improved quality of life.
Active life program is a very unique yet useful program offered by Daman. This program
is basically designed for the members to have a platform to support them and lead a
healthier lifestyle and be more active in life.
Daman health insurance card is the prime insurance policy for the citizens of UAE. It is mandatory
for each and every individual in the UAE to have insurance. Good or bad, cheap or expensive
insurance has to be made. This is also mandatory because the government of UAE doesnt paste
the residence visa onto the passport if the person does not have a valid insurance. If a person is an
employment visa then his/her insurance will be paid for by the company.
The insurance card carries important information like the persons name, date of birth, nationality
and insurance policy number etc. Then there will be the type of insurance plan that will be
mentioned on the card. Whenever a patient will visit a healthcare facility they will present the
insurance card to the facility to avail benefits from the insurance card. Given below is a figure of
Daman insurance card.
Daman members have the right of information. Information regarding insurance plans and
services.
Members have PBM pharmacy benefits management services.
Treatment with respect and dignity.
Rights to privacy
Confidentiality of records of patients.
Voice complaints
Claim settlement
Members have the rights to receive services in Arabic and English.
Information about ones insurance plan, benefits and exclusions.
Commenting to help improve the performance of daman
Read all the insurance policies for details of all the benefits.
Know all terms and conditions
Present daman card at any healthcare facility
Knowledge of how to access covered health services
Payment of the applicable co-insurance
Demonstration of mutual respect and courtesy towards the providers
This is the surgery that is done to construct any dental cause that
happened during the accident
Accident related Dental Treatment
This is a manual for the user which explains all the benefits that
Benefit Plan
the consumer will get.
The percentage of every claim that has been paid by the policy
Co-Insurance
holder after paying off the deductible amount.
Consumable Medical Supplies Supplies that are usually disposable and cannot be used more
than one time.
Insurance card.
Daman card
Durable Medical Equipment Any equipment that is not disposable. It can be used one or more
times
Effective Date The date when the coverage or insurance becomes effective from
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