A question asked by everyone who visits us or meets us.The answer is YES.

The Uplift Model that creates a two pillared structure enables communities to manage their risks effectively and benefit from such services that make their lives easier,happier and healthier!

This two pillared structure comprises of a community represented democratically managed one that takes the product policy decision and a second one comprising of the technical support that provides the entire technical framework to run and manage the operations and growth.

We list below how a mutual organisation looks like!

CHARACTERISTICS OF A MUTUAL ORGANISATION

While Mutual funds are popular financial instrument available in the market, Mutual Organisations (mutual insurance) can be defined as an autonomous, not for profit organization based on solidarity between members and that is democratically accountable to them. Its objective is to share risks (in Uplift case its Health and Life) of the members and share services. One of the main objectives of Mutuals is p

romotion of democratic decision making.

Mutual organisations can have the following characteristics

•      Mutual Organisations are partnerships who are financed primarily by means of the contributions of their members.

•      The Mutual Organisations implement solidarity between their members. They do not carry out a personalized selection of the risks to adhesion can you explain this and they do not institute personalized tariff conditions. Reciprocity develops an action of general interest by supporting the access to health care of all and the improvement of the protection of the member. (Commercial insurance companies manage the risk and often personalize the risk and the tariffs with exclusions - or non mutualisation - of higher risks like seniors or HIV positive /AIDS patients.)

•      Mutual Organisations are non-profit institutions which do not have the role to carry out surpluses and to distribute them to their members. Their vocation is to organize for and with their members the answers to the social needs which they express. (Commercial insurance companies have the role to carry out benefit and to distribute them to their shareholders.)

•      The vocation of the Mutual Organisation is the precaution, solidarity and mutual aid in order to contribute to the cultural development, moral, intellectual and physic of the members and with the improvement of their living conditions. The activity of the Mutual Organisations is thus in the field of social protection exclusively with regard to the human person.

•      Democratic and participative functioning of the MUTUAL ORGANISATION under the responsibility of the members General Assembly. The Mutual Organisations are managed by a board of administrators elected by the members of the general assembly (members). The functions of administrator are not remunerated and free, they receive a proper training in order to be able to take decisions. Daily operating activities are done with a team of insurance specialist hired for this purpose by the mutual organisation. This team reports to the General Assembly and board of administrators.

•      Members Responsibility: MUTUAL ORGANISATION activities are driven in a permanent search for members responsibility vis-à-vis their own health and a high level of management quality in order to be able to face its commitments vis-à-vis third parties and beneficiaries. This principles cover the good management principles namely:

1.    Separation of data and activities

2.    Collection of relevant and accurate data

3.    Production of financial statements

4.    Calculation and setting up Contributions and claim reserves

5.    Efficient claims monitoring

6.    Clear investment policy

7.    Right technical insurance expertise

8.    Transparency

•      Autonomy and Freedom: A MUTUAL ORGANISATION is a private structure independent of the public institutions, of the religious institutions or other interest groups. Its management must not be dependant of a third party interference. Its management must be respecting the legalities (Accounts).

•      Production Cycle Inversion: In a commercial insurance company the premium is evaluated a priori and the insurance must face commitments with this premium without re-evaluating it later. In a MUTUAL ORGANISATION, the final contribution (term used instead of premium) is known at the end of the year. Although this possibility opens to call for further contributions although the period of coverage is over, it should not be used thanks to an appropriate use of insurance management techniques.

•      Empanelment and contracting with Health Care Providers:  Such activity born by commercial Third Party Administrators in the commercial insurance sector, is an important aspect of a MUTUAL ORGANISATION as this set of operations consists in the core control of spending the contributions gathered by members. Therefore such contracts contain agreements on the nature, quality and pricing of health services covered as well as the payment modalities (cashless or not…). The empanelment of health care providers for a MUTUAL ORGANISATION is to be validated by a board democratically elected from the general assembly.

These principles should be strictly controlled in order to avoid organisations abusing nouns like Mutuality, Mutual and Mutualism without applying “stricto sensu” the abovementioned principles.

A MUTUAL ORGANISATION has the capacity to receive donations and subsidies to perform its activities.