A STUDY ON AWARNESS AND SATISFACTION OF CHIEF MINISTER HEALTH INSURANCE

PROVIDED BY GOVERNMENT OF TAMILNADU WITH REFERENCE TO RURAL ANDURBAN

AREAS IN SULUR TALUK .
CHAPTER-I

INTRODUCTION

The Chief minister’s Health Insurance Scheme is a comprehensive healthcare initiative introduced by
various state governments to provide affordable and accessible medical coverage to Tamil Nadu public. Under
this scheme, individuals can avail themselves of a range of healthcare services, including hospitalization,
outpatient care, and essential medical treatments. Aimed at improving overall health outcomes, the CM Health
Insurance Scheme plays a crucial role in ensuring that citizens have financial protection against medical
expenses, promoting a healthier and more secure society.

Amidst the difficulties of accessing advanced healthcare and enduring long waitlists for critical
surgeries, the Chief Minister’s Comprehensive Health Insurance Scheme (CMCHIS) shines as a ray of hope
for the underprivileged families in Tamil Nadu. This revolutionary program serves as a bridge between
affordable healthcare and those who are most in need of it. With CMCHIS, families with a modest yearly
income receive a comprehensive health insurance coverage, which relieves them from financial constraints
while ensuring that their medical requirements are met with no delay.

Introduced by the Government of Tamil Nadu in 2012, the Chief Minister’s Comprehensive Health
Insurance Scheme (CMCHISTN) stands as a groundbreaking initiative. Its primary objective is to make
healthcare services easily accessible and of excellent quality for economically disadvantaged individuals. By
addressing existing financial barriers, CMCHISTN ensures that beneficiaries have access to a wide range of
medical treatments and procedures. This article serves as a comprehensive guide, providing all the necessary
information about CMCHISTN. It can be regarded as a one-stop resource for understanding the intricacies of
this noble scheme.

The Chief Minister's Comprehensive Health Insurance Scheme (CMCHISTN) was launched by the
Government of Tamil Nadu on 23rd October 2012. This ambitious scheme was implemented with the
objective of providing financial protection and comprehensive healthcare coverage to the underprivileged
sections of society.
SCOPE OF THE STUDY
The scope of the study on the awareness and satisfaction of CM health insurance scheme encompasses
examining the extent to which individuals are informed about the scheme's benefits, eligibility criteria, and
enrollment process. Additionally, it involves assessing participants' satisfaction levels regarding the scheme's
coverage, accessibility, and quality of services provided. The study aims to explore potential factors
influencing awareness and satisfaction, such as demographic characteristics, prior healthcare experiences, and
communication channels utilized for dissemination. Through qualitative and quantitative methodologies, it
seeks to provide insights to policymakers for enhancing the scheme's effectiveness and addressing any gaps
in awareness and satisfaction among beneficiaries. To provide cashless hospitalization facility for certain
specified ailments/ procedures. To alleviating financial burdens for enrolled families and progressing towards
universal health coverage by establishing effective connections with the public health system.

STATEMENT OF PROBLEM

The "Chief Minister Health Insurance Scheme " (CM Health Insurance) represents a pivotal initiative
inthe domain of public health, aiming to provide comprehensive healthcare coverage. As researchers dedicated
to understanding and improving healthcare policies, our focus on the CM Health Insurance Scheme prompts
an exploration of key issues that Barriers to Enrollment and Participation, Equity in Access and Coverage,
Quality of Healthcare Services, Feedback Mechanisms and Continuous Improvement. The Comprehensive
Health Insurance Scheme (CMCHIS) in Tamil Nadu faces challenges such as inadequate coverage for certain
medical procedures, limited access to healthcare in rural areas, and bureaucratic hurdles in claim processing.
Additionally, there may be issues with awareness and enrollment among eligible beneficiaries. The CM Health
Insurance Scheme may encounter challenges such as insufficient coverage for specialized treatments,
disparities in access to healthcare facilities across regions, administrative complexities in claims processing,
and potential issues related to the identification and enrollment of eligible beneficiaries.

The "Chief Minister Health Insurance Scheme " (CM Health Insurance) represents a pivotal initiative
in the domain of public health, aiming to provide comprehensive healthcare coverage. As researchers
dedicated to understanding and improving healthcare policies, our focus on the CM Health Insurance Scheme
prompts an exploration of key issues that Barriers to Enrollment and Participation, Equity in Access and
Coverage, Quality of Healthcare Services, Feedback Mechanisms and Continuous Improvement.
OBJECTIVES

• To study the Socio-economic factor of sample respondent.

• To assess the level of awareness about the health insurance scheme in rural areas of sulur taluk.

• To identify the customer preference towards the health insurance policies.

• To analyze the customer level of satisfaction towards the service rendered by the health insurance
companies and the settlement of claims.

• To offer suitable Findings & suggestions about the health insurance scheme.
SCOPE OF THE SCHEME

The scope of a study on the CM Health Insurance Scheme could include assessing the effectiveness of
coverage in meeting the healthcare needs of beneficiaries, analyzing the impact of the scheme on healthcare
access and utilization, evaluating the efficiency of administrative processes, identifying barriers to enrollment
and utilization, exploring opportunities for improvement, and comparing the scheme with similar initiatives
in other regions or countries. to provide cashless hospitalization facility for certain specified ailments/
procedures. To alleviating financial burdens for enrolled families and progressing towards universal health
coverage by establishingeffective connections with the public health system.

RESEARCH METHODOLOGY
The current study is descriptive in nature and is based on primary and secondary data obtained from a variety
of sources, including books, journals, papers, and pertinent websites. The researcher uses a questionnaire that
was written for this study, and there was also an oral encounter. In this study, the researcher employed the
convenience sampling method. The acquired data was categorized and coded before being transferred to
master sheets. The data was tabulated, analyses, and interpreted once it hadbeen coded.

RESEARCH DESIGN

A logical, methodical plan created for guiding a research project is known as a research design. The researcher
chose the descriptive design for the study from among several available designs. Studies in which the goal is
to describe something are known as descriptive research studies. qualities of a specific person or group.
Utilizing Descriptive Design, In sulur taluk Coimbatore CM Health Insurance Scheme. the researcher has
planned to analyses beneficiary satisfaction. The study has been conducted in sulur taluk.

SOURCES OF THE DATA

The validity of any research is based on the data collected for the study. The present research is based on
primary data as well as secondary data.

1. PRIMARY DATA Primary data are original data collected for the purpose of a particular study. In the
present study primary data have been collected by personal interview method with the help of questionnaire.
2. SECONDARY DATA The secondary sources consist of existing available materials and already compiled
statistical statements. Secondary data for the present research collected the major sources from. Newspaper &
Articles, Business line, Various websites, Different marketing journal.
SAMPLE SIZE
The study's sample size was 185 beneficiaries of the CM Health Insurance Scheme.

SAMPLE TECHNIQUE
The process of selecting a group of persons from a statistical population in order to estimate the demographics
of the whole population is referred to as sampling in survey technique. The data collection analyzes used for
the current scenario was convenient sampling.

TOOLS FOR ANALYSIS

1. Ranking.
2. Weighted average method.
3. Simple percentage.

LIMITATIONS
1.The study is restricted to 185 respondents beneficiaries only.
2.The results of the research depend only on the data extracted from respondents.
3.The study is restricted in sulur taluk
CHAPTER SCHEME
CHAPTER – I
The first chapter deals with Introduction of study.
CHAPTER – II
The second chapter deals with Review of literature.
CHAPTER – III
The third chapter deals with introduction to CM Health insurance.
CHAPTER – IV
The fourth chapter deals with Analysis and Interpretation of Statistical data
CHAPTER – V
The fifth chapter deals with Finding, Suggestions and Conclusion.
 CHAPTER II

REVIEW OF LITERATURE

The effectiveness of the study is greatly influenced by the literature review. It helps the researcher in
getting a better understanding of the chosen issue. It also offers guidance for structuring the current
investigation. This chapter serves as a record of the analysis of prior research in the area of it workers. Here
is a presentation of the reviewed studies.
This review article includes a review of the relevant theses, reports from organizations, and
numerous research studies. In order to comprehend the job happiness of academicians and industrial personnel
from prior studies all around the world, the author had studied almost 16 research publications, research
papers, theses, or organizational reports. According to the study, employee job satisfaction and contentment
are key factors in organizational development, staff productivity, employee commitment, and a host of other
factors. It has been noted that a substantial amount of research has been done on the topic of job satisfaction,
including different types of concerns in numerous of its dimensions.
A literature review reviews and evaluates information that has been published in a certain field
of study. Sometimes the data is limited to a specific time frame. A literature review has an organizational
structure that includes summary and synthesis; it goes beyond simply summarizing the sources. A synthesis
is a reorganization or reshuffle of the material in a summary, which is a recap of the key points from the
source. It could provide a fresh interpretation of dated information or blend fresh and outdated perspectives.
Or it could outline the field's intellectual history, including significant arguments. The literature review may
also assess the sources and advise the reader on which are the most topical or relevant, depending on the
circumstances.

Thilakraj G(2024) Impact of Health Insurance Literacy and Satisfaction on Enrolment with Health Insurance.
This literature review aims to explore the Impact of Health Insurance Literacy and Satisfaction on Enrolment
with Health Insurance The study analyzes and synthesizes existing research articles, studies, and reports to
understand the Impact of Health Insurance Literacy and Satisfaction on Enrolment with Health Insurance. The
current research is based on a positivist research paradigm and a deductive research approach is to be used to
examine the facts and figures. The descriptive research design will be used because it helps in furnishing a
detailed data collection procedure and plan. The study examining the Impact of Health Insurance Literacy and
Satisfaction on Enrolment with Health Insurance offers valuable insights that can be of practical significance
to multiple stakeholders and enhance the growth and effectiveness of the Insurance industry.
Bigi Thomas, Dharmesh P. Raykundaliya, Sonal Bhatt, Ketal Vadhel (2023) Study of awareness,
enrolment, and utilization of Ayushman Bharat Pradhan Mantri Jan Arogya Yojana in Gujarat, India.
Ayushman Bharat-Pradhanmantri Jan Arogya Yojana (AB-PMJAY) envisages complete financial protection
for around 50 crores of identified poor and vulnerable Indian beneficiaries against their catastrophic healthcare
needs. Awareness is a pre-requisite that ensures enrolment and utilization of any health insurance program.
Beinga newly implemented scheme, very few studies are reported on the level of awareness, enrolment, and
utilization ofthe AB-PMJAY scheme as well as the sources of information and support to the beneficiaries
from Gujarat. So, thisstudy aims to assess the current status of awareness, enrolment, and utilization of AB-
PMJAY in Gujarat.Conclusions:The reported utilization rate in this study was only 43.3%, despite having
impressive awareness and enrolment rates. The OOP costs must be reduced, and the issues that prevented
households from using the AB-PMJAY benefits despite their need must be addressed
Byambajav, B. (2022). Awareness and Willingness to Pay for Private Health Insurance: The study will have
the variables which include independent variables, (Age, Gender, Marital status, Living year, Occupation,
Income, Self-rated health, Medical expenditure ), and dependent variables (Awareness and (Willingness to
pay). This study will use the valid questionnaire adopted from two similar published studies, one conducted
in Vietnam and another one conducted in India, Darjeeling district. Results: Knowledge and awareness about
PHI is very low among Mongolians living and the results suggest that educating Mongolians living is essential
for increasing enrollment. Information and communication strategies should be developed to increase
awareness and knowledge about PHI to enrol on PHI. One of the key factors that influence whether or not to
join private health insurance is monthly income.
Chitra, D. K. V., Ramya, D. V., & Gajenderan, V. (2021). A Study on Customer Awareness Level and
Satisfaction of Health Insurance Policies in Chennai City. The study focused on assessing the customer
awareness level and Satisfaction of Health Insurance Policies in Chennai city. It is observed from the study;
that the customers felt that the health insurance policies are essential and also provide the financial protection
of medical expenses. The study's outcome also exhibits that the customers are well aware of the, i.e.,
hospitalization expenses, daycare procedures, domiciliary expenses, and ambulance charges.
Ganguly, S., Singh, P. K., Bhakat, N., & Bhattacharyya, S. (2021). Consumer Perception Towards Health
Insurance During Pandemic and Post-Pandemic Era in India. Total enrollments have steadily increased from
36,153 (2008–2009) to 96,716 (2018–2019). Madhya Pradesh state accounted for more than two-thirds of total
enrollments in the year 2018–2019, and enrollments from many other states and union territories are less than
100.
Garge, D., Tare, S., & Das, S. (2020). A study on consumer's understanding of health insurance benefits.
The study revealed that ninety-seven per cent are aware of health insurance and also have a policy. About
47.1% have all the family members covered under the health insurance, whereas 8.5% said that only the head
of the family is covered. About 79.4% of the consumers were satisfied with the service provided by their
health insurance provider. In the private sector, Apollo Munich and ICICI Lombard are among the ones that
were preferred by the people. Sources of awareness of health insurance include employers, the Internet,
newspapers, friends, and television.
Islam, N. (2019). Challenges for increasing insurance awareness among the people of Bangladesh. In Training
Workshop on Raising Awareness Regarding Insurance, The insurance industry in Bangladesh has very high potential
due to the increase in GDP, per capita income and population. Most of the insurance companies provide more or less
the same services. For this reason, the competition is increasing between the companies. Unethical practices are also
increasing due to severe competition.
Nair (2019) has made a comparative study of the satisfaction level of health insurance claimants of public and
private sector general insurance companies. It was revealed that majority of the respondents had claim of
reimbursement nature through third party administrator. Satisfaction with respect to settlement of claim was
found relatively higher for public sector than private
Gambhir et al. (2019) studied out-patient coverage of private sector insurance in India. It was revealed that
the share of the private health insurance companies has increased considerably, despite of the fact that health
insurance is not a good deal.
Chauhan (2019) examined medical underwriting and rating modalities in health insurance sector. It was
revealed that while underwriting a health policy one has to keep in mind the various aspects of insured
including lifestyle, occupation, health condition and habits. There have been substantial studies on health
insurance done in India and abroad. But there has not been any work on performance of health insurance sector
based on underwriting profit or loss.
Satakshi Chatterjee, Dr.Arunangshu Giri, Dr.S.N.Bandyopadhyay (2018), Health insurance sector in
India: A study. The study is descriptive and describes various health insurance products offered in India. It
attempts to analyze the insurance models of healthcare of selected other countries as well. Non amalgamation
between public and private companies is identified as a major hindrance in development of the health
insurance sector in the country. Health insurance is regarded as an unsaturated market in India and the middle
income group i.e. the targeted population of this industry will definitely create a boom in health insurance in
years to come. It is estimated that overall insurance sector will value around USD 280 billion by the end of
2020. The health insurance sector is required to be made universal irrespective of the income level and
background of individual and a family.
Chatterjee et al. (2018) have studied health insurance sector in India. The premise of this paper was to study
the current situation of the health-care insurance industry in India. It was observed that India is focusing more
on short-term care of its citizens and must move from short-term to long-term care.
Jacob, A. (2018). A study on customer perception towards health insurance. The research found that most of
the questionnaire respondents are graduates. The major source of awareness is friends /relatives/colleagues
with 176 points. All the respondents are aware of coverage, claim procedure, withdrawal procedure, and
consequence of non-payment but not about tax benefits. The major reason for choosing a particular health
insurance company is the easy accessibility of linked hospitals. It is concluded from the study that the most
important factor considered by the respondents before taking health insurance is to cover risk with 187 points
36% of respondents are satisfied.
Ghaddar, S., Byun, J., & Krishnaswami, J. (2018). Health insurance literacy and awareness of the
Affordable Care Act in a vulnerable Hispanic population. The study revealed that Almost 70% of participants
knew nothing/very little about the ACA. Multivariate analyses revealed that no/very little ACA knowledge
was associated with low levels of confidence in “choosing health insurance plans” (OR:0.55; 95%CI:0.40-
0.75) (full sample) and “comparing plans”
Prinja S, Chauhan AS, Karan A, Kaur G, Kumar R (2017) Impact of Publicly Financed Health Insurance
Schemes on Healthcare Utilization and Financial Risk Protection in India. The study revealed that the health
system in India has had a maternal and child health (MCH)) centric approach, both in financing and delivery
of health services. Low public spending on health care shifted the burden of seeking care on households by
paying out-of-pocket expenditures. This led to either a barrier in accessing health services, or catastrophic
outcomes for those who sought care. Further, the low capacity of the public health system has resulted in the
rapid development of private healthcare delivery systems, as well as a push towards various demand-side
financing mechanisms.
Shah (2017) analyse health insurance sector post liberalization in India. It was found that significant
relationship exists between premiums collected and claims paid and demographic variables impacted policy
holding status of the respondents.
Binny and Gupta (2017) examined opportunities and challenges of health insurance in India. These
opportunities are facilitating market players to expand their business and competitiveness in the market. But
there are some structural problems faced by the companies such as high claim ratio and changing need of the
customers which entails companies to innovate products for the satisfaction of the customers.
Suresha, K., & Srinivas, V. (2017). Effectiveness of Health Insurance Empirical Study in Mysore City. The
present study tested positively the hypotheses in the income and positive perceptions: Education and positive
assessment and overall effectiveness of health insurance policies in Mysore. Health insurance is becoming
popular with the notable inclination on the part of knowledge society towards a wellness society.
Yadav and Sudhakar (2017) studied personal factors influencing purchase decision of health insurance
policies in India. It was found that factors such as awareness, tax benefit, financial security and risk coverage
has significant influence on purchase decision of health insurance policy holders.
Thomas (2017) examined health insurance in India from the perspective of consumer insights. It was found
that consumers consider various aspects before choosing a health insurer like presence of a good hospital
network, policy coverage and firm with wide product choice and responsive employees.
K, Indumathi & Saba Ishaq, Hajira & Gopi, Arun & Subramanian, Mangala. (2016). Awareness of
health insurance in a rural population of Bangalore, The study revealed that awareness of health insurance was
associated with socioeconomic status and education. The study revealed that just 18.5% are being covered by
some form of health insurance and a large portion of the population is still financing health care expenditures
out of pocket. Various socio-economic variables like marital status, education, income level, occupation etc
drive people of Darjeeling to decide to take health insurance.
Meeta Rajivlochan (2015) in her article humanizing health care services at educed prices focused on: thekey
to improving the quality of healthcare services in India and reducing costs at the same time can be found by
enacting legislation which lays down minimum standards of patient care. In the absence of such standards and
the reluctance of health insurance companies to standardize either price or quality, health care services
continue to be expensive and of doubtful quality. Developing standards of patient care by legislative mandate
and a change in the attitude of health insurers can change the equation in the favour ofa patient who is now at
the mercy of the hospital. Further, similar studies (Gopinath, 2019) were discussed on Customer Perception
and socio demographic dimensions.
Shahi, A. K., & Singh, H. (2015). Comparative performance of health insurance business of public and
private general insurance companies in India. Management Review The study revealed that the comparative
performance of the health insurance business of 4 public, 8 private general insurance companies and 2
standalone health insurance companies has been examined using the Claim Ratio and Net Retention Ratio.
These ratios have been analysed and interpreted by calculating the mean, median, standard deviation and
coefficient of variation. It has been found that the mean of the claim ratio was - 2.82 (p>0.05) and the mean
of the net retention ratio was -1.98 (p>0.05) which showed a significant difference between the claim ratio
and net retention ratio of health insurance business.
Chennappa (2015) in his article - Health insurance in India was introduced in 1986 in the form of Mediclaim
policy by the Public Sector General Insurance Companies. Post liberalization, 4 Public, 22 Private and 4
Standalone insurance companies have entered this sector to provide superior health care at affordable rates.
As a result, the number of people covered (penetration) has developed from 0.69 million in 2001-02 to 2.048
million in 2013-14, which amounts to only 0.16 percent of the total population.
Priya, A., & Srinivasan, R. (2015). A study on customer awareness towards health insurance with special
reference to Coimbatore city. The study revealed that the public must be educated through intensive
campaigns, similar to Life and general insurance. Though some corporations and Governments have taken up
the initiative to provide health insurance to employees, in Tamil Nadu government has brought up low-
premium health insurance for the benefit of the poor as a welcome measure. Clarity of the disease covered by
the policy, when and how a claim has to be submitted with the insurance company, procedures and documents
to be submitted in case of critical and other hospitalization with the insurance company, etc.
URBAN, I. S. W. I. (2015). EXTENDING HEALTH INSURANCE TO INFORMAL sector workers in urban
settings: findings from a micro-insurance pilot in Lagos, Nigeria. Results from the baseline survey detailed in
this report indicated that while female MFB clients represented just over half of the study sample, they were
disproportionately more likely to report a need for health services and recalled significantly higher health
expenditures than male clients. The survey confirmed that the MFB’s clients needed improved financial
protection. Nearly all clients who reported health events financed their healthcare via out-of-pocket spending
before insurance enrollment; all respondents were using personal savings and most were relying on support
from family and neighbours to finance needed health services.
Savita (2014) studied the reason for the decline of membership of micro health insurance in Karnataka. Major
reason for this decline was lack of money, lack of clarity on the scheme and intra house-hold factors. However
designing the scheme according to the need of the customer is the main challenge of the micro insurance
sector.
Sarika Malhotra (2014) in her article focused on why health care has become a preferred sector for private
equity firms. Health care is talented as a blue – eyed sector for investors, partly because of some big-ticket
exits newly. The healthcare sector has previously clocked 16 PE investments in the first quarter of 2014. The
few challenges, however, are unlikely to deter investors attracted by the recession-proof character of the
industry sector.
Aubu (2014) conducted a comparative study on public and private companies towards marketing of health
insurance policies. Study revealed that private sector services evoked better response than that of public sector
because of new strategies and technologies adopted by them.
Dror (2014) studied about willingness among rural and poor persons in India to pay for their health insurance.
Study revealed that insured persons were more willing to pay for their insurance than the uninsured persons.
Dr. Y. Nagaraju (2014) A Study on Performance of Health Insurance Schemes in India. Health insurance is
an insurance coverage purchased in advance by an individual or a group after paying a fee called ̳premium‘.
It is a complimentary financing mechanism for enhancing access to quality health. Health insurance is one of
the products offered by the general insurance companies as well as by life insurance companies in India.
Health indicators of a nation are assessed through parameters like infant mortality, maternal mortality
rate, life expectancy, birth and death rate. India recorded notable achievement in all the parameters since
independence. The Eleventh Plan observed that the cost of health care services in the country was higher in
the private sector in comparison with the public sector. A study group appointed by the Ministry of Health
and Family Welfare suggested to explore arisk pooling system with a view to reduce the burden of the poor.

Dr. N. Sivakumar (2013) : observed that for a sustained growth of the health insurance industry, the vision
of the insurers matters a great deal, although technology would be there to support this vision, in times of
need. To sustain visionary growth, the sector must realize that they are trustees of huge amounts of public
moneycollected in the form of premiums and hence insurance professionals must develop high level of ethics
and integrity. Also, firms must have social conscientiousness in all its strategies and action plans.
R.Venugopal (2013) was of the opinion that although the portability associated with Health insurance may not be the
panacea for all ills, it is bound to be a game-changer in the days to come. Till now the customer was reluctant to change
the Health insurer even though he/she was not satisfied with the services of the insurer in view of the fear that the
customer would lose all the present benefits of the health plan like waiting period cover to the pre-existing diseases like
Diabetes, Heart ailment etc., and the ‗No Claim Bonus‘. But the portability clause approved by IRDA recognizes these
issues, according to the researcher.

Dr. N. Sivakumar (2013) observed that for a sustained growth of the health insurance industry, the vision of the insurers
matters a great deal, although technology would be there to support this vision, in times of need. To sustain visionary
growth, the sector must realize that they are trustees of huge amounts of public money collected in the form of premiums
and hence insurance professionals must develop high level of ethics and integrity. Also, firms must have social
conscientiousness in all its strategies and action plans.
Kumar (2013) examined the role of insurance in financing health care in India. It was found that insurance
can be an important means of mobilizing resources, providing risk protection and health insurance facilities.
But for this to happen, it will require systemic reforms of this sector from the end of the Government of India.
 CHAPTER-III
OVERVIEW OF THE STUDY
The Chief Minister Comprehensive Health Insurance Scheme, formerly known as Kalaingar Kaappittu
Thittam, was launched on 23rd July 2009, with the objective of providing quality healthcare to eligible
individuals through empaneled government and private hospitals, thereby reducing financial hardship for
enrolled families and moving towards universal health coverage by effectively linking with the public health
system. From January 2022 to 2027, the scheme is being implemented through United India Insurance
Company. As of January 2022, the scheme covers around 1.37 crore families. A total of 1090 procedures, 8
follow-up procedures, and 52 diagnostic procedures are covered under CMCHIS in 800 government and 900
private empaneled hospitals.
The scheme aims to provide cashless hospitalization for specific ailments/procedures and provides
coverage up to Rs. 5,00,000/- per family, per year on a floater basis for the ailments and procedures covered
under the scheme. The CMCHIS is a significant step towards ensuring that vulnerable sections of society
receive adequate healthcare without suffering financial distress, while simultaneously promoting access to
quality medical care.

WHO WILL BE BENEFICIARIES UNDER THIS SCHEME

The eligibility for participation in the Chief Minister's Comprehensive Health Insurance Scheme is
determined by the inclusion of the individual's name in the family card and a family annual income below Rs.
1.2 lakh for residents of Tamil Nadu.
The scheme provides up to Rs 5 lakh insurance coverage through a network of private and public
hospitals. It provides cashless services aimed at ensuring universal health coverage in the state. United India
Insurance has partnered with the state's private and public hospitals for the service.

WHAT CHARACTERISTICS DOES CM HEALTH INSURANCE HOLD

You can avail cashless treatment at a wide range of empaneled network hospitals by showing the
Amma Kapitu Thittam Card issued to you at the time of enrollment. Since the CMCHIS claim process
is ideally cashless, you do not have to pay anything at the hospital from your pocket.
CMCHIS provides high coverage of 5 lakh rupees to each family for every policy year. This amount
of sum insured seems sufficient to avail most of the minor health treatments.
CM HEALTH INSURANCE SCHEME ENROMENT
Approach your village administration authorities for an income certificate (annual family income must
be less than ₹72,000). Along with the income certificate, submit the ration card, identity and address proof,
and self-declaration to the enrolment center.

ACHIEVEMENTS OF CM HEALTH INSURANCE SCHEME

Chief Minister Comprehensive Health Insurance Scheme launched on 23.07. 2009 as kalaingar Kapittu
Thittam.
Offered through United India Insurance Company Ltd, this scheme safeguards 1.37 Crore families as
of January 2022. Also known as Amma Health Insurance, it covers 1090 procedures, 8 follow-up procedures
and 52 diagnostic procedures.
WHO IS ELIGIBLE FOR CM HEALTH INSURANCE SCHEME
The family must be a resident of Tamil Nadu and should have an annual income of less than
₹72,000. The family member should have a ration card or be mentioned in the ration card of the family.
Migrants of other states, if they carry a migration certificate, are eligible.
The minimum age to get health insurance for your child is 15 days, going all the way up to 18 years.
For adults, the entry age is 18 years, and the maximum limit is 65 years.
NEEDS COVER IN CM HEALTH INSURANCE SCHEME
Under the scheme, the sum assured for each family would be Rs.1 lakh every year for a total period of
four years and for a total value of Rs. 4 lakh. In the case of certain procedures, the ceiling would be raised to
Rs.1.5 lakh per annum. No fewer than 250 hospitals would be empaneled under the scheme. At least six
hospitals in each district would be covered. There would be more hospitals in cities such as Chennai,
Coimbatore and Madurai.
The scheme would cover 1,016 procedures, 113 follow up procedures and 23 diagnostic procedures.
The cost of tests required for treatment would also be part of the insurance cover.
CM HEALTH INSURANCE SCHEME OVERVIEW AND OBJECTIVE
The Chief Minister’s Comprehensive Health Insurance Scheme (CMCHISTN) was launched by the
Government of Tamil Nadu on 23rd October 2012. This ambitious scheme was implemented with the
objective of providing financial protection and comprehensive healthcare coverage to the underprivileged
sections of society. CMCHISTN was designed to ensure that individuals or families could access necessary
medical treatment without facing financial barriers or denials.
Primary Universal Health Coverage: The scheme aims to ensure that every eligible family in Tamil Nadu
has access to quality healthcare services without financial constraints. By providing cashless treatment, it
enables beneficiaries to seek necessary medical care without worrying about the expenses. Financial
Protection: CMCHISTN seeks to protect vulnerable families from the burden of catastrophic health expenses.
It provides financial coverage for various medical procedures, hospitalization, surgeries, diagnostics, and
follow-up treatments, among others.
Improved Healthcare Infrastructure: The scheme aims to strengthen healthcare infrastructure and service
delivery in both government and private hospitals. By empaneling hospitals and healthcare providers,
CMCHISTN contributes to the development of a robust healthcare system in Tamil Nadu. Health Awareness
and Prevention: CMCHISTN also focuses on promoting health awareness and preventive measures among
the beneficiaries. It aims to create a healthier society by encouraging regular health check-ups, disease
prevention, and health education.
BENIFITS OF CM HEALTH INSURANCE SCHEME

The Chief Minister’s Comprehensive Health Insurance Scheme (CMCHIS) offers a multitude of
benefits to its eligible beneficiaries. These benefits encompass a wide range of medical expenses and
provide financial security during times of healthcare need. Let’s explore the benefits of the scheme in detail,
including those mentioned and additional benefits:

Hospitalization Coverage:
CMCHIS provides coverage for expenses related to hospitalization, ensuring that beneficiaries can
receive necessary medical care without financial burden. This includes costs associated with room charges,
surgical procedures, medicines, and other hospital services.
Diagnostic Procedures:
The scheme covers the expenses of diagnostic procedures, enabling beneficiaries to undergo
necessary tests and investigations to diagnose and monitor their medical condition. This ensures timely and
accurate medical intervention.
Follow-up Treatments:
CMCHIS extends its coverage to follow-up treatments, ensuring that beneficiaries receive continued
medical care even after hospitalization. This includes consultations, medications, and other essential
treatments required for the recovery process
Financial Assistance:
Beneficiaries who have made adequate CMCHISTN claims are assured an amount of Rs. 1 lakh per
year for a duration of four years. This financial support provides significant relief to families facing the
financial burden of medical expenses.
Scheme Card:
Eligible beneficiaries receive a CMCHIS scheme card, which serves as proof of their enrollment
and entitlement to the scheme’s benefits. This card allows easy identification and access to cashless
treatments at empaneled hospitals.
Extended Coverage:
The scheme provides coverage of up to Rs. 4 lakh over the four-year duration for eligible
beneficiaries. In cases where certain medical procedures cost more, the ceiling limit may be raised to
0.5 lakhs per annum, ensuring that individuals have sufficient financial coverage for their healthcare needs.
Extensive Hospital Network:
CMCHIS has established tie-ups with a wide network of hospitals, including those in cities, to
provide quality healthcare services to beneficiaries.
Coverage of Tests:
The insurance provided under CMCHIS also covers the cost of tests required for treatment, even
before the actual treatment commences. This provision is particularly beneficial for patients who are
undergoing diagnostic tests to determine their medical condition, ensuring that they can receive accurate
diagnoses and appropriate medical care. By exploring CMCHIS-TN online, individuals can delve deeper
into the scheme’s coverage, specific procedures, and hospital network, gaining a comprehensive
understanding of the benefits and opportunities it provides for healthcare assistance.

The Chief Minister’s Comprehensive Health Insurance Scheme continues to be a lifeline for
underprivileged families, offering financial protection, improved healthcare access, and peace of mind
during times of medical emergencies.
DOCUMENTS RERUIRED
To apply for CMCHISTN, applicants need to submit the following documents:
1. Identity Proof: Aadhaar card, Voter ID, or any other government-issued identity document.
2. Address Proof: Recent utility bills, ration card, or any other valid address proof.
3. Income Certificate: A document verifying the annual income of the applicant and family members.
4. Photographs: Recent passport-sized photographs of the applicant and family members.
5. BPL Card or AAY Card: If applicable, provide a copy of the Below Poverty Line (BPL).

PROFILE OF THE SCHEME

Name of the Scheme: Chief Minister Health Insurance Scheme (CM Health Insurance)
Initiating Authority: Government of the respective state.
Geographic Coverage: Specify the regions, districts, or states where the CM Health Insurance Scheme is
implemented.
Healthcare Services Covered: Detail the range of medical services, treatments, and procedures covered
under thescheme.
Enrollment Process: Describe the procedures involved in enrolling beneficiaries into the health insurance
scheme.Eligibility Criteria: Outline the criteria individuals must meet to qualify for coverage, considering
factors like income, residency, or pre-existing health conditions.
Funding Source: Specify the sources of funding for the CM Health Insurance Scheme, including
government allocations, contributions, or any partnership arrangements.
 CHAPTER-IV
DATA ANALYSIS AND INTERPRETATION
ANALYSIS & INTERPRETATION
The term “analysis and interpretation” describes a methodical and critical analysis of the financial
statements. In addition to establishing a causal chain between the various financial statement components,
it also accurately portrays the financial data. The process of giving meaning to the information gathered, as
well as determining the conclusions, importance, and consequences of the findings, is known as data
analysis and interpretation.
The method through which the data obtained during qualitative research is given context, and by
which the information that has emerged is applied to the issues faced by employees individual planning.
Procedures of reviewing and immersing themselves in the data as well as through complicated actions of
structuring, re-framing, or other investigating it.
Data analysis is the process of cleaning, transforming, and modelling the data to find relevant
information for business decision-making. The goal of data analysis is to draw out relevant information
from the gathered data and make judgments based on the analysis. Once the data has been gathered,
purified, and processed, it should be analyses using the proper statistical methods. The data must then be
simply explained in words or in tables and charts after being thoroughly examined. Percentage analysis has
been used to analyses the basic data that was gathered. It entails using the outcomes of data analysis to draw
conclusions from relations research. It is clear that data interpretation is crucial, and as such, it must be
done correctly. In order to facilitate this process, research has found certain data interpretation techniques.
Simple Percentage Analysis
Simple percentage analysis is carried out for most of all the questions gives in questionnaire. This analysis
describes the classification of the respondents falling in each category. Through the use of percentages, the
data are reduced in the standard form with base equal to 120 respondents, which fact facilities relative
comparisons
FORMULA:
Percentage analysis = No. of respondents
------------------------------ *100
Total No. of respondent.

It is one of the simple forms of analysis which is very easy for everyone to understand the outcome of the
research. It is normally used by commercial research Organization.
Ranking Analysis
Based on the data given by the respondents the average rank is calculated and the first rank is given for the
highest mean score and the least rank is given to the lowest mean score. Thus “Higher the mean score,
higher is the priority”. The results are presented in the table with appropriate interpretation.
 THE TABLE SHOWING THE AGE OF THE RESPONDENTS
TABLE - 4.1.1
AGE GROUP RESPONDENT PERCENTAGE
18-30 112 60.5
31-40 37 20.0
41-50 27 14.6
Above 60 9 4.9
Total 185 100.0
(Source: Primary Data)

INTERPRETATION: From the above table 60.5% of the respondents are in between the age 18-
30 and 20.0% of the respondents are 31-40 and 14.6% of the respondents are 41-50 and 4.9% are
above 50 ages.

INFERENCE: Majority 60.5% of the responses are between age 18-30.

THE CHART SHOWING THE AGE OF THE RESPONDENTS
TABLE - 4.1.1

AGE GROUP
18-30 31-40 41-50 Above 60

5%
15%

20%
60%
 THE TABLE SHOWING THE GENDER OF THE RESPONDENTS
TABLE - 4.1.2

GENDER RESPONDENT PERCENTAGE

Male 85 45.95
Female 100 54.05
Total 185 100.00
(Source: Primary Data)

INTERPRETATION: From the above table 45.95% of the respondents are male and the 54.05%
of the respondents are female.

INFERENCE: Majority 54.05% of the responses are female.

 THE CHART SHOWING THE GENDER OF THE RESPONDENTS
CHART - 4.1.2

GENDER
56.00

54.00

52.00

50.00

48.00

46.00

44.00

42.00

40.00
Percentage

male female
THE TABLE SHOWING THE AREA OF RESIDENCE OF THE RESPONDENTS
TABLE - 4.1.3

AREA OF RESIDENCE RESPONDENT PERCENTAGE

Rural 164 88.65
Semi rural 1 0.54
Urban 8 4.32
Semi urban 12 6.49
Total 185 100.00
(Source: Primary Data)

INTERPRETATION: From the above table 88.65% of the respondents are from rural and 0.54%
of the respondents are from semirural 4.32% of the respondents are from urban and 6.49% of
the respondents are from semi urban.

INFERENCE: Majority 88.65% of the responses are from rural.

THE CHART SHOWING THE AREA OF RESIDENCE OF THE RESPONDENTS

CHART - 4.1.3

AREAOF RESIDENCE

100.00 88.65

50.00
0.54
0.00 4.32
6.49
rural Percentage
semi rural
urban
semi urban

Percentage
THE TABLE SHOWING THE EDUCATION QUALIFICATION OF THE RESPONDENTS
TABLE - 4.1.4

EDUCATIONAL QUALIFICATION RESPONDENT PERCENTAGE

Degree 71 38.38
Post Graduate 64 34.59
School 29 15.68
Professional 18 9.73
College 1 0.54
Under Graduate 2 1.08
Total 185 100.00
(Source: Primary Data)

INTERPRETATION: From the above table 38.38% of the respondents are degree and the 34.59%
of the respondents are post graduate and 15.68% of the respondents are school and 9.73% of the
respondents are professional and 0.54% of the respondents are college and 1.08% of the respondents
are under graduate.

INFERENCE: Mostly 38.38% of the responses are degree.

THE CHART SHOWING THE EDUCATION QUALIFICATION OF THE RESPONDENTS
CHART - 4.1.4

EDUCATIONAL QUALIFICATION
0.54 1.08

9.73

15.68 38.38

34.59

Degree Post Graduate School Professional College Under Graduate

 THE TABLE SHOWING THE EMPLOYMENT OF THE RESPONDENTS
TABLE - 4.1.5
EMPLOYMENT RESPONDENT PERCENTAGE
Agriculture 22 11.89
Self Employed/Business 37 20.00
Practicing Professional 42 22.70
Private Organization Service 52 28.11
Government service 24 12.97
Other 8 4.32
Total 185 100.00
(Source: Primary Data)

INTERPRETATION: From the above table 28.11% of the respondents are from private
organization service and 22.70% of the respondents are from practicing professional and 20% of
the respondents are from self employed/business and 12.97% of the respondents are from
government service and 11.89% of the respondents are from agriculture.

INFERENCE: Mostly 28.11% of the responses are from private organization service.
 THE CHART SHOWING THE EMPLOYMENT OF THE RESPONDENTS
CHART - 4.1.5

EMPLOYMENT
30.00

25.00

20.00

15.00

10.00

5.00

0.00
 THE TABLE SHOWING THE MARITAL STATUS OF THE RESPONDENTS
TABLE - 4.1.6

MARITAL STATUS RESPONDENT PERCENTAGE

Married 106 57.30

Un married 79 42.70

Total 185 100

(Source: Primary Data)

INTERPRETATION: From the above table 57.30% of the respondents are married and the
42.70% of the respondents are un married.

INFERENCE: Majority 57.30% of the responses are married.

THE CHART SHOWING THE MARITAL STATUS OF THE RESPONDENTS
CHART - 4.1.6

MARITAL STATUS
70.00

60.00

50.00

40.00

30.00

20.00

10.00

0.00
Percentage

Unmarried Married
 THE TABLE SHOWING THE MONTHLY INCOME OF THE FAMILY
TABLE - 4.1.7

MONTHLY INCOME OF THE FAMILY RESPONDENT PERCENTAGE

Less than Rs 5000/- 13 7.03
Rs5001-10000 41 22.16
Rs 10001-21000 58 31.35
Rs 25000-50000 55 29.73
Above Rs 50000 18 9.73
TOTAL 185 100
(Source: Primary Data)

INTERPRETATION: From the above table 31.35% of the respondent salary is between Rs 10001-
21000 and 29.73% of the respondent salary is between Rs 25000-50000 and 22.16% of the
respondent salary is between Rs 5001-10000 and 9.73% of the respondent salary is between Rs
Above Rs 50000 7.03% of the respondent salary is between Rs Above Rs 50000

INFERENCE: Mostly 31.35% of the respondent salary is between Rs 10001-21000.

 THE CHAT SHOWING THE MONTHLY INCOME OF THE FAMILY
CHART - 4.1.7

Monthly Income of the family

35.00

30.00

25.00

20.00

15.00

10.00

5.00

0.00
Less than Rs 5000/- Rs5001-10000 Rs 10001-21000 Rs 25000-50000 Above Rs 50000
 THE TABLE SHOWING NO. OF DEPENDENT OF FAMILY MEMBERS OF THE
RESPONDENTS
TABLE - 4.1.8
NO OF DEPENDENT FAMILY MEMBERS RESPONDENT PERCENTAGE
1 49 26.49
2 89 48.11
>2 47 25.41
TOTAL 185 100
(Source: Primary Data)

INTERPRETATION: From the above table 48.11% of the respondents dependent family members
are 2 and 26.49% of the respondents dependent family members are 1 and 25.41% of the respondents
are above 2.

INFERENCE: Majority 48.11% of the responses are from 2 dependent family members.
THE CHART SHOWING THE NO OF DEPENDENT FAMILY MEMBERS OF THE
RESPONDENTS
TABLE - 4.1.8

No of dependent family members

47 49

89

1 2 >2
 THE TABLE SHOWING THE AVERAGE MONTHLY MEDICAL EXPENSES OF THE
FAMILY

TABLE - 4.1.9
AVERAGE MONTHLY MEDICAL EXPENSE OF THE
FAMILY RESPONDENT PERCENTAGE
UPTO 500 26 14.05
501-1000 77 41.62
1001-2000 64 34.59
ABOVE 2000 18 9.73
TOTAL 185 100
(Source: Primary Data)

INTERPRETATION: From the above table 41.62% of the respondent average medical expenses is 501-1000
and 34.59% of the respondent average medical expenses is 1001-2000 and 14.05% of the respondent average
medical expenses is UPTO-500 and 9.73% of the respondent average medical expenses is Above 2000

INFERENCE: Mostly 41.62% of the v respondent verge medical expenses is 501-1000.

 THE CHART SHOWING THE AVERAGE MONTHLY MEDICAL EXPENSES OF THE
FAMILY

TABLE - 4.1.9

Average monthly medical expense of the family

45.00 41.62

40.00
34.59
35.00

30.00

25.00

20.00
14.05
15.00
9.73
10.00

5.00

0.00
UPTO 500 501-1000 1001-2000 ABOVE 2000

THE TABLE SHOWING THE ABOUT HEALTH INSURANCE POLICY

 TABLE - 4.1.10

DID YOU HEAR ABOUT HEALTH

INSURANCE POLICY? RESPONDENT PERCENTAGE
YES 156 84.32
NO 29 15.68
TOTAL 185 100
(Source: Primary Data)

INTERPRETATION: From the above table 84.32% of the respondents are heard about HI policy
and 15.68% of the respondents are not heard about HI policy.

INFERENCE: Majority 84.32% of the responses are heard about HI policy.

THE CHART SHOWING THE ABOUT HEALTH INSURANCE POLICY
CHART - 4.1.10

Did you heard about health insurance policy?

15.68

84.32

YES NO
 THE TABLE SHOWING THE CHALLENGES OR DIFFICULTIES HAVE YOU FACED, IF
ANY, WHILE USING THIS SCHEME

TABLE - 4.1.11
NAME THE SOURCES WHERE YOU GET THE
INFORMATION ON HEALTH INSURANCE RESPONDENT PERCENTAGE
Newspaper Advertisement 16 8.65
Friends & relatives 35 18.92
Insurance agent 63 34.05
Company Broachers/events 33 17.84
Internet 19 10.27
Hospitals 18 9.73
No where 1 0.54
TOTAL 185 100
(Source: Primary Data)

INTERPRETATION: From the above table 34.05% of the respondent sources where they get the
information on health insurance is Insurance agent and 17.84% of the respondent sources where they get
the information on health insurance is Company Broachers/events and 18.92% of the respondent sources
where they get the information on health insurance is Friends & relatives and 10.27% of the respondent
sources where they get the information on health insurance is Internet and 8.65% of the respondent sources
where they get the information on health insurance is Newspaper Advertisement and 9.73% of the
respondent sources where they get the information on health insurance is Hospitals and 0.54% of the
respondent sources where they get the information on health insurance is No where.

INFERENCE: Mostly 41.62% of the respondent average Medical expenses is 501-1000.

THE CHART SHOWING THE CHALLENGES OR DIFFICULTIES HAVE YOU FACED, IF
ANY, WHILE USING THIS SCHEME

CHART - 4.1.11

Name three sources where you get the information on health

insurance

0.54

9.73 8.65

10.27
18.92

17.84

34.05

Newspaper Advertisement Friends & relatives Insurance agent

Company Brouchers/events Internet Hospitals
No where
 THE TABLE SHOWING THE IMPROVE AWARENESS AND PARTICIPATION IN HEALTH
INSURANCE SCHEMES IN YOUR COMMUNITY

TABLE - 4.1.12

WHAT CAN BE DONE TO IMPROVE AWARENESS AND

PARTICIPATION IN HEALTH INSURANCE SCHEMES
IN YOUR COMMUNITY? RESPONDENT PERCENTAGE
Community Workshop 41 22.16
Local Partnership 58 31.35
Door-to-Door Campaigns 46 24.86
Cultural Sensitivity 28 15.14
Youth Engagement 12 6.49
Total 185 100
(Source: Primary Data)

INTERPRETATION: From the above table 31.35% of the respondents improve awareness and participation
in health insurance schemes in your community is Local Partnership and 24.86% of the respondents improve
awareness and participation in health insurance schemes in your community is Door-to-Door Campaigns and
22.16% of the respondents improve awareness and participation in health insurance schemes in your
community is Community Workshop and 15.14% of the respondents improve awareness and participation in
health insurance schemes in your community is Cultural Sensitivity and 6.49% of the respondents improve
awareness and participation in health insurance schemes in your community is Youth Engagement.

INFERENCE: Mostly 31.35% of the respondents improve awareness and participation in health insurance
schemes in your community is Local Partnership.
THE CHART SHOWING THE IMPROVE AWARENESS AND PARTICIPATION IN HEALTH
INSURANCE SCHEMES IN YOUR COMMUNITY

CHART - 4.1.12

What can be done to improve awareness and participation in

health insurance schemes in your community?

Youth Engagement

Cultural Sensitivity

Door-to-Door Campaigns

Local Partnership

Community Workshop

0.00 5.00 10.00 15.00 20.00 25.00 30.00 35.00

 THE CHART SHOWING THE REASONS HOW LONG HAVE YOU BEEN A
CUSTOMER OF YOUR CURRENT HEALTH INSURANCE COMPANY
Level of awareness about the CM Health Insurance scheme the customer level of satisfaction towards
CM Health Insurance companies and the settlement of claims, where respondents indicate their
satisfaction levels.
FACTORS HIGHLY SATISFIE NEUTRA DISAGRE HIGHLY TOTA RAN
SATISFIE D L E DISAGRE L K
D (4) (3) (2) E
(5) (1)
Knowledge 66(5) 73(4) 35(3) 8(2) 3(1) 894 I
about the 330 292 105 160 3
existence of
the CM
Health
insurance
scheme.
Understandin 18(5) 118(4) 35(3) 8(2) 6(1) 689 II
g of the 90 472 105 16 6
benefits
provided by
the CM
Health
Insurance
scheme.
Awarness of 31(5) 81(4) 52(3) 15(2) 6(1) 631 VI
the enrolment 115 324 156 30 6
process for
the CM
Health
Insurance
scheme.
Familiarity 26(5) 86(4) 43(3) 23(2) 7(1) 656 IV
with specific 130 344 129 46 7
details about
coverage
under the CM
Health
Insurance
scheme.
Aware of the 42(5) 76(4) 37(3) 24(2) 6(1) 679 III
eligibility 210 304 111 48 6
criteria for
enrollment in
these health
insurance
schemes
How do you 28(5) 90(4) 25(3) 24(2) 18(1) 641 V
think 140 360 75 48 18
awareness
and access to
health
insurance
schemes
could be
improved
in rural areas?
(Source: Primary Data)

Interpretation
The above table Knowledge about the existence of the CM Health insurance scheme that which was
given 1st rank , while Understanding of the benefits provided by the CM Health Insurance scheme which
was given 2nd rank .The Aware of the eligibility criteria for enrollment in these health insurance schemes
which was 3rd rank.

Inference
Hence, it is found that Knowledge about the existence of the CM Health insurance scheme is reasons
how long have you been a customer of your current health insurance company.
 THE TABLE SHOWING THE FACTORS INFLUENCED YOUR DECISION TO OPT FOR
THIS HEALTH INSURANCE SCHEME

TABLE - 4.1.14
Factors influenced your decision to opt for this health
insurance scheme Respondent Percentage
Coverage offered 45 24.32
Premium cost 56 30.27
Network of hospitals/health care providers 63 34.05
Ease of Availing benefits 21 11.35
Total 185 100
(Source: Primary Data)

INTERPRETATION: From the above table 34.05% of the Factors influenced your decision to opt is
Network of hospitals/health care providers and 30.27% of the Factors influenced your decision to opt is
Premium Cost and 24.32% of the Factors influenced your decision to opt is Coverage offered Cost and
11.35% of the Factors influenced your decision to opt is Ease of Availing benefits

INFERENCE: Mostly 34.05% of the Factors influenced your decision to opt is Network of hospitals/health
care providers.
THE CHART SHOWING THE FACTORS INFLUENCED YOUR DECISION TO OPT FOR
THIS HEALTH INSURANCE SCHEME

TABLE - 4.1.14

Factors influenced your decision to opt for this health

insurance scheme

40.00

20.00

0.00
THE TABLE SHOWING THE CHALLENGES OR DIFFICULTIES HAVE YOU FACED, IF
ANY, WHILE USING THIS SCHEME

TABLE - 4.1.3

Challenges or difficulties have you faced, if any, while

using this scheme? Respondent Percentage
Difficulty in finding healthcare providers 37 20
Limited coverage for certain medical conditions or
treatments. 69 37.30
Limited accessibility to health care facilities in rural or
remote areas 53 28.65

Challenges in renewing or updating the insurance policy. 26 14.05

Total 185 100
(Source: Primary Data)

INTERPRETATION: From the above table 37.30% of the challenges or difficulties have you faced
is Limited coverage for certain medical conditions or treatments and 28.65% of the challenges or
difficulties have you faced is Limited accessibility to health care facilities in rural or remote areas and
28.65% of the challenges or difficulties have you faced is Difficulty in finding healthcare providers
and 14.05% of the challenges or difficulties have you faced is renewing or updating the insurance
policy.

INFERENCE: Mostly 37.30% of the challenges or difficulties have you faced is Limited coverage for
certain medical conditions or treatments.
THE CHART SHOWING THE CHALLENGES OR DIFFICULTIES HAVE YOU FACED, IF
ANY, WHILE USING THIS SCHEME

CHART-4.1.15

Challenges or difficulties
Series1

40
37.30
35
30 28.65
25
20 20
15 14.05
10
5
0
Difficulty in finding Limited coverage for Limited accessibility to Challenges in renewing
healthcare providers certain healthcarefacilities in or updating
medicalconditions or rural or remote areas theinsurance policy.
treatments.
 THE TABLE SHOWING THE FACTORS WHICH COULD IMPROVE AWARENESS ABOUT
HEALTH INSURANCE SCHEMES IN RURAL AREAS

TABLE - 4.1.16

FACTORS DO YOU THINK COULD IMPROVE

AWARENESS ABOUT HEALTH INSURANCE SCHEMES
IN RURAL AREAS RESPONDENT PERCENTAGE
More government outreach programs and awareness campaigns. 39 21.08

Simplified information and education materials about the schemes. 62 33.51

Involvement of local community leaders and organizations in
spreading awareness. 48 25.95
Better access to healthcare facilities and information centers in
rural areas. 23 12.43

Subsidized or free enrolment options for low-income families. 13 7.03

Total 185 100
(Source: Primary Data)

INTERPRETATION: From the above table 33.51% of the respondents are aware on Simplified
information and education materials about the schemes and 25.95% of the respondents are aware on
Involvement of local community leaders and organizations in spreading awareness and 21.08 % of
respondents are More government outreach programs and awareness campaigns and 12.43% are aware on
better access to healthcare facilities and information centers in rural areas and 7.03% are aware on
Subsidized or free enrolment options for low-income families.

INFERENCE: Mostly 33.51% of the responses are asked to improve awareness on Simplified information
and education materials about the schemes.
THE CHART SHOWING THE FACTORS WHICH COULD IMPROVE AWARENESS ABOUT
HEALTH INSURANCE SCHEMES IN RURAL AREAS

CHART - 4.1.16

Chart Title
40.00
33.51
30.00 25.95
21.08
20.00
12.43
10.00 7.03

0.00
1

More government outreach programsand awareness campaigns.

Simplified information and educationmaterials about the schemes.
Involvement of local community leaders and organizations in spreading awareness.
Better access to healthcare facilities andinformation centers in rural areas.
Subsidized or free enrollment options forlow-income families.
 THE TABLE SHOWING THE IMPORTANT REASON, TO TAKE A HI POLICY

TABLE - 4.1.17

Most important reason, why you think you should take a HI

policy Respondent Percentage
To protect from rising cost of healthcare 41 22.16
Tax benefits 34 18.38
Attractive schemes area available 35 18.92
Expecting health problems 34 18.38
Better healthcare for family 22 11.89
Covers big expenses 19 10.27
Total 185 100
(Source: Primary Data)

INTERPRETATION: From the above table 22.16% of the respondents reason to take a HI Policy is To
protect from rising cost of healthcare and 18.92% of the respondents reason to take a HI Policy is Attractive
schemes area available and 21.08 % of respondents are More government outreach programs and awareness
campaigns and 12.43% are aware on better access to healthcare facilities and information centers in rural
areas and 7.03% are aware on Subsidized or free enrolment options for low-income families.

INFERENCE: Mostly 22.16% of the respondent’s reason to take a HI Policy is to protect from rising cost
of healthcare.
 THE CHART SHOWING THE IMPORTANT REASON, TOTAKE A HI POLICY

CHART - 4.1.17

Most important reason, why you think you should take a HI policy
25.00 22.16

18.38 18.92 18.38

20.00

15.00
11.89
10.27
10.00

5.00

0.00
To protect from Tax benefits Attractive schemes Expecting Better healthcare Covers big expenses
risingcost of areavailable healthproblems forfamily
healthcare

Series1
THE TABLE SHOWING THE REASONS FOR NOT ENROLLING IN A HEALTH INSURANCE
SCHEME

TABLE - 4.1.18

What are the reasons for not enrolling in a

health insurance scheme Respondent Percentage
Lack of Information 48 25.95
Affordability 76 41.08
Trust issues 61 32.97
Total 185 100
(Source: Primary Data)

INTERPRETATION: From the above table 41.08% of the respondents reason for not enrolling HI
Policy is Affordability and 32.97% of the respondents reason for not enrolling a HI Policy is Trust
issues and 25.95% of respondents are not enrolling in a health insurance scheme due to lack of
Information.

INFERENCE: Mostly 41.08% of the respondents reason for not enrolling HI Policy is Affordability.
THE CHART SHOWING THE REASONS FOR NOT ENROLLING IN A HEALTH
INSURANCE SCHEME

CHART - 4.1.18
What are the reasons for not enrolling in a health insurance
scheme

50.00

40.00

30.00

20.00

10.00

0.00
Lack of Information Affordability Trust Issues

Series1
 THE TABLE SHOWING THE HOW LONG HAVE YOU BEEN A CUSTOMER OF YOUR
CURRENT HEALTH INSURANCE COMPANY

TABLE - 4.1.19

HOW LONG HAVE YOU BEEN A CUSTOMER OF YOUR

CURRENT HEALTH INSURANCE COMPANY RESPONDENT PERCENTAGE
Less than 1 year 43 23.24
1-3 years 78 42.16
3-5 years 52 28.11
More than 5 years 12 6.49
Total 185 100
(Source: Primary Data)

INTERPRETATION: From the above table 42.16% of the respondent period is between 1-3 years and
28.11% of the respondents period is between 3-5years and 23.24% of respondents
Less than 1 year and 6.49% of the respondent period are more than 5 years.

INFERENCE: Mostly 42.16% of the respondent period is between 1-3 years.

THE CHART SHOWING THE REASONS HOW LONG HAVE YOU BEEN A
CUSTOMER OF YOUR CURRENT HEALTH INSURANCE COMPANY

CHART - 4.1.19
How long have you been a customer of your current
health insurance company

6.49

23.24

28.11

42.16

Less than 1 year 1-3 years 3-5 years More than 5 years
 THE TABLE SHOWING THE CUSTOMER LEVEL OF SATISFACTION TOWARDS CM
HEALTH INSURANCE COMPANIES AND THE SETTLEMENT OF CLAIMS

TABLE - 4.1.20

FACTORS HIGHLY SATISFIED NEUTRAL DISAGREE HIGHLY TOTAL RANK

SATISFIED (4) (3) (2) DISAGREE
(5) (1)
Overall 67(5) 91(4) 19(3) 5(2) 3(1) 769 I
Satisfication 335 364 57 10 3
with CM
Health
insurance
Clarity in the 24(5) 124(4) 28(3) 6(2) 3(1) 715 II
claims process 120 496 84 12 3

Speed of 31(5) 91(4) 48(3) 9(2) 6(1) 687 V

claims 155 364 144 18 6
settlement
Transparency 22(5) 90(4) 48(3) 18(2) 7(1) 457 IX
in handling 110 360 144 36 7
claims
Responsiveness 33(5) 83(4) 41(3) 19(2) 9(1) 657 VII
of customer 165 322 123 38 9
service
Ease of 31(5) 90(4) 35(3) 22(2) 7(1) 471 VIII
reaching 155 360 105 44 7
customer
support (phone,
email, online
chat)
Regular 38(5) 84(4) 41(3) 18(2) 4(1) 689 IV
updates on the 190 336 123 36 4
status of your
claims
Satisfaction 29(5) 101(4) 36(3) 10(2) 9(1) 686 VI
with the 145 404 108 20 9
coverage
provided
Satisfaction 34(5) 97(4) 36(3) 11(2) 7(1) 695 III
with additional 170 388 108 22 7
benefits
(Source: Primary Data)

INTERPRETATION: The above table Overall Satisfaction with CM Health insurance that which was given
1st rank , while Clarity in the claims process which was given 2nd rank .The Satisfaction with additional benefits
which was 3rd rank.

INFERENCE: Hence, it is found that overall satisfaction with cm health insurance that which was given as a
customer level of satisfaction towards cm health insurance companies and the settlement of claims
 THE TABLE SHOWING THE COVERAGE FEATURES ARE MOST
IMPORTANT TO YOU IN A HEALTH INSURANCE POLICY

TABLE - 4.1.21

Coverage features are most

important to you in a health insurance policy Respondent Percentage
Hospitalization coverage 30 16.22
Outpatient services 45 24.32
SPrescription medication coverage 49 26.49
Maternity benefits 41 22.16
Dental and vision coverage 20 10.81
Total 185 100
(Source: Primary Data)

INTERPRETATION: From the above table 26.49% of the respondents coverage feature is
Prescription medication coverage and 24.32% of the respondents coverage feature is Outpatient
services and 22.16% of the respondents coverage feature is Maternity benefits and 16.22% of the
respondents coverage feature is Hospitalization coverage and 10.81% of the respondents coverage
feature is Dental and vision coverage.

INFERENCE: Mostly 26.49% of the respondents coverage feature is Prescription medication

coverage
THE CHART SHOWING THE RANK YOUR LEVEL OF AGREEMENT ON A SCALE.

TABLE - 4.1.22

Coverage features are most

important to you in a health insurance policy

10.81
16.22

22.16

24.32

26.49

HospitalizationCoverage Outpatient Services Prescription MedicationCoverage

Maternity Benefits Dental and VisionCoverage
 THE CHART SHOWING THE REASONS HOW LONG HAVE YOU BEEN A
CUSTOMER OF YOUR CURRENT HEALTH INSURANCE COMPANY

CHART - 4.1.21
FACTORS HIGHLY SATISFIED NEUTRAL DISAGREE HIGHLY TOTAL WEIGHTED
SATISFIED (4) (3) (2) DISAGREE RANKING RANKING
(5) (1)
Health 66(5) 90(4) 14(3) 7(2) 8(1) 754 4.07 I
insurance 330 360 42 14 8
helps in
covering
medical
expenses.
Health 22(5) 133(4) 20(3) 7(2) 3(1) 719 3.88 II
insurance 110 532 60 14 3
can provide
financial
support
during a
medical
emergency.
Health 42(5) 81(4) 45(3) 13(2) 4(1) 699 3.77 IV
insurance is 210 324 135 26 4
beneficial
for
preventive
healthcare
measures.
Believing 14(5) 96(4) 49(3) 25(2) 1(1) 652 3.52 VI
that health 70 384 147 50 1
insurance is
important
for financial
security.
The 39(5) 75(4) 41(3) 18(2) 12(1) 666 3.6 VII
government 195 300 123 36 12
should
provide
more
information
about health
insurance in
rural areas.
how would 19(5) 107(4) 30(3) 21(2) 8(1) 663 3.58 V
you rate 95 428 90 42 8
you’re
knowledge
about the
benefits
offered by
the health
insurance
scheme?
Are you 47(5) 90(4) 27(3) 12(2) 9(1) 709 3.83 III
aware of 235 360 81 24 9
CM health
insurance
scheme
provided by
Government
of Tamil
Nadu.
(Source: Primary Data)

INTERPRETATION: The above table Health insurance helps in covering medical expenses. That which
was given 1st rank, while Health insurance can provide financial support during a medical emergency.
which was given 2nd rank. The aware of CM health insurance scheme provided by Government of Tamil
Nadu.which was 3rd rank.

INFERENCE: Hence, it is found that overall Health insurance helps in covering medical expenses.
THE TABLE SHOWING THE MOST USED SOURCE OF FUND FOR MEETING YOUR
MEDICAL EXPENSES

TABLE - 4.1.23

The most used source of fund for meeting your

medical expenses Respondent Percentage

Free medical service from government. 43 23.24

Own savings 54 29.19

Paid by employer/company. 52 28.11

Health insurance 36 19.46

Total 185 100

(Source: Primary Data)

INTERPRETATION: From the above table 29.19% of the respondents most used source of fund
for meeting medical expenses Own savings and 28.11% of the respondents most used source of
fund for meeting medical expenses is Paid by employer/company and 19.46% of the respondents
most used source of fund for meeting medical expenses is Health insurance.

INFERENCE: Mostly 29.19% of the respondents most used source of fund for meeting medical
expenses Own savings.
THE CHART SHOWING THE REASONS HOW LONG HAVE YOU BEEN A
CUSTOMER OF YOUR CURRENT HEALTH INSURANCE COMPANY

CHART - 4.1.23

The most used source of fund for meeting your medical

expenses.

19.46
23.24

28.11
29.19

Free medical service Own savings Paid by employer/company. Health insurance

from government.
 THE TABLE SHOWING THE PREFERENCE TO ACCESS PLAN INFORMATION

TABLE - 4.1.24

The preference to access plan information Respondent Percentage

Mobile app 52 28.10
Advisor 50 27.02
Online portal 67 36.21
Social media 16 8.64
Total 185 100
(Source: Primary Data)

INTERPRETATION: From the above table 36.21% of the respondents preference to access plan
information through Online portal and 28.10% of the respondents preference to access plan information is
Mobile app and 27.02% of the respondents preference to access plan information through advisor and
8.64% of the respondents preference to access plan information through Social Media.

INFERENCE: Mostly 36.21% of the respondents preference to access plan information through Online
portal.
THE CHART SHOWING THE PREFERENCE TO ACCESS PLAN INFORMATION

CHART - 4.1.24
The preference to access plan information

40

30

20

10

0
Mobile app Advisor. Online Portal Social media
 CHAPTER-V
FINDINGS AND SUGGESTIONS

FINDINGS:

• Majority 60.5% of the responses are between age 18-30.

• Majority 54.05% of the responses are female.

• Majority 57.30% of the responses are married.
• Mostly 28.11% of the responses are from private organization service.
• Mostly 38.38% of the responses are degree.
• Majority 88.65% of the responses are from rural.
• Mostly 36.21% of the respondent’s preference to access plan information through Online portal.
• Mostly 29.19% of the respondents most used source of fund for meeting medical expenses Own
savings.
• Mostly 26.49% of the respondent’s coverage feature is Prescription medication coverage
• Majority 42.16% of the respondent period is between 1-3 years.
• Mostly 41.08% of the respondent’s reason for not enrolling HI Policy is Affordability.
• Mostly 22.16% of the respondent’s reason to take a HI Policy is to protect from rising cost of
healthcare.
• Mostly 33.51% of the responses are asked to improve awareness on Simplified information and
education materials about the schemes.
• Mostly 37.30% of the challenges or difficulties have you faced is Limited coverage for certain
medical conditions or treatments
• Mostly 34.05% of the Factors influenced your decision to opt is Network of hospitals/health care
providers.
• Mostly 31.35% of the respondents improve awareness and participation in health insurance schemes
in your community is Local Partnership.
• Mostly 41.62% of the respondent average medical expenses is 501-1000.
• Majority 84.32% of the responses are heard about HI policy.
• Majority 41.62% of the v respondent average medical expenses is 501-1000.
• Majority 48.11% of the responses are from 2 dependent family members.
• Mostly 31.35% of the respondent salary is between Rs 10001-21000
CONCLUSION:
Present study suggest that need of the hour is to launch information, education and communication
activities in order to make communities aware of the need of health insurance to meet the ever-rising
medical expenses in view of unpredictable illness and injuries. The major source of information was media
(television and newspaper). Among the not aware/not exposed, maximum was illiterate or had only primary
education. Most of the subjects in our study preferred government over a private plan.
Amongst the aware, thoughtless but a significant number of subjects thought that health insurance provides
protection only against critical illnesses. A significant number of subjects amongst those aware did not have
any knowledge of the nationalized banking sector schemes in association with insurance companies which
provide health insurance at low premium.