A STUDY ON HEALTH INSURANCE PORTFOLIO IN UNITED INDIA INSURANCE COMPANY

GROUP PROJECT
Submitted to P.S.G.R.Krishnammal College for Women, in partial fulfillment of the requirements for the award of the degree of BACHELOR OF COMMERCE (ACTUARIAL MANAGEMENT)

S.ARUNA M.DIVYA V.MIRUNALINI T.NARMADHA G.SAI SARANYA

BY, (07BAG004) (07BAG00 (07BAG017) (07BAG018) (07BAG027) (07BAG041)

R.VISHNUPRIYA

2007-2010 DEPARTMENT OF ACTUARIAL MANAGEMENT P.S.G.R. KRISHNAMMAL COLLEGE FOR WOMEN (AN AUTONOMOUS INSTITUTION AFFILIATED TO
BHARATHIAR UNIVERSITY) (AN ISO 9001: 2000 CERTIFIED INSTITUTION)

Peelamedu, Coimbatore 641 004. SEPTEMBER- 2009

CERTIFICATE

CERTIFICATE
This is to certify that the project entitled A STUDY ON HEALTH INSURANCE PORTFOLIO IN UNITED INDIA INSURANCE COMPANY submitted to P.S.G.R.Krishnammal College For Women, the BACHELOR OF (An Autonomous Institution Affiliated To MANAGEMENT ) in by

Bharathiyar University) in partial fulfillment of the requirements for the award of the degree of COMMERCE(ACTUARIAL M.DIVYA(07BAG000), P.S.G.R.Krishnammal College For Women is a record of the original research done S.ARUNA(07BAG004),

V.MIRUNALINI(07BAG017),

T.NARMADHA(07BAG018), G.SAISARANYA (07BAG027), R.VISHNUPRIYA(07BAG041) during the period 2007-2010 of their study in the Department Of Commerce (Actuarial Management), Coimbatore, under my supervision and guidance and this project work has not formed the basis for the award of any Degree/Diploma/Associateship/Fellowship or other similar title to any candidate of any University.

--------------------------------Signature of the guide

(Name and Designation)

Countersigned ----------------------Dr.(Mrs).R.Niramala Devi M.Com., M.Phil., PGDCA.,P.hd. Head of the Department

------------------------Dr.(Mrs).N.Yasodha Devi M.Com., P.hd. Principal

DECLARATION
DECLARATION

We, S.ARUNA(07BAG004), M.DIVYA(07BAG000), V.MIRUNALINI(07BAG017), T.NARMADHA(07BAG018), G.SAISARANYA (07BAG027), R.VISHNUPRIYA(07BAG041) hereby declare that the project entitled A STUDY ON HEALTH INSURANCE PORTFOLIO IN UNITED INDIA INSURANCE COMPANY submitted to P.S.G.R.Krishnammal College For Women, fulfillment of the (An Autonomous Institution Affiliated To Bharathiyar University) in partial requirements for the award of the degree of the BACHELOR OF during the period 2007-2010 of their study in the supervision and

COMMERCE(ACTUARIAL MANAGEMENT ) in P.S.G.R.Krishnammal College For Women is a record of the original research done by us Department Of Commerce (Actuarial Management), Coimbatore, under the

guidance of Mrs.GOMATHY.C M.Com.,M.PhiL., and this project work has not formed the basis for the award of any Degree/Diploma/Associateship/Fellowship or other similar title to any candidate of any University. SIGNATURE OF THE CANDIDATES S.ARUNA M.DIVYA V.MIRUNALINI T.NARMADHA G.SAISARANYA R.VISHNUPRIYA (07BAG004) (07BAG000) (07BAG017) (07BAG018) (07BAG027) (07BAG041)

--------------------------------Signature of the guide

(Name and Designation) Department Of Commerce(Actuarial Management)

ACKNOWLEDGEME NT

ACKNOWLEDGEMENT
We take this opportunity to acknowledge with great pleasure, deep satisfaction and gratitude, the contribution of many individuals in the successful completion of the study. We offer our profound gratitude to Sri.G.Ranagaswamy, Managing Trustee, GRG Institutions for providing us an opportunity to persue our studies and Smt.Nandhini Secretary, P.S.G.R Krishnamal College for women, Coimbatore for having given us this opportunity to undertake this study. We express our sincere thanks to Dr. (Mrs) N.YeshodhaDevi, M.Com, Ph.D. Principal, P.S.G.R Krishnammal College for Women, Coimbatore for her sustained interest and advise that she has contributed to great extent to the completion of this study. We express our greatful thanks to Dr.(Mrs.) R.Nirmala Devi, M.com.,M.Phil.,PGDCA., Ph.D , H.O.D department of Actuarial Management for the support extended by her in completing the project successfully. We express our heartful thanks to Mrs.C. Gomathy., M.Com.,M.Phil, lecturer P.S.G.R Krishnammal college for women, Coimbatore for her guidance and support without whom we wouldnt have been able to carry out our study successfully. We also take this opportunity to express my deep gratitude to all the facility members of the Department of Commerce (AM), P.S.G.R Krishnammal College for women. We also extend my esteemed thanks to Mr.Ragupathi, Branch Manager, BRILA SUN LIFE INSURANCE COMPANY for their valuable guidance and suggestions during the entire period of our study.

We take this opportunity to thank United India Insurance Company ltd who has been generous in allowing us to access the facilities. We appreciate all the employees, clients, corporate clients, agents, hospitals, self help groups of our study for the patient response to all our detailed queries. Last but not the least, I thank the Almighty for being with us in each and every activity and make the things always a successful one.

S.L.AISHWARYA M.K.DEVI KALA J.P.S.JENIFER PREETHY S.SANITA P.SHALINIE S.VIJAYALAKSHMI

CHAPTER I

INTRODUCTIO N

CHAPTER I
1.1 INTRODUCTION OF THE STUDY HEALTH IS WEALTH. Our health insurance makes healthier to the customer and also takes care of their wealth. The same way the health insurance makes the company to grow in all aspects and makes the service with smile. On analysing the scope of insurance is broad and miles to go. Hence the health insurance should be more essential and voluntary taking up the days are not far off.

General Insurance Company The entire general insurance business in India was nationalized by General Insurance Business (Nationalization) Act, 1972(GIBNA). The Government of India (GOI), through nationalization took over the share of 55 Indian Insurance companies and the undertakings of 52 insurers carrying on general insurance business. As soon as GIC was formed, GOI transferred all the shares it held of the general insurance companies to GIC. After a process of mergers among Indian Insurance companies, four companies were left as fully owned subsidiary companies of GIC. On 19th April 2000, when the IRDA act, 1999 come into force. This act also introduced amendment to GIBNA. An amendment to GIBNA removed the exclusive privilege of GIC and its subsidiaries carrying on general insurance in India. The following are the four subsidiary companies of GIC. UNITED INDIA INSURANCE Co. Ltd NEW INDIA INSURANCE Co. Ltd

ORIENTAL INDIA INSURANCE Co. Ltd NATIONAL INDIA INSURANCE Co. Ltd United India Insurance Company Ltd United India insurance company limited was incorporated as a company on 18th February 1938. General insurance business in India was nationalized in 1972. United India has grown by leaps and bounds and has 18300 work force spread across 1340 offices providing insurance cover to more than 1 crore policy holders. The company has variety of insurance products to provide insurance cover from bullock carts to satellites. Recently they made their presence in towns and villages through their innovative MICRO OFFICES.

Health Insurance Health Insurance, as an insurance cover, and its spread, is the most talked about topic by almost all sections of the society. Yet the intricacies, the complexities and the deficiencies of the current processes of product design, pricing, distribution and after sales service on the part of the insurers, and the role of the TPAs and the Ethical Standards of the Healthcare Providers, when the claims are settled, have not been probed enough due to the lack of availability of credible data. The IRDA should be really thanked for asking the TAC to put out its Data on Health Insurance in its website. Though the data is incomplete in many respects and not fully current, we have made a very good beginning

1.4 OBJECTIVES OF THE STUDY To examine the awareness about health insurance. To analyse how the health insurance policies of UIIC reaches the public.

 To identify whether the UIIC health insurance policy premiums are affordable by middle class society. To analyse and understand the future market trend for health insurance. 1.5 METHODOLOGY OF THE STUDY Area of the study: Data are collected from Regional office, Divisional office IV, III, II , hospitals, SHGs of Coimbatore city. Research size of the study: Totally 600 respondents were chosen using convenient sampling technique, which includes: Employees Agents Clients Corporate clients Hospitals SHG Source of Data The data were collected directly from the respondents through questionnaire framed in a simple and understandable way. It is well structured to cover the objective of the study. Data Collection The study consists of both primary and secondary data. The primary data collected from respondents using interview schedule and secondary data was collected from journals, magazines and websites. Tools used for analysis - 150 samples - 150 samples - 150 samples - 50 samples - 50 samples - 50 samples

For analyzing the data collected, the following tools viz., Percentages, Chi- square analysis have been used. Chi- Square Test Chi-square test is a non- parametric test which is used to find whether significant association exists between two attributes like type of business, position of membership. Formula: Chi- Square (2) = (O-E)2/E Period of study The study was conducted during the period of 3 months from July 2009- September 2009. 1.6 LIMITATIONS OF THE STUDY 1) The study was applicable to Coimbatore city only not any other area. 2) Due to limited period, the study was analyzed for 3 months only. 3) The study depends on the data supplied by the respondents. 1.7 CHAPTER SCHEME The first chapter will deal with introduction, statement of the problem, scope of the study, objective of the study, sampling design, field work and data collection and chapter scheme. The second chapter will deal with the review of literature The third chapter will deal with explanation to health insurance, what kinds of charges do the policy holders levy tax benefits. The fourth chapter will deal with the analysis and interpretation of the data collected. The fifth chapter will deal with findings, suggestions and conclusions.

CHAPTER II

REVIEW OF LITERATURE

CHAPTER - II REVIEW OF LITERATURE

The Robert Wood Johnson Foundation had published a paper on

COMPREHENSIVE HEALTH REFORM in the year 2009. The study shows that coring the un insured, improving the quality safety and equality of care focusing on prevention, and trigging spending under control are realistically within the nations reach. Kevin Quinn, Cathy Socheon and Louisa Buatti had made a study on YOUNG ADULTS LIVING WITHOUT HEALTH INSURANCE in the year 2000. The study shows that nearly a third of young adults ages 19 to 29 are uninsured. Individuals in this age group are nearly twice as likely as all children and olden adults to be without health insurance. Elizabeth Dugan had presented a paper on INSURANCE AGENTS BEHAVIOR UNDER HEALTH INSURANCE MARKET REFORMS in the year 2000. The study shows that the insurers encourage agents to engage in field underwriting to avoid high risks under health insurance. Helen levy and David Meltzer (Institute for social Research, University of Michigan) had made a study on IMPACT OF HEALTH INSURANCE ON HEALTH

insurance can improve health measure of some population subgroups, that would be the likely targets of coverage expansion policies. James Butikofer published a paper on CHILDREN HEALTH INSURANCE in the year 2005 which studies that the issue of the impact of providing public health insurance to uninsured children has on improving childrens health.

K.Donelan, C.Desroches and C.Schoen has mad a study on INADEQUATE HEALTH INSURANCE: COST AND CONSEQUENCES in the year 2000. The study shows that two of there Americans under age 65-155 million people-have employer sponsored health coverage Americans strongly prefer that employers retain their traditional role as the primary providers of health insurance rather than obtaining coverage through government or individual purchase of insurance. Jonathan Gruber, Brigitte C.Madrain had presented a paper on HEALTH INSURANCE, LABORSSS SUPPLY, AND JOB MOBILITY in the year 2002. This paper studies the relationship between health insurance, labs our supply and job. Mobility. Health insurance has important effects on both lab our force participation and job choice, but that it is not clean whether or not these effects result in large losers of either welfare or efficiency. Jonathan Grubs, Robin McKnight had made a study on WHY DID EMPLOYEE HEALTH INSURANCE CONTRIBUTIONS RISE? in the year 2002. The study shows that the large impact of falling in tax rates, rising eligibility for insurance through Medicaid system and through spouses, and deteriorating economic conditions (in late 1980s and early 1990s) are the factors that led to the increased penetration and rise in employee premiums over the 1982-1996.

CHAPTER - III

ABOUT UIIC AND HEALTH INSURANCE

CHAPTER III HISTORY OF INSURANCE
In some sense we can say that insurance appears simultaneously with the of human society. We know two types of economies in human societies: money economies (with markets, money, financial instruments and so on) and non-money or natural economies (without money markets, financial instruments and so on). The second type is a more ancient form than the first. In such an economy and community, we can see insurance in the form of people helping each other. For example, if a house burns down, the members of the community help build a new one. Should the same thing happen to ones neighbour, the other neighbours must help Otherwise, neighbours will not receive help in the future. This type of insurance has survived to the present day in some countries where modern money economy with its financial instruments is not widespread (for example countries in the territory of the former Soviet Union). Turning to insurance in the modern sense (i.e. insurance in a modern economy, in which insurance is part of the financial sphere), early methods of transferring or distributing risk were practiced by Chinese and Babylonian traders as long ago as the 3rd and 2nd millennia BC, respectively. Chinese merchants traveling treacherous river rapids would redistribute their wares across many vessels to limit the loss due to any single vessels capsizing. The Babylonians developed a system which was recorded in the famous Code of Hammurabi,

c.1750 BC, and practiced by early Mediterranean sailing merchants. If a merchant received a loan to fund his shipment, he would pay the lender an additional sum in exchange for the lenders guarantee to cancel the loan should the shipment be stolen. Achaemenian monarchs of Iran were the first to insure their people and made it official by registering the insuring process in governmental notary offices. The insurance tradition was performed each year in Norouz (beginning of the Iranian New Year.); heads of different ethnic groups as well as others willing to take part, presented gifts to the monarch. The most important gift was presented during a appearance special ceremony. When a gift was worth more than 10,000 Derrik (Achaemenian gold coin) the issue was registered in a special office. This was advantageous to those who presented such special gifts. For others, the presents were fairly assessed by the confidants of the court then the assessment was registered in special offices. Toward the end of the seventeenth century, Londons growing importance as a centre for trade increased demand for marine insurance. In the late 1680s. Mr.Edward Lloyd opened a coffee house that became a popular haunt of ship owners, merchants, and ships captains, and thereby a reliable source of the latest shipping news. It became the meeting place for parties wishing to insure cargoes and ships, and those willing to underwrite such ventures. Today, Lloyds of London remains the leading market (note that it is not an insurance company) for marine and other specialist types of insurance, but it works rather differently than the more familiar kinds of insurance. Insurance as we know it today can be traced to the Great Fire of London, which in 1666 devoured 13,200 houses. In the aftermath of this disaster, Nicholas Barbon opened an office to insure buildings. In 1680, he established Englands first fire insurance company, The Fire Office, to insure brick frame homes.

HISTORY OF INSURANCE IN INDIA:

In India, insurance has deep-rooted history. It finds mention in the writings of Manu (Manusmrithi), Yagnavalkya (Dharmasastra) and Kautilya (Arthasastra). The writings talk in terms of pooling of resources that could be re-distributed in times of calamities such as fire, floods, epidemics and famine. This was probably a pre-cursor to modern day insurance.

Ancient Indian history has preserved the earliest traces of insurance in the form of marine trade loan and carriers contracts. Insurance in India has evolved over time heavily drawing from other countries, England in particular. The history of general insurance dates back to the Industrial Revolution in the west and the consequent growth of sea-faring trade and commerce in the 17th century. It came to India as a legacy of British occupation. General Insurance in India has its roots in the establishment of Triton Insurance Company Ltd., in the year 1850 in Calcutta by the British. In 1907, the Indian Mercantile Insurance Ltd, was set up. This was the first company to transact all classes of general insurance business. 1957 saw the formation of the General Insurance Council, a wing of the Insurance Association of India. The General Insurance Council framed a code of conduct for ensuring fair conduct and sound business practices.

GENERAL INSURANCE INDUSTRY IN INDIA :

The non-life insurance industry in India witnesses tumultuous times, seen never before. The intensity of competition was at its highest and the regulator brought in deregulation of pricing of those segments, hitherto controlled by tariffs. The markets witnessed steep fall in prices of some segments. The general insurance business (without AIC, ECGC and two exclusive health insurers) grew at 12.63% in 2007-08 as the industry crossed Rs.28000 crores (7 billion USD). The health segment grew at more than 30%. Motor and health segments are emerging as the future drivers of non-life insurance business. The total increase in business (without ECGC, AIC and health insures ) in 2007 08 was Rs.3155.33 crores as against the increase of Rs.4570.65 crores in 2006-07. The general slowdown, compared to previous year, is attributed to fall in premium of the tariffed segment in the current year. The industry witnessed more tie ups with automobile manufacturers and banks, group insurance scheme in micro finance sector, government driven business etc. The non-life insurers are expected to meet the competition in this market, by coming out with innovations in the products, strengthening distribution channels, reducing the cost of

operation and leveraging technology for reaching out. The industry is undergoing business metamorphosis, and the ultimate beneficiary would be the customer.

INTRODUCTION TO INSURANCE:
Meaning of Insurance A Contract of insurance is a contract by which one party
undertakes to make good the loss of another, in consideration of a sum of money, on the happening of a specified event, e.g., fire accident or death. Law recognizes insurance as a system of sharing risk too great to be borne by an individual.

Purpose- Assets like building, machinery and stocks and persons are called as risks, These
risks are exposed perils like fire, lightning. riot, strike. When the perils operate upon the risk, then the risks are lost/damaged /injured / died. Under such contingency insurance pays compensation to the insured for the affected property/person. This is the primary function of Insurance.

How does Insurance work?

People facing common risks come together and make small contribution (premium ) to a common fund (maintained by insurer). When a few unfortunate people whose property / life is damaged or lost and injured/died, insurer pays monetary compensation (claims) to the victims from out of the common fund.Thus, sharing of losses of a few by many or spreading of losses of a few over many is the method by which the insurance companies work.

Contract of Insurance

The proposer (insured) pays premium to the insurer who the accepts the risk after scrutinizing all the material facts and issues policy which is the policy which is the evidence of the contract. This practice is known as contract of insurance. The following are some of the essential conditions for making an insurance contract a valid one: a) Payment of premium b) Promise to indemnity c) Competency (majors) d) Sound mind e) Legal capacity (not against public policy) examples stolen/smuggled goods.

FUNDMENTAL PRINCIPLES GOVERNING GENERAL INSURANCE BUSINESS

1) Utmost good faith means absence of fraud or deceit. Otherwise means disclosure of all material information and representation of all material facts. If this principles is not followed either by insured by the insurer then the contract becomes void. 2) Insurable Interest means the legal right to insure making the insurance contract valid. Without the insurable interest insurable contract become void. 3) Indemnity means to place the insured after a loss in the same financial interest of the insured). 4) Subrogation- means transfer of rights and remedies (implied in all contracts of indemnity) except fire and miscellaneous where it is expressed. 5) Contribution means the insured does not recover more than the actual loss or the sum insured in the event of loss or damage. 6)

Proximate cause means the most important, effective and powerful cause in
bringing about the loss, damage, injury and death. This is also known as cause proxima and non remota.

LEGISLATIVE AND REGULATORY MATTERS:

Every general insurance employee is expected to know some of provisions of the provisions of the following three major laws: 1) Insurance Act, 1938 2) General Insurance Business (Nationalization ) Act, 1972 (GIBNA) 3) Insurance Regulatory and Development Authority Act, 1999 (IRDA)

1) MAJOR PROVISION OF INSURANCE ACT, 1938 AS AMENDED:

a) REGISTRATON - Paid up capital for life or general Rs.100 crores Paid up capital for Re-insurance Rs.200Crores b) DEPOSIT with RBI - Non Life 3% of total gross premium -Life 1% of total gross premium Re-Insurance Rs.20 Crores c) LICENSING - i) Agents ii) Surveyors and loss Assessors iii) Brokers d) PAYMENT OF PREMIUM - i) as per section 64 VB of the Insurance Act payment of Premium in advance i.e. prior to Commencement Risks are compulsory. e) SOLVENCY MARGIN - Insures should ensure this aspect. of the

2) OBJECT OF NATIONALISATION OF GENERAL INSURANCE BUSINESS (NATIONALISATION) ACT 1972

a) Spread the message to rural areas b) Prevent concentration of wealth in private hands c) Develop general insurance business

3) MAJOR PROVISIONS OF IRDA ACT 1999

1) Project the interest of policy holders. 2) Regulate the orderly growth of general insurance business 3) Licensing of agents, surveyors and brokers. 4) Matter concerning registration. 5) Stipulate terms and conditions of direct insurance/reinsurance business. 6) Matter relating to investment of surplus funds. 7) Matter concerning solvency margin. 8) To regulate advertisement. 9) Matters regarding management of assets and liabilities 10) Matters relating to submission of final statement of accounts.

UNITED INDIA INSURANCE:

United India Insurance Company Limited was incorporated as a Company on 18th February 1938. General Insurance Business in India was nationalized in 1972. 12 Indian Insurance Companies, 4 Cooperative Insurance Societies and Indian operations of 5 Foreign Insurers, besides General Insurance operations of southern region of Life Insurance Corporation of India were merged with United India Insurance Company Limited. After Nationalization United India has grown by leaps and bounds and has 18300 work forces spread across 1340 offices providing insurance cover to more than 1 Crore policy holders. The Company has variety of insurance products to provide insurance cover from bullock carts to satellites.

United India has been in the forefront of designing and implementing complex covers to large customers, as in cases of ONGC Ltd, GMR- Hyderabad International Airport Ltd, and Mumbai International Airport Ltd Tirumala-Tirupati Devasthanam etc. They have been also the pioneer in taking Insurance to rural masses with large level implementation of Universal Health Insurance Programme of Government of India & Vijaya Raji Janani Kalyan Yojana ( covering 45 lakhs women in the state of Madhya Pradesh) , Tsunami Jan Bima Yojana (in 4 states covering 4.59 lakhs of families) , National Livestock Insurance and many such schemes. They have also made their presence in more than 200 tier II & III towns and villages through our innovative Micro Offices UI is a leading General Insurance Company. More than three decades of experience in Non-life Insurance business. Formed by the merger of 23 companies, consequent to nationalisation of General Insurance. Corporate Mission: To provide Insurance protection to all. To ensure customer satisfaction. To function on sound business principle. To help minimize national waste and to help develop the Indian economy.

UNITED INDIA INSURANCE COMPANY LIMITED

Type Founded Headquarter Industry Net income Employee strength

: Public : 1938 : Chennai, India : General Insurance : 520 crore (2008) : 21000

COMPANY PROFILE: Beginnings:March 1906 Lingam Brothers Floated United India Life Insurance Co (Shri vijendra Rao, played a Leading role) Feb 1938 -United India Insurance Co.Ltd.a Sister concern was floated with: 1. Authorished share capital-Rs.50lakhs 2. Issued subscribed and paid up capital Rs3,15848 3. Run by board consist of: 1973 Shri.M.ct.M.Chidambaram (MD) Shri.M.Shanmuga mudaliar Shri.st.sadasivam Shri. N.Rama Rao. the

- 23 companies were amalgamated and the new company was born in

name of United India Insurance Co.Ltd . 1974 emineries. Shri.P.C.Sekar (CMD) Shri.P.C. Joseph, Director Shri.D.K.Singh, Director Shri P.R.Majumdar, Director Shri.T.N. Padmanaban, Director -Board of Director was constituted consisting of the following

 1975

Shri. B.B.Sawhney, Director

- The revised Organisational pattern started operation.

Present:
Board of directors: Shri. G. Srinivasan, Chairman Cum managing Director Shri. Sanjeev Kumar Jindal, Director (Insurance), Govt of India Shri M.S.Sundrara Rajan, Chairaman & Managing Director, Indian Bank Shri. A. Asthana, Director & General Manager, UIIC Shri. Milind. A. Kharat, Director & General Manager, UIIC Shri. A.V.Rathnam, Director Shri. Abhjit Bandyopadhyay, Director

ORGANISATIONAL STRUCTURE :
Head Office Regional Offices Regional Cell Large Corporate & Brokers Unit (LCBU) Divisional Offices Branch Offices Micro Offices TOTAL Chennai 25 1 3 361 677 271 1338

HEALTH INSURANCE A GLAMOROUS PRODUCT:

Health Insurance, as an insurance cover, and its spread, is the most talked about topic by almost all sections of the society.Yet the intricacies, the complexities and the deficiencies of the current processes of product design, pricing, distribution and after sales service on the part of the insurers, and the role of the TPAs and the Ethical Standards of the Healthcare Providers, when the claims are settled, have not been probed enough due to the lack of availability of credible data.

CURRENT MARKETING SCENARIO HEALTH INSURANCE:

With DKV Apollo, emerging as another exclusive Health Insurer, in addition to Star Health, LIC is also expected to join the race for the development of the Health Insurance Sector, LIC being armed with much superior data in the form of Morbidity tables, the non-life health insurance market is getting a lot more spicier. The TTK group is also set to join the race track soon. All these insurers are in the exciting race to harness the rapidly growing potential for health insurance business that has been witnessing growth rates of almost 40% annually.Consumers have fuelled the demand for health covers.Health Insurance with 13% of the GDPI of the nonlife industry, ranks third after Motor with 42% and Fire with 17%Marine and Engineering share the 4th position with 7% each.Analysts expect that the health insurance premiums would overtake the fire insurance premiums in another two years. (Health 3200 cr. Fire 4250 cr. difference is only 1050 cr.).With so much glamour attached to health insurance potential, it has posed numerous problems to the current insurers, who have been making consistent losses almost for the past 15 years.

RISK MANAGEMENT IN HEALTH INSRUANCE:

Risk Management is a process of loss prevention and loss mitigation practiced both by the insured and insurer.An insurer bases the pricing of the product based on his perception of the risk factors in the proposal under consideration.Unfortunately, the pricing of current health insurance product is based on age bond risk factors only, to the exclusion of all other health risk factors peculiar to each person.Moreover, the product sold is homogeneous, where as the target group is heterogeneous.

Factors like gender, heredity, life-styles, domiciles, availability and usage of expensive healthcare providers excessive usage of medical services, occupation, income levels are not given any credence in the price-making chart.There are many product variants like Hospitalization following accidents only, hospitalization for named surgeries only, hospitalization for named diseases only, hospitalization as reimbursable basis, and as cashless, with deductibles and co-payments and without.

Insurers do not provide product differentiation with differentiated prices. In the aspect of pricing, there is increasing evidence that competition in all economic activities is moving towards PRICE-LED COSTING of the product than. COST-LED PRICING, which is the popular norm in the insurance sector.PRICE-LED COSTING would put pressure on the insurers to reduce both their claims costs and management cost, including procurement cost.Insurers wrongly perceive Risk Management as a tool available to them, only at the stage of acceptance of business.This perception has to change, so that their claims processes can also be risk managed in the form of the selection of the health cover provider, deductibles, co-payments and limiting claim payments per hospitalization.

The involvement and co-operation of the Insured in claims processing is important. For such cooperation, suitable price incentives have to be provided to customers The above analysis would show that the present way the health business is conceived, priced and transacted with huge dissatisfaction on the part of both the contractual parties is essentially the creation of the insurers coupled with the greed of the insured. The pre-existing disease syndrome is beyond large a myth of the creation of insurers themselves.The TAC has published statistics that are analyzed elsewhere in this presentation.Out of 1.63 cr. Lives insured, the number of claimants are only 10 lakhs. 1.53 cr. Of lives only pay premiums, without making claims.Even assuming that there are a few black sheep in the 10 lakh segment, their numbers are pitifully small, not to raise the that consumers seek health insurance mainly with a pre-existing illness to hide from insurers.

TACs HEALTH INSURANCE STATISTICS:

24 TPAs have serviced the requirements of 1.63 cr. Of policy holders who have paid a total premium of RS.2000 cr.in 2008-09. According to the statistics published by IRDA, the total health health insurance premium in 2008-2009 was 2200 cr.This is quite close to the statistics analysed by the TAC. So, the numbers are close enough for doing an analysis of the health insurance business. These statistics, however, do not provide age-bond wise data on premiums and claims in numbers and in value. Nor do they provide such information for the major diseases the TAC has listed. As only 10 lakh claims out of a policy holders figure of 1.63 cr., the frequency of the claims is around 6.2%. 1.5 cr of policy holders did not put claims of any kind. The claims paid to 10 lakh customers were 1800 cr., signifying an average claim of Rs.18000 per person. The average premium per person was Rs.1200/The claims ratio was 91% sans procurement cost and management costs The health premium grew to 3200 cr. In 2008-09 at a growth rate of about 40% with an accretion of Rs.980 cr. This emphasizes that this business segment is crucial to the growth trajectory of the future for all non-life insurers. This portfolio needs to be better understood and more meticulously analysed, and appropriate solutions found to make the portfolio viable, not only claimants, as in the present case, but to the insurers as well. This should be done without having to jack up premium rates to recoup losses through lack of understanding the dynamics of the portfolio.

HEALTH INSURANCE PREMIUMS IN 2008-09: (in crores)

COMPANY NEW INDIA ICICI ORIENTAL UIIC NATIONAL BAJAJ PUBLIC PRIVATE 2007-08 665 225 360 355 1700 500 2008-09 765 735 440 430 330 2000 1200

IS THE HEALTH INSURANCE COVER BOUGHT OR SOLD?

One must remember at all times that health insurance covers today are bought by consumers rather than necessarily sold by insurers. This is a total reversal of the insurers entire sales mechanism, they are now used to Insurers should also answer the question: Is the health cover sold, regarded by them, as a matter of client accommodation or as a commercial deal they are keen to promote. Selling it as a commercial deal, and then treating claims, as a matter of accommodation is inherently unacceptable to the market Insurers are better placed in putting conditions at the acceptance stage than in the sale of any other product. Providing information to the consumers on health insurance, (both benefits and restrictions) is the beginning of the sale process. Right now, precious little is done on this front. Moral hazard and adverse selection should be on the top of their agenda. They should endeavor to control these factors, by providing information on restrictive conditions, and their claims scrutiny standards, asking for additional medical data if necessary. Underwriting by insurers is today equated to acceptance of the proposal at the rate listed in the proposal. To say the least, it is unprofessional to the insured and to the investors of the insurers as well.

DEFICIENCIES IN PRODUCT DESIGN AND PRICING:

The main problem with the product design in its present form is based on the universal assumption that one size fits all. Selling the product of one design, with minor variations in the age bonds has poorly served the PSU insurers. They have badly suffered in the process With the advent of TPAs, insurers have become mere reimbursing agencies of claims, than perform their roles, as underwritrs or decision makers on claims. Product design must also cater to controlling likely claims costs at the level of each age bond, gender and life style infirmities

and diseases. The premium pricing formula must yield place to Loadings and Discounts on the PERCEPTUAL ANALYSIS of the risk exposures of the insured, and the likely claim costs depending upon the category of the healthcare provider chosen.

If proposers were to be offered multiple choices of premium (deductibles and co-payments) and qualified product benefits, they would certainly apply their minds more judiciously and become more familiar with the restrictive conditions. The restrictive conditions must be seen in the context of superior claims management by the insured himself, rather than as on imposition by the insurer. The result is the economic viability of the product that is beneficial to the insured. The context of consumer education thus gets more focused A certification of good health by the proposer is a must The declaration present in todays product is omnibus and obsolete Such declarations must be sought for even at every renewal which is not resorted to as of now.

HEALTHCARE SERVICE PROVIDERS PROBLEMS & TRAVAILS:

Health care service providers are self-motivated to encourage more consumption of their services by insrued patients, even if such services are not needed. Insurers have problems in proving that there has been an excessive use of health services Insurers should have trained medical volunteers posted at hospitals they are tied up with, to provide assistance and to ensure that their insured get quality care and limit excessive medical services by the service provider. Insurers leave this responsibility in TPAs with little supervision on the quality of their services Insurers must device systems of their own to detect frauds likely to be committed by health care service providers and the TPAs. With medical tourism growing in hype and with healthcare service provides acing intense competition among themselves, the future medical costs are likely to go up (7.5% per annum). Involvement of claimants in negotiation with hospitals, through higher deductibles and co-payment clauses, would encourage them to quickly get out of the hospital quickly rather than lingering there. As they are coinsurers, it could bdring in some check. There are arguments that the patients connive with hospitals to pod up claims not all

insured are corrupt. They have a renewal to do with the insurer, and the higher cost of the claim can add to their premium cost, or render renewals unobtainable. Press reports have highlighted that the health core business is facing a financial crisis. Other hospitals like Moral, Fortis, Kovai Medical, Devaki are also down on a comparative basis. It is argued that operational deficiencies the minimum bed size required is 150-200 and this can be through additional capacity creation, and that needs more money. Real estate prices have increased phenomenally, and they are financially constrained in their expansion plants. Prices of drugs are shooting up Doctors fees are sky rocketing For the 2nd quarter of 2007, Apollos proits have dwindled from 50 cr. To 24 cr. More patients want treatment in super-specialty hospitals, just because insurers do not restrict treatments to lesser known hospitals through premium differentiation nor in the claims payment methods If hospitals have financial problems, they could be only unloaded, and more easily so on the patients, and particularly those that are financed by the health insurers.

Health Insurance : Need

Population covered under some form of Healthcare Prepayment

16 14 12 10 8 6 4 2 0 14.3

Percentage (%)

3.4 0.9 Private Health Insurance Social Insurance

Employer Spend

Community Insurance

Total

Healthcare Type

INDIAN HEALTH INSURANCE CHALLENGES:

Increase in health care costs High financial burden on the poor Need for long term and nursing care for senior citizens Increasing burden of new diseases and health risks Due to under funding, preventive and primary care and public health functions are yet to meet their objectives.

Health Insurance potential to become a Rs.25000 crores industry by 2012. No. of Elderly People in the Developing World will TRIPLE in 25yrs. (WHO)

 In India, the no. of people above 60 yrs is about 8% today, with that no. expected to hit 21% by 2025. (Asia Insurance Review)

HEALTH INSURANCE THE WAY AHEAD

Creating awareness on Rights & Responsibilities Data Pool Regulator as a repository Standardization of Cost Increased Tax benefit Removal of Service Tax Standardization of definition a right step ahead Gradation of Health service providers Pool for Senior Citizen Renewability / Portability Compulsory Health Benefits for organized sector Government role on mass healthcare initiatives

CHAPTER IV

ANALYSIS AND INTERPRETATION

CHAPTER IV
4.1 EMPLOYEES PERCENTAGE ANALYSIS
TABLE NO: 4.1.1 Age of employees Options 20-25 25-30 30-35 35-40 Above 40 Total Number of respondents 15 15 11 34 34 150 Percent 10 33 23 23 27 100

From the above table it is clear that 33% of the respondents belongs to 25-30 age group, 27% belong to above 40 age group, 23% belong to 30-35 age group, 23% to 35-40 age group, 10% to 20-25 age group. Maximum (33%) of the respondents belong to the age group of 25-30 years. CHART NO: 4.1.1 AGE OF THE RESPONDENTS
35 30 PERCENT 25 20 15 10 5 0 AGE 20-25 25-30 30-35 35-40 above 40

TABLE NO: 4.1.2 Academic qualification. Options School level UG PG Professional others Total Number of respondents 30 68 45 7 150 Percent 20 45 30 5 100

The above table depicts that 45% of the employees are under graduates 30% of them are post graduates, 20% of them had completed up to school level, 5% of the employees are professionals.

Maximum (45%) of the respondents are under graduates. TABLE NO: 4.1.3 Insurance qualification Options Licentiate Associate fellowship Actuarial Science others Total Number of respondents 60 56 30 4 0 150 Percent 40 37 20 3 0 100

The above table discloses that 40% of the respondents have completed Licentiate , 37% of them have completed Associate, 20% of them have completed Fellowship, 3% have completed Actuarial Science . Maximum(40%) of the respondents have completed licentiate .

TABLE NO: 4.1.4 Department Options Technical Marketing IT Accounts Administration Total Number of respondents 60 38 15 22 15 150 Percent 40 25 10 15 10 100

From the above table it is clear that 40% of the respondents belong to technical department, 25% to marketing department, 15% of to accounts department, 10% to IT and administration department each.

Maximum (40%) of the respondents belong to technical department.

CHART NO: 4.1.2

10% 15%

40%

Technical Marketing IT Accounts Administration

10%

25%

TABLE NO: 4.1.5 Premium rates of health insurance policy Options Abnormal Normal Total Number of respondents 38 112 150 Percent 25 75 100

The above table discloses that 75% of the respondents feel that the premium rates are normal in UIIC, 25% feel that the premium rates are abnormal. Majority(75%) of the respondents feel that the premium rates are normal in UIIC.

TABLE NO: 4.1.6 Reason for abnormal premium rates

Options Group Policy Individual Policy Floater Policy Gold / Senior citizen Policy Total

Number of respondents 7 60 15 68 150

Percent 5 40 10 45 100

The above table depicts that 45% of the respondents feel that premium rates are abnormal in Gold/senior citizen, 40% in individual policy, 10% in floater policy, 5% in Group policy. Maximum (45%) of respondents feel that premium rates are abnormal in Gold/senior citizen policy.

TABLE NO: 4.1.7 Premium charges according to the diseases Options Yes No Total Number of respondents 15 135 150 Percent 10 90 100

From the above table it is clear that 90% of the respondents do not agree that the premium is charged according to the diseases and 10% of them agree that the premium rates are charged according to the diseases. Majority(90%) of the respondents disagree that the premium is charged according to the diseases.

TABLE NO: 4.1.8 Occupation of insured as a part of risk

Options Yes No Total

Number of respondents 138 12 150

Percent 92 8 100

The above table depicts that 92% of the respondents agree that occupation of the insured is a part of risk, 8% of the them agree to this. Majority (92%) of the respondents agree that the occupation of the insured is a part of risk.

TABLE NO: 4.1.9 Premium rating Scale Options 5 years 10 years 15 years Total Number of respondents 30 45 75 150 Percent 20 30 50 100

The above table discloses that 50% of the respondents feel that the rating scale for 15 years 30% of them feel the premium rating scale for 10 years, 20% of them feel the premium rating scale for 5 years. Majority(50%) of respondents feel that the premium rating scale should be 15 years. TABLE NO: 4.1.10 After detarrifing premium rates are affordable by all sections Options Yes Number of respondents 91 Percent 61

No Total

59 150

39 100

From the above table it is clear that 61% of the respondents feel that the premium rates are affordable by all sections of the society and 39% of the do not agree to this. Majority (61%) of the respondents feel that the premium rates are affordable by all sections of the society after detarrifing.

TABLE NO: 4.1.11 Gender wise premium Options Yes No Total Number of respondents 0 150 150 Percent 0 100 100

The above table depicts that 100% of the respondents disagree that the premium charged according to the gender. Entire 100% of the respondents feel that the premium is charged according to the gender.

TABLE NO: 4.1.12 Intimation about the hereditary diseases Options Yes No Number of respondents 30 120 Percent 20 80

Total

150

100

The above table discloses that 80% of the respondents do not agree regarding the clients intimation about the hereditary diseases, 20% of the employees agree that the clients intimate about the hereditary diseases. Majority(80%) of the respondents do not agree regarding the clients intimation about the hereditary diseases.

TABLE NO:4.1.13 Previous claim details Options Yes No Total Number of respondents 34 116 150 Percent 33 77 100

From the above table it is clear that 77% of the respondents do not agree that previous claim details are collected from previous insurer of the client 33% agree this statement. Majority (77%) of the respondents do not agree that previous claim details are collected from previous insurer of the client.

TABLE NO:4.1.14 High claim ratio Options Group policies Individual policies Number of respondents 112 38 Percent 74 26

Total

150

100

The above table depicts that 74% of the respondents feel that there is a high claim ratio in group policies, 26% in individual policies. Majority(74%) of the respondents feel that there is a high claim ratio in group policies.

TABLE NO: 4.1.15 Rapid growth Options Motor Fire Health Marine Total Number of respondents 45 30 60 15 150 Percent 30 20 40 10 100

The above table discloses that 40% of the respondents feel that there is a rapid growth in health sector, 30% in motor sector, 20% in fire sector 10% in marine sector. Maximum(40%) of the respondents feel that there is a rapid growth in health sector. SECTOR HAVING RAPID GROWTH CHART 4.1.3
40 35 30 25 PERCENT 20 15 10 5 0 Motor Fire Marine Motor Fire Health Marine 1 SECTOR Health

NO:

TABLE NO: 4.1.16 Awarness of health insurance products Options Yes No Total Number of respondents 38 112 150 Percent 26 74 100

From the above table it is clear that 74% of the respondents do not accept that the health insurance products have reached, 26% accept that the health insurance products have reached. Majority(74%) of the respondents do not accept that the health insurance products have reached to the public.

TABLE NO: 4.1.17 Intimation about repudiation in claim Options Less than 15 days Less than a month More than a month Number of respondents 53 45 52 Percent 35 30 35

Total

150

100

The above discloses that 35% of the respondents feel that they get the information form TPA regarding repudiation in claim in less than 15 days, 35% of them feel that they get the information from TPA regarding repudiation in claim in more than a month, 30% of them feel that they get the information for TPA regarding repudiation in claim in less than a month. Maximum(35%) of the respondents feel that they get the information from TPA regarding repudiation in claim in less than 15 days. TABLE NO: 4.1.17 Reason for lack of awareness Options Lack of publicity Minimum number of prospectus Non awareness of marketing force Non impacting of Commission structure Non issuance of proper training Total Number of respondents 60 30 22 15 23 150 Percent 40 20 14 11 15 100

The above table depicts that 40% of the respondents feel that awareness about latest health Insurance products due to the lack of publicity. 20% feel due to minimum number of prospectus,15% feel due to non issuance of proper training to underwriting department , 14% feel due to non-awareness of marketing force, and 11% feel due to non -impacting of commission structure. . Maximum(40%) of the respondents feel that awareness about latest health Insurance products due to the lock of publicity. TABLE NO:4.1.20 TPA Management Satisfactory Options Yes Number of respondents 60 Percent 40

No Total

90 150

60 100

Form the above table it is clear that 60% of the respondents are not satisfied regarding TPA management and 40% of them are satisfied regarding TPA management. Majority(60%) the respondents are not satisfied regarding TPA management

TABLE NO:4.1.21 Intervals between two meetings Options Monthly Quarterly Half yearly Yearly once Total Number of respondents 30 61 59 150 Percent 20 40 40 100

The above table discloses that 40% of the respondents feel half yearly once each meeting in conducted, 20% of them feel that Quarterly once meetings are conducted. Maximum (40%) of the respondents feel half yearly once each meeting in conducted with TPA. TABLE NO: 4.1.22 E- Payment facility Options Yes No Total Number of respondents 23 127 150 Percent 16 84 100

The above table depicts that 84% of the respondents feel that their company do not have E payment facility as a mode of premium payment, 16% of them feel that their company have e-payment facility as a mode of premium payment. Majority (84%) of the, respondents feel that their company do not have E- payment facility as a mode of premium payment. TABLE NO: 4.1.23 Grievance faced due to TPA Service Options Id card issuance Claim repudiation Non Clarity of reason for repudiation Delay settlement Total Number of respondents 15 45 60 30 150 Percent 10 30 40 20 100

From the above table it is clear that 40% of the respondents feel that the grievance faced frequently is non-clarity of reason for repudiations, 30% as delay in settlement of claim, 20% as delay in settlement of claim and 10% as delay in issuance of ID card. Maximum (40%) of the respondents feel that the grievance faced frequently is nonclarity of reason for repudiations.

CHART NO: 4.1.4 FREQUENT GRIEVENCE FACED

40 35 30 25 PERCENT 20 15 10 5 0

Id card issuance Claim repudiation Non Clarity of reason for repudiation 1 GRIEVENCE Delay settlement

TABLE NO: 4.1.24 Receiving claim Intimation and settlement details Options Daily Weekly Monthly Quarterly Total Number of respondents 8 36 75 30 150 Percent 6 24 50 20 100

The above table discloses that 50% of the respondents feel that they receive claim intimation and settlement details monthly, 24% of them feel as weekly, 20% of them feel that they receive claim intimation and claim settlement details Quarterly, 6% as daily. Majority(50%) of the respondents feel that they receive claim intimation and settlement details monthly TABLE NO: 4.1.25 Improvements in UIIC after detarrifing Options Bank account holders designed products super top up /top up policy family medicare policy Platinum policy Total Number of respondents 23 15 45 67 150 Percent 16 10 30 44 100

The above table depicts that 44% of the respondents feel that there is improvement in platinum policy after detariffing , 30% feel in family medicare policy,16% feel the improvements in bank account holders designed products , 10% in super to up / top up policy.

Maximum(44%) of the respondents feel that there is improvement in platinum policy after detariffing TABLE NO: 4.1.29 Number of specialist officer recruited Options 4 6 8 Total Number of respondents 90 37 23 150 Percent 60 24 16 100

From the above table it is clear that 60% of the respondents feel that there are 4 specialist officers recruited, 24% of them feel that 6 specialist officer are recruited,16% feel that 8 specialist officer are recruited. Majority (60%) of the respondents feel that there are 4 specialist officers recruited for TPA management. TABLE NO: 4.1.30 Interval of inspection in hospital Options Monthly Quarterly Annual Whenever necessary Total Number of respondents 7 38 15 90 150 Percent 4 26 10 60 100

The above table discloses that 60% of the respondents feel that the inspection at hospital is done whenever necessity arise, 26 % feel that the inspection at hospital is done quarterly, 10% as annually, 4% of them feel that the inspection at hospital is done monthly.

Majority(60%) of the respondents feel that the inspection at hospital is done whenever necessity arise.

CHI SQUARE TEST

EDUCATIONAL QUALIFICATION AND OTHER DEPENDENT VARIABLES: Hypothesis: There is no significant difference between the educational qualification of the

employees and their opinion upon policy having abnormal premium rates, sector having rapid growth, intimation about the repudiation in claim, frequent grievance faced and the improvements in UIIC after detariffing. TABLE NO: 4.1.31 Variable Policy having abnormal premium rates Sector having rapid growth Intimation about repudiation in claim Frequent grievances faced Improvement in UIIC after detariffing S-Significant (Chi square>Table value) NS-Not significant (Chi square<Table value) From the above table it is clear that the null hypothesis is accepted in one case and it is rejected in the other four cases. There is no significant difference between the educational qualification and the opinion on intimation by TPA about the repudiation in claim. There is significant difference between the educational qualification and the opinion on policy having abnormal premium rates, sector having rapid growth, frequent grievance faced and the improvements in UIIC after detariffing. Chi-square value 19.17 19.86 14.12 23.97 17.72 Table value 16.92 16.92 16.92 16.92 16.92 NS/S S S NS S S

4.2. AGENTS PERCENTAGE ANALYSIS

TABLE NO: 4.2.1 Age of the employees Options 20-30 30-40 40-50 50 & above Total Number of Respondents 75 31 17 27 150 Percent 50 21 11 19 100

From the above table it is clear that 50% of the respondents are belonging to the age group of 20-30 years, 21% is between 30-40 years 19% above 50 years and 21% is between40-50 years. Majority (50%) of the respondents are belonging to the age group of 20-30 years. CHART NO: 4.2.1 AGE OF THE RESPONDENTS

50 & above 50 & above AGE 40-50 30-40 20-30 40-50 30-40 20-30

10

20

30 PERCENT

40

50

60

TABLE NO: 4.2.2 Educational Qualification Options School level UG PG Professional Others Total Number of Respondents 38 59 31 22 150 Percent 25 40 20 15 100

From the above table, it is clear that 40% of the respondents have completed their UG, 25% had completed their schooling 20% PG and 15% are professionals. Maximum (40%) of the respondents had completed their Post graduation. TABLE NO: 4.2.3 Monthly income Options Rs. Less than 20000 20000-30000 30000-40000 Above 40000 Total Number of Respondents 76 36 23 15 150 Percent 50 25 15 10 100

The above table shows that the 50% of the respondents have their monthly income less than 20000, 25% between 20000-30000, 15% between 30000-40000 and 10% have above 40000. Maximum (50%) of the respondents have their monthly salary below Rs.20000

TABLE NO: 4.2.4 Premium rates Options Abnormal Normal Total Number of Respondents 37 113 150 Percent 25 75 100

From the above table it is clear that 75% of the respondents feel the premium rates of health insurance policies in UIIC as normal and 25% feel abnormal. Majority (75%) of the respondents that the premium rates of health insurance policies in UIIC are normal.

TABLE NO: 4.2.5 Policies having abnormal premium rates Options Group Policy Floater policy Individual policy Gold /Senior citizen policy Total Number of Respondents 2 4 15 16 37 Percent 6 11 42 43 100

The above table shows that 43% of the agent respondents feel that there is an abnormal premium rate prevailing in gold /senior citizen policy, 42% in individual policy. Maximum (43%) of the agent respondents feel that the premium rates are abnormal in gold/senior citizen policy

TABLE NO: 4.2.6 Renewal reminder through sms & e-mail Options Yes No Total Number of Respondents 150 150 Percent 100 100

Entire (100 %) of the respondents say that they do not relieve renewal reminder from the company through sms and e mail.

TABLE NO: 4.2.7 specially designed policy to cover only selected diseases Options Yes No Total Number of Respondents 150 150 Percent 100 100

The above table discloses that 100% of the respondents feel that there is no specially designed policy to cover only selected diseases. Entire (100%) of the respondents feel that there is no specially designed policy to cover only selected diseases.

TABLE NO: 4.2.8 Mediclaim policy covering entire family

Options Health insurance policy Jan Arokya Bima policy Floater policy Universal health insurance policy Others Total

Number of Respondents 73 17 45 15 150

Percent 49 11 10 10 100

The above table shows that 49% of the respondents feel that the entire family is covered under medic aim policy in health insurance policy, 30% in floater policy, 11% in Jan Arokaya Bima policy and 10% in universal health insurance policy. Maximum (49%) of the respondents feel that the mediclaim policy covering entire family is health insurance policy.

CHART NO: 4.2.2

13% Health insurance policy 13% Jan Arokya Bima policy Floater policy 14% 60% Universal health insurance policy

TABLE NO: 4.2.9 Improvements after detarrifing

Options Blank account holders designed products Super top up policy /top up policy Family Medicare policy Platinum policy Total

Number of Respondents 23 14 47 66 150

Percent 25 9 31 45 100

From the above table, it is clear that 45% of the respondents feel that there are improvements after detarrifing in platinum policy, 31% in family Medicare policy, 15% in bank account holders designed products and 9 % in super top up/top up policy. Maximum (45%) of the respondents feel that there are improvements in platinum policy after detarriffing TABLE NO: 4.2.10 Difficulties faced in marketing Options Inadequate cover Premium hike Previous policy claim settlement Lack of publicity about new products Total Number of Respondents 12 31 65 42 150 Percent 8 21 43 28 100

The above table depicts that 43% of the respondents feel that previous policy claim settlement as the difficulty faced while marketing 28% as lack of publicity about new products, 21% as premium like and 8% as inadequate cover. Majority (43%) of the respondents feel that the previous policy claim settlement as the difficulty faced while marketing. TABLE NO: 4.2.11 TPA Claim settlement procedure simple Options Yes No Total Number of Respondents 66 84 150 Percent 44 56 100

The above table shows that 56% of the respondents feel that the TPA claim settlement procedure is not simple and 44% feel it to be as simple. Majority (56%) of the respondents feel that the TPA claim settlement procedure is not simple.

TABLE NO: 4.2.12 Explanation to clients about the exclusion diseases and pre existing disease through printed notices. Options Yes No Total Number of Respondents 17 133 150 Percent 11 89 100

From the above table it is clear that 89% of the respondents do not explain to the clients about the exclusion diseases and pre exiting diseases through printed notices and 11% explain through printed notices.

Majority (89%) of the respondent do not explain to the clients about the exclusion diseases and pre existing diseases through printed notices.

TABLE NO: 4.2.13 Reason for difficulty in claim settlement procedure of TPA Options Submission of documents Repudiation reasons Hospital preauthorization Delay in issuance of ID cards Total Number of Respondents 18 44 15 7 84 Percent 21 52 18 9 100

The above table discloses that 52% of the respondents feel repudiation reasons as the difficulty in claim settlement procedure of TPA, 21% as submission of documents, 18% as hospital pre authorization procedure, and 9% as delay in issuance of Id cards . Majority (52%) of the respondents feel that the repudiation reasons as the difficulty in claim settlement procedure of TPA.

CHART NO: 4.2.3 DIFFICULTIES IN CLAIM SETTLEMENT

60 50 PERCENT 40 30 20 10 0 REASON Delay in issuance of ID cards Submission of documents Repudiation Hospital preauthorization

TABLE NO: 4.2.14 Number of question untilled in proposal form out of 30 Options 3 5 7 10 Total Number of Respondents 15 22 51 62 150 Percent 10 15 34 41 100

The above table shows that 41% of the respondents feel that 10 questions are kept unfilled by the proper in the proposal form, 34% feel that there are 7 question left unfilled 15% feel 5 questions and 10% feel 5 questions Maximum (41% )of the respondents feel that there are to questions kept unfilled in the proposal form by the proposed.

TABLE NO: 4.2.15 Collection of medical check up certificate Options Yes No Total Number of Respondents 48 102 150 Percent 32 68 100

The above table depicts that 68% if the respondents do not collect medical checkup certificate for fresh or break up insurance cover and 32% of the respondents. Majority (68%) of the respondents do not collect the medical check certificate.

TABLE NO: 4.2.16 Satisfaction of commission structure compared to private sector Options Yes No Total Number of Percent 45 55 100

Respondents 67 83 150

The above table discloses that 55% of the agent respondents are not satisfied with the commission structure compared to private sector and 45% are satisfied. Majority (55%) of the respondents are not satisfied with the commission structure based on volume of business comparing to private sector.

TABLE NO: 4.2.17 Display of target achievers name list in the office premises Options Agree Disagree Total Number of Respondents 40 110 150 Percent 27 73 100

The above table shows that 73% of the respondents say that the name list of the target achieves are not displayed in their office premises and 27% say, it is displayed. Majority (73%) the respondents say that the name list of the target achieves are not displayed in their office premises

TABLE NO: 4.2.18 Training and refresher course to cope up with latest competitive scenario Options Strongly agree Agree Strongly disagree Neither agree nor disagree Total Number of Respondents 46 63 34 37 150 Percent 31 42 22 25 100

From the above table it is clear that 42% of the respondents agree that they are given proper training to cope up with the latest competitive scenario, 31% strongly agree, 25% neither agree nor disagree and 22% strongly disagree. Maximum (42%) of the respondents agree that are given proper training to cope up with the latest competitive scenario.

CHI SQUARE TEST

EDUCATIONAL QUALIFICATION AND THE OTHER DEPENDENT VARIABLES: Hypothesis:- There is no significant difference between the educational qualification of the agents and their opinion upon mediclaim policy covering the entire family, improvements after detariffing, difficulties faced in marketing and by UIIC to cope up with the latest competition scenario. TABLE NO: 4.2.19 Variable Mediclaim policy cover ship the entire family Improvements after detariffing Difficulties faced in marketing Training and refresher course S-Significant (Chi square>Table value) NS-Not significant (Chi square<Table value) The above table depicts that, the null hypothesis is accepted in two cases and it is rejected in the other two cases. There is no significant difference between the educational qualification of the agents and their opinion upon mediclaim policy covering the entire family and difficulties faced in marketing and there is a significant difference between the educational qualification and opinion on improvements after detariffing and training and refresher course offered by UIIC. Chi-square value 16.73 20.09 12.32 17.89 Table value 16.92 16.92 16.92 16.92 NS/S NS S NS S

4.3 CLIENTS PERCENTAGE ANALYSIS

TABLE NO: 4.3.1 Age in years Options 20-30 30-40 40-50 50 above Total Number of respondents 10 70 40 30 150 Percent 9 47 23 21 100

From the above table it is clear 47% of the respondents are between the age groups 30-40 yrs 23% of the respondents are b/w 40-50 yrs 21% are b/w 50 yrs is above and 9% of the respondents are between 20-30 yrs. Maximum (47%) of the respondents are between the age group 30-40 yrs. TABLE NO: 4.3.2 Educational Qualification Options School level Under graduate Post Graduate Professional Others Total Number of respondents 63 34 28 15 10 150 42 23 19 10 6 100 Percent

The above table depicts that 42% of the respondents are educated till school level 23% are undergraduates, 19% are post graduates, 10% are professionals and 6% belong to other category. Maximum (42%) of the respondents are educated till school level.

TABLE NO: 4.3.3 Occupation Options Government Employee Private employee Professional Others Total Number of respondents 36 69 23 22 150 Percent 24 46 15 15 100

The above table discloses that 46% of the client respondents air private sector Employees 24% are govt employees, 15% work in other categories . Maximum (46%) of the respondents all private sector employees.

CHART NO:4.3.1

OCCUPATION OF THE RESPONDENTS

50 40 PERCENT 30 20 10 0 1 OCCUPATION Government Employee Private employee Professional Others

TABLE NO: 4.3.4. Monthly Income

Options (Rs) Less than 20000 20000-30000 30000-40000 Above 40000 Total

Number of respondents 70 46 25 9 150

Percent 47 31 17 5 100

The above table discloses that 47% of the respondents have their monthly income less than Rs.20000-30000, 17% have between Rs.30000-40000 and 5% have above Rs.40000. Maximum (47%) of the respondents have their monthly income below Rs.20000.

TABLE NO: 4.3.5. Health Insurance Coverage Options Yes No Total Number of respondents 94 56 150 Percent 63 37 100

From the above table it is clear that 63% of the respondents are covered under health Insurance and 37% are not cover of under health insurance. Majority (67%) of the respondents are covered under health Insurance.

TABLE NO: 4.3.6. Awareness about health Insurance Options Number of Percent

respondents Advertisement Friends Agents Others Total 32 49 36 33 150 21 33 24 22 100

The above table discloses that 33% of the respondents awarne about health insurance through their friends 24% through the agents, 22% from other sources, and 21% from advertisement. Maximum (33%) of the respondents aware about health insurance through their friends.

CHART NO: 4.3.2

MODE OF AWARENESS

Others MODE Agents Friends Advertisement

10

20 PERCENT

30

40

TABLE NO: 4.3.7. Sum Assured Options(Rs) Number of respondents Percent

100000-200000 200000-300000 300000-400000 400000-500000 Above 500000 Total

61 37 22 15 15 150

41 25 14 10 10 100

From the above table discloses that 41% of the respondents have their sum assured between Rs.100000-200000. 25% of them, have their sum assured between Rs.300000-400000 and 10% between 4-5 lakhs , 10% above Rs 50000. Maximum (41%) of the respondents have their sum assured between Rs.100000200000

TABLE NO: 4.3.8. Drinking smoking habits Options Yes No Total Number of respondents 108 42 150 Percent 72 28 100

The above table discloses that 72% of client respondents have drinking smoking habits and 28% do not have drinking smoking habits Majority (72%) of the client respondents have drinking smoking habits.

TABLE NO: 4.3.9. Frequency of drinking Options Number of Percent

Regular user 15-30 days Less than 15 days Monthly once Social drinker Total

respondents 28 48 27 32 15 150

19 32 18 21 10 100

From the above table clears that 32% of the respondents have alcohol @ a frequency of less than 15 days and 10% are Social drinkers. Maximum (32%) of the respondents have alcohol a frequency of 15-30 days.

CHART NO:4.3.3

FREQUENCY OF DRINKING
35 30 PERCENT 25 20 15 10 5 0 FREQUENCY Regular user 15-30 days Less than 15 days Monthly once Social drinker

TABLE NO: 4.3.10 Mode of travel Options Two Wheeler without gear Two Wheeler with gear Four wheeler Others Number of respondents 36 37 54 23 Percent 24 25 36 15

Total The above table shows that 36% of the travel

150

100

respondents use four wheelers, 25% use two

wheeler with gear 24% use two wheeler with out gear 15% use other type of vehicle for mode of

Maximum (36%) of the respondents travel through four wheeler. TABLE NO: 4.3.11. Policy covering the entire family Options Health Insurance Super top up policy Jana Arokaya bima policy Floater policy universal health Total Number of respondents 78 16 44 12 150 Percent 52 11 29 8 100

The above table discloses that 52% of the respondents family is covered under health Insurance super top up policy, 29% under floater policy, 71% under Jana Arokaya Bima Policy, 8% under universal health Insurance policy. Majority (32%) of the respondents family is cover and under health Insurance super top up policy.

TABLE NO: 4.3.12.Number of years under Coverage Options (years) 0-2 2-4 4-6 Above 6 Total Number of respondents 60 52 23 15 150 Percent 40 35 15 10 100

The above table depicts that 40% of the respondents have their health Insurance Coverage between 0-2 yrs 35% between 2-4 yrs, 15% between 4-6 yrs, 6% have their lower age has more than 6 yrs. Maximum (40%) of the respondents have their health Insurance cover age between 0-2 yrs. TABLE NO: 4.3.13. Awareness about health Insurance Providing family discount Options Yes No Total Number of respondents 111 39 150 Percent 74 26 100

From the about table, it is clear that 74% of the respondents are aware of the family discount provided under health Insurance 26% are un aware of it. Majority (74%) of the client respondents are aware of the family discount provided under health Insurance. TABLE NO: 4.3.14. Premium rates according to the disease Options Yes No Total Number of respondents 18 132 150 Percent 12 88 100

The above table discloses that 88% of the respondents feel that premium rates are not charged according to the disease of the policy holders, 22% of the respondents feel it is charged according to the disease.

Majority (88%) of the respondents feel that premium rates are not charged according to the disease of the policy holders.

TABLE NO: 4.3.15. Classification of hospitals according to their accreditation Options Yes No Total Number of respondents 91 59 150 Percent 60 40 100

The above table shows that 60% of the respondents classify the hospitals according to their accreditation and 40% of them do not classify the hospitals according to the accreditation. Majority (60%) of the respondents classify the hospitals according to their accreditations.

TABLE NO: 4.3.17. Payment of premium according to hospital selected Options Yes No Total Number of respondents 105 45 150 Percent 70 30 100

The above table portraits that 70% of the respondents would like to pay premium according to the hospital they select $30% of the client respondents do not like to option. Majority (70%) of the respondents would like to pay premium according to the hospital they select. TABLE NO: 4.3.18. Payment of extra premium for already existing disease Options Yes No Total Number of respondents 53 98 150 Percent 35 65 100

The above table discloses that 65% of the client respondents are not ready to pay extra premium for already existing disease and 35% of the client respondents are ready to pay extra premium for already existing diseases. Majority (65%) of the client respondents are not ready to pay extra premium for already existing diseases.

TABLE NO: 4.3.19. Awareness about HELLO HEALTHY FACILITY Options Yes No Total Number of respondents 17 133 150 Percent 11 89 100

From the above table it is clear that 89% of the respondents are not aware of the hello healthy facility & 11% of the respondents are aware of it.

Majority (89%) of the respondents are not aware of the hello healthy facility offered by UIIC.

TABLE NO: 4.3.20. Approach to TPA during weekends Options Yes No Total Number of respondents 63 87 150 Percent 42 58 100

The above table depicts that 58% of the respondents feel that they are not free to approach to TPA during the weekends, and 42% of the respondents feel that would approach TPA during the weekends. Majority (58%) the respondents feel that they are not free to approach to TPA during the weekends.

TABLE NO: 4.321. Receiving of Renewal notice Options Yes No Total Number of respondents 87 63 150 Percent 58 42 100

The above table discloses that 60% of the respondents do not receive the renewal notice properly and 40% of the respondents receive the renewal notice properly.

Majority (60%) of the respondents receive the renewal notice properly.

TABLE NO: 4.3.22. Proper treatment given by the hospital when provided under Health Insurance Products Options Yes No Total Number of Percent respondents 73 49 77 51 150 100

From the above table shows that 51% of the respondents feel that they are not given proper. Information in the hospital about the Non-coverage of specific diseases 49% of the respondents feel that they are given proper information the hospital about the non-coverage of specification disease. Majority (51%) of the respondents feel that they are not given proper. Information in the hospital about the Non-coverage of specific diseases.

TABLE NO: 4.3.24. Co payment facility of there is redaction in premium Options Yes No Total Number of respondents 77 73 150 Percent 51 49 100

The above table discloses that 51% of the respondents would not like to access the CoPayment facility if there is reduction in premium, 49% of the respondents would like to accept the Co-Payment facility if them is reduction in premium. Majority (51%) of the respondents would not like to access the Co-Payment facility if there is reduction in premium. TABLE NO: 4.3.25. Reason for abnormal rates of hospitals

Options Improper investigation Delay intimation to the client about the non coverage Non operation of own labs & Pharmacy Admitting the patients in ICU when it is / not needed Total

Number of respondents 54 21

Percent 36 14

30 45 150

20 30 100

From the above table clearly that 36% of the respondents feel improper investigation as a reason behind the hospital changing than the normal rates, 30% of the respondents fees admitting the patients in ICU when it is not needed as a reason, 20% as non-operation of own labs and pharmacy, 14% as delay in intimation to the patients about non-operation . Majority (46%) of the respondents feel improper investigation as a reason behind the hospital changing than the normal rates TABLE NO: 4.3.28. Easy claim settlement procedure Options Yes No Total Number of respondents 68 82 150 Percent 45 55 100

From the above table it is clear that 55% of the Respondents fee that the claim settlement procedure of UIIC under health insurance to be difficult and 45% of respondents feel to be easier. Majority (55%) of the respondents feel that the claim settlement procedure of UIIC under health Insurance to difficult. TABLE NO: 4.3.29. Reason for difficult claim settlement procedure

Options Improper investigation Repudiation reasons Hospital pre authorization procedure Delay in issuance of ID cards Total

Number of respondents 24 81 37 8 150

Percent 16 54 25 5 100

From the above table it is clear that 54% of the Respondents, feel Repudiation Reason as the difficulty in claim settlement procedure 25% as hospital pre authorization procedure as the difficulty 16% as submission of documents and 5% of Delay In Issuance of ID cards. Majority( 54% )of the Respondents feel Repudiation Reason as the difficulty in claim settlement procedure. TABLE NO: 4.3.30. Free health checkup during 3 claim free years Options Yes No Total Number of respondents 61 89 150 Percent 40 60 100

The above table discloses that 60% of respondents have enjoyed free health checkup during 3 Claim free years and 40% of Respondents have not enjoyed free health checkup during 3 Claim face year. Majority (60%) of respondents have enjoyed free health checkup during 3 Claim free years.

TABLE NO: 4.3.31. Intimation from TPA about the Repudiation in Claim Options Number of respondents Percent

Less than 15 days Less than a month Other (specify) Total

30 67 53 150

20 45 35 100

The above table discloses that 45% of Respondents Receive intimation from TPA in less than a month Regard the Repudiation in Claim, 35% of Respondent Received the intimation in 15 days Maximum (45%) of respondents Receive Intimation from TPA in less than month Regarding the Repudiation in claim.

TABLE NO: 4.3.32. Attractive advertisement Options Private insurer Public insurer Total Number of respondents 112 38 150 Percent 75 25 100

From the above table it is clear that 78% of respondents are attracted by private Insurer Advertisement and 25% of Respondents are attracted by public Insurer Advertisement . Majority ( 75%) of respondents are attracted by private insurer Advertisement.

CHART NO: 4.3.4

ATTRACTIVE ADVERTISEMENT

Public insurer 25%

Private insurer 75%

TABLE NO: 4.3.33 filling of all questions in Proposal form Options Yes No Total Number of Percent respondents 61 89 150 41 59 100

From the above table it is clear that 59% of the Respondents do not fill all the question in the proposal firm and 41% of Respondents fill all the questions in the proposal from. Majority (59% ) of the respondent do not fill all the questions in the proposal firm.

TABLE NO: 4.3.34 Intimation of Renewal through SMS or E-Mail

Options Yes No Total

Number of respondents 0 150 150

Percent 0 100 100

From the above table it is clear that Entire 100% of Respondents Do not receive Renewal premium notes through SMS or e-Mail. Entire 100% of Respondents do not Receive Renewal premium notes through SMS re-Mail.

TABLE NO: 4.3.35 Free health checkup at company cost Options Yes No Total Number of respondents 113 37 150 Percent 75 25 100

The above table discloses that 75% of respondents are ready to take free health checkup at company cost at the time of taking the policy and 25% of Respondents are not Ready to take free health check up at company cost at the time of taking the policy. Majority (75%) of Respondents are ready to take free health checkup at Company cost at the time of taking the policy. TABLE NO: 4.3.36 Consultation to hospitalization

Options

Number of respondents

Percent

Family doctor journey Elders Friends Total

56 34 41 19 150

37 23 27 13 100

The above table discloses that 37% of the respondents get consultation from family doctor for hospitalization 27% from elders 23% they themselves get hospitalized, 17% from friends. Maximum (37%) of the respondents get consultation from family doctor for hospitalization TABLE NO: 4.3.37. Hospital Chosen . Options KG KMCH Kuppusamy Naidu PSG Ganga Others Total Number of respondents 34 37 19 32 25 3 150 Percent 23 24 13 21 17 2 100

The above table depicts that 24% of the respondents would like to go to KMCH in case of hospitalization, 23% to KG, 21% to PSG , 17% to ganga, 13% to Kuppusamy Naidu and 2% to other local hospitals. Maximum (24%) of the respondent would like to go to KMCH in case of hospitalization. CHART NO:4.3.5

HOSPITAL CHOSEN
30 25 PERCENT 20 15 10 5 0 HOSPITAL KG KMCH Kuppusamy Naidu PSG Ganga Others

TABLE NO: 4.3.38. Hospital chosen for accident care Options KG KMCH Kuppusamy Naidu PSG Ganga Others Total Number of respondents 19 41 24 48 11 7 150 Percent 13 27 16 32 7 5 100

From the above table it is clear that 32% of the respondents would like to choose PSG for accident care, 27% to KMCH 16% to kuppusamy Naidu 13% to KG 7% to ganga 5% to other hospitals. Maximum (32%) of the respondents would like to choose PSG for accident care.

CHART NO: 4.3.6

HOSPITAL CHOSEN FOR ACCIDENT CARE

Others HOSPITAL Ganga PSG Kuppusamy Naidu KMCH KG 0 10 20 PERCENT 30 40

TABLE NO: 4.3.39. Best infrastructure hospital Options KG KMCH Kuppusamy Naidu PSG Ganga Others Total Number of respondents 41 22 9 18 58 2 150 Percent 27 15 6 12 39 1 100

The above table discloses that 39% of the respondents feel that ganga hospital has the best infrastructure, 27% feel as KG, 15% an KMCH 12% as PSG , 6% as Kuppusamy Naidu and 1% as other hospitals Maximum (39%) of the respondents feel that Ganga hospital has the best infrastructure. CHART NO: 4.3.7

BEST INFRACTURE HOSPITAL

40 35 30 25 PERCENT 20 15 10 5 0

KG KMCH Kuppusamy Naidu PSG Ganga 1 HOSPITAL Others

TABLE NO: 4.3.40. Hospital equipped with latest technology Options KG KMCH Kuppusamy Naidu PSG Ganga Others Total Number of respondents 34 21 19 61 15 150 Percent 23 14 13 40 10 100

The above table depicts that 40% of the respondents feels PSG is equipped with latest technology, 23% as K.G, 14% as KMCH, 13% as Kuppusamy Naidu and 10% as ganga. Maximum (40%) of the respondents feel that PSG is equipped in the latest technology.

CHART NO: 4.3.8

HOSPITAL WITH LATEST TECHNOLOGY

40 35 30 25 PERCENT 20 15 10 5 0

KG KMCH Kuppusamy Naidu PSG Ganga 1 HOSPITAL

TABLE NO: 4.3.41. Expectation in a hospital to join in it Options Infrastructure Latest technology Service Diagnosis Accident care Total Number of respondents 16 13 29 77 15 150 Percent 11 9 19 51 10 100

From the above table it is clear that 51% of the respondents expect best diagnosis in a hospital to join in if 19% as service, 11% as infrastructure, 10% as accident care and 9% as latest technology. Majority (51%) of the respondents expect best diagnosis in a hospital.

CHI SQUARE TEST

AGE AND THE OTHER DEPENDENT VARIABLES: Hypothesis: There is no significant difference between the age and the occupation, monthly income and sum assured. TABLE NO: 4.3.42 Variable Occupation Monthly income Sum assured Chi-square value 17.26 15.37 24.83 Table value 16.92 16.92 21.03 NS/S S NS S

S-Significant (Chi square>Table value) NS-Not significant (Chi square<Table value) From the above table it is clear that the Null hypothesis is rejected in two cases and accepted in one case.

There is no significant difference between the age and the monthly income and there is a significant difference between the age the occupation and sum assured.

EDUCATIONAL QUALIFICATION AND THE OTHER DEPENDENT VARIABLES: Hypothesis: There is no difference between the educational qualification and the opinion upon Reason hospitals charging abnormal rates, choice of hospital, hospital chosen for accident care, best infrastructure hospital, hospital equipped with latest technology, Expectation in hospital to join in it. TABLE VALUE: 4.3.43 Variable Reason for hospital Charging abnormal rates Choice of hospital Hospital chosen for accident care Best infrastructure hospital Hospital equipped with latest technology Expectation in a hospital 11.79 21.03 NS 29.82 36.45 NS 31.27 36.45 NS 27.92 37.23 36.45 36.45 NS S Chi-square value 14.61 Table value 16.92 NS/S NS

S-Significant (Chi square>Table value) NS-Not significant (Chi square<Table value)

The above table discloses that the null hypothesis is reject in one case and accepted in the other five cases. There is no significant difference between the educational qualification and the opinion upon reason for hospitals charging abnormal rates, Choice of hospital, best infrastructured hospital, hospital equipped in the latest technology and expectation in a hospital and there is significant difference between the educational qualification and the opinion upon hospital chosen for accident care.

PERCENTAGE ANALYSIS 1) Size of the Group Options Less than 5 5 to 10 10-15 15 and above Total Self help group Number of Respondents 8 6 31 5 50 Percentage 16 12 63 9 100

From the above table it is clear that 63% of the self help groups Consist of 10-15 members, 16% of self help groups consist of less than 5 members, 12% of self help groups consist of 5 to 10 members and 9% of self help groups consist of 15 and above member Majority 63% of self help groups consist of 10-15 members.

2) Registration of the group Options Yes No Total Number of Respondent 50 50 Percentage 100 100

From the above table it is clear that 100% if the self help groups are registered Majority 100% of self help registered group are registered. 3) Entire family courage under health Insurance Options Yes No Total Number of Respondent 8 42 50 Percentage 15 85 100

From the above table it is clear that 85% of the member Entire family in not covered under health Insurance. Majority 85 of the Members Entire family is not covered under health Insurance. 4) Policy covering the Entire family Options Health insurance Policy Jana Arokaya Bima Policy Number of Respondent 20 14 Percentage 45 29 19 7 100

Family Medicare policy 3 Universal health Insurance 23 policy Total 50

From the above table it is clear that 45% of their family is covered under health Insurance Policy, 29% of their family is covered under Jana Arokaya bima Bima policy, 19% of their family is covered under family Medicare policy and 7% of their family is covered under universal health Insurance. Majority 45% the Members family is covered under health Insurance policy. 5) Marketing of health Insurance Policy

Options 0-2 2-4 4-6 above 6 Total

Number of Respondent 50 50

Percentage 100 100

From the above table it is clear that 100% of the self help groups have been marketing the health Insurance policy between 0-2 years. All the self help groups have been marketing the health Insurance policy between 0-2 years. 6) Mode of awareness about health Insurance Options Advertisement Agents Friends others Total Number of Respondent 4 5 36 5 50 Percentage 8 10 72 10 100

From the above table it is clear that 72% of them are aware about health insurance through their friends, 10% of them are aware through both agents and others equally. And 8% of them are aware through Advertisement. Majority 72% of the members are award of about health Insurance through their friends 7) Receiving the Renewal notices Options Yes Number of Respondent 13 Percentage 26

No Total

37 50

74 100

From the above table it is clear that 74% of the self help groups do not receive Renewal notice, 26% of the self help groups Receive Renewal notice. Majority 74% of the self help groups do not receives the Renewal notice. 8) Satisfaction, Commission comparing to private sector Options Yes No Total Number of Respondent 17 33 50 Percentage 34 66 100

From the above table it is clear that 66% of the self help groups are not satisfied with commission Received, 34% of self help groups are satisfied with the commission Received. Majority of the respondent are not satisfied with the commission Received. Comparing the Private sector. 9) Awareness about Hello health facility Options Yes No Total Number of Respondent 4 46 50 Percentage 8 92 100

From the above table it is clear that 92% of the self help groups are not aware of Hello healthy Facility of UIIC. Majority 92% of the self help groups are not aware of Hello healthy facility. 10) Awareness abut Jana Arokaya bema policy

Options Yes No Total

Number of Respondent 19 31 50

Percentage 37 63 100

From the above table it is clear that 63% of the self help group are not aware of Jana Arokaya bema policy of UIIC . 37% of the self help group are aware of Jana Arokaya bima policy of UIIC Majority of the self help groups are not aware of Jana Arokaya bima policy . 11) Awareness about Universal health Insurance policy

Options Yes No Total

Number of Respondent 41 9 50

Percentage 83 17 100

From the above table it is clear that 83% of the self help groups are aware of universal health Insurance.17% of the self help groups are not aware of universal health Insurance of UIIC. Majority of the self help groups are aware of universal health Insurance.

Percentage analysis Hospitals 1. Category of the hospital Hospital Clinic Group Network hospital Multi specialty Number of respondents 20 5 10 8 Percentage 40 10 20 16

Limited hospital Total

7 50

14 100

The above table shows that 40% of the respondents have clinics, 20%. Are network hospitals, 16% are multi specialty hospitals, 14% are limited hospitals and 10% are group hospitals. Maximum (40%) of the hospital respondents have clinics. 2. Number of patients bed. Beds Less than 25 25 to 50 50 to 100 100 & above Total Number of respondents 12 15 13 10 50 Percentage 24 30 26 20 100

From the above table it was clearly stated that of the 30% respondents have 25 to 50 beds, 26% have 50 to 100 beds, 24% have less than 25 beds and 20% have above 100 beds. Majority (30%) of the respondents have 25 to 50 in their hospitals. 3) Management of loss prevention and loss mitigation practice Options Yes No Total Number of Respondent 23 27 50 Percentage 46 54 100

The above table depicts that 54% of the reopens that there is no loss prevention and loss mitigation practice in UIIC and 46% feel that is a loss mitigation and loss prevention practice in UIIC. Majority (54%) of the hospital respondents feel that there is proper management of loss prevention and loss mitigation practice in UIIC. 4. Awaress about health insurance products. Options Number of respondents Percentage Advertisement 9 19 Friends 20 41 Agents 17 31 Others 4 9 Total 50 100 The above table depicts that 41% of the respondents got awareness about health insurance through their friends, 31% through agents, 19% through advertisements, and 9% from other sources.

Maximum (41%) of the respondents a warn about health insurance products through their friends. 5) Verification of ID cards with expiry date Options Yes No Total Number of Respondent 42 8 50 Percentage 83 17 100

The above table clearly states that 83% of the respondents verify the ID card with expiry date and 17% of majority (83%) of the respondents verity the ID card with expiry date the respondents verify the ID card with expiry date. 6) Discount for own lab and pharmacy usage. Options Yes No Total Number of Respondent 13 37 50 Percentage 27 73 100

The above table shows that 73% of the hospital respondents do not allow discount for using their own lab pharmacy and 27% of the hospital respondents allow discount for using their own lab and pharmacy. Majority (73%) of he hospital respondents do not allow discount for using their own lab and pharmacy. 7) Gender having the higher risk of disease occurrence Options Male Female Total Number of Respondent 21 29 50 Percentage 40 60 100

The above table reveals that 60% of the hospital respondents feel that females have the higher risk of disease occurrence and 40% feels that male have the higher risk of disease occurrence. Majority (60%) of the hospital respondents feel that females have the higher risk of disease occurrence.

8) Appointment of PRO/Administrative officer for health insurance policy TPA service. Options Yes No Total Number of Respondent 37 13 50 Percentage 74 26 100

The above table states that 74% of the hospital respondents have appointed PRO/administrative officer for health insurance policy TPA service and 26% of the hospital respondents have not appointed PRO/administrative officer. Majority (74%) of the hospital respondents have appointed PRO/administrative officer for health insurance policy TPA services. 9) Awareness about Hello Healthy facility Options Yes No Total Number of Respondent 6 44 50 Percentage 12 88 100

The above table indicates that 88% of the hospital respondents are not aware of hello healthy facility offered by UIIC. And 12% of the hospital respondents are aware of hello healthy facility. Majority (88%) of the hospital respondents are not aware of hello healthy facility. 10) Reason for increase in number of policy holders.

Options Publicity Detarrification Entry of private players Public necessity Total

Number of Respondent 7 6 13 24 50

Percentage 14 12 26 48 100

The above table represents that 48% of the hospital respondents feel that public necessity is the reason for increasing number necessity is the reason for increasing in number of policy holders, 26% feel the reason as the entry of private players, 14% feel the reason as publicity & 12% feel the reason as detarrification.

Maximum (48%) of the hospital respondents feel that public necessity is the reason for increase in number of policy holders. 11) Acceptance of free health check up during 3 claim free policy period. Options Yes No Total Number of Respondent 37 13 50 Percentage 74 26 100

The above table confers that 74% of the hospital respondents accept giving free health check up during 3 claim free policy periods & 26% do not accept in giving free health check up during 3 claim free policy period. Majority (74%) of the hospital respondents accept giving free health check up during 3 claim free policy periods. 12) Simple Claim reimbursement procedure Options Yes No Total Number of Respondent Percentage 81 19 100

From the above table it may be clearly stated that 81% of the hospital respondents feel that the claim reimbursement procedure is very simple and 19% of the hospital respondents feel that claim reimbursement procedure is not simple in IM Warne companies . Majority(81%) 13)Frequent Inspection from the UIIC Company. Options Yes No Total Number of Respondent 4 46 50 Percentage 9 91 100

The about table depicts that 91% of the hospital respondents feel that there is no frequent inspection from the UIIC and 9% of the hospital respondents feel that there is frequent inspection from the UIIC. Majority (91%) of the hospital respondents feel that there is no frequent inspection from the UIIC.

14) Free approach to TPA during the week ends for the purpose of pre authorization letter. Options Yes No Total Number of Respondent 37 13 50 Percentage 74 26 100

The above table portraits that 74% of the hospital respondents feel there is free approach to TPA during the week ends for the purpose of pre authorization letter, and 26% of the hospital respondents feel there is no free approach to TPA. Majority (74%) of the hospital respondents feel there is free approach to TPA during the week ends for the purpose of pre authorization letter. 15) Maintenance patients past history Options Yes No Total Number of Respondent 50 Percentage 22 78 100

The above table indicates that 78% of the hospital respondents do not maintain the patients past history and case summary in a systematic manner 22% of he hospital respondents maintain the patients past history and case summary in a systematic manner. Majority (78%) of the hospital respondents do not maintain the patients post history and case summary in a systematic manner.

INTERPRETATION OR CORPORATE CLIENTS

1. Number of employees

Options Less than 100 101-500 50l-1000 1000 and above Total

Number of Respondent 8 25 10 7 50

Percentage 16 50 20 14 100

From the above table it is clear that 50% of the company are 101-500 employees 20% of the Company have 501-1000 employees, 16% of he Company have less than 100 employees, 14% of the company have 1000 employees. Majority (50%) of the Companies have 101-500 employees. 2. Number of yrs coverage Options 0-2 2-4 4-6 Above 6 Total Number of Respondent 22 18 7 3 50 Percentage 44 36 14 6 100

From the above table it is clear that 44% of Insurance policy for 0-2 yrs 36% of the employees are covered this policy for 24yrs 14yr of the employees are covered under policy for 4-6 yrs, 6% of the employee are cover under this policy for above 6 yrs Majority (44%) of the employees are covered under Health Insurance policy for 10-2 yrs. 3) Use of hazardous or pollution contaminated products. Options Yes No Total Number of Respondent 33 17 50 Percentage 66 44 100

From the above table it is clear that 66% of the companies use hazardous or pollution contaminated products, 44% do not use hazardous or pollution contaminated products. Majority (66%) of comparable sector use hazardous or pollution contaminated products. 4) Purpose of taking the Health Insurance policy. Options Tax benefit Minimize the loss Illness Others Total Number of Respondent 5 15 25 5 50 Percentage 10 30 50 10 100

From the above table it is clear that 50% of them health Insurance policy for illness coverage, 30% of them health Insurance policy to minimize the loss, 10% of the take this policy for both tax benefit and others equally. Majority (50%) of them take this policy for illness coverage 5) Premium rates of health Insurance policy in UIIC. Options Abnormal No Total Number of Respondent 30 20 50 Percentage 60 40 100

From the above table it is clear that 60% of them feel that the premium rates of health Insurance policy in UIIC is Abnormal,40% of them feel that the premium rates of health Insurance policy in UIIC is normal. Majority (60%) of them feel that a premium rate in health insurance policy in UIIC is Abnormal.

6) Type of policy (Abnormal) Options Group Individual Total Number of Respondents 11 19 30 Percentage 36 64 100

From the above table it is clear that 64% of them feel that the premium rates is Abnormal in Individual policy, 36% of them feel that premium rate is normal in Group policy. Majority (64%) of them feel that the premium rates is abnormal individual policy 7 Riders Convenient Options Yes Number of Respondent 41 Percentage 82

No Total

9 50

18 100

From the above table it is clear that 82% of them feel that the riders are convenient, 18% of them feel that riders are not convenient. Majority (82%) of the feel that the riders are convenient in UIIC. 8) Premium rates charged according to the diseases Options Yes No Total Number of Respondent 6 44 50 Percentage 12 88 100

From the above table it is clear that 88% of them feel that the premium rates are not charged according to the diseases, 12% of them. Feel that the Premium is charged according to the diseases. Majority (88%) of them feel that the premium rates are not charged according to the diseases. 9) Necessary exceptions. Options Majority benefit Floater policy Pre existing Policy Exclusion diseases coverage Total Number of Respondent 10 15 8 17 50 Percentage 20 30 16 34 100

From the above table it is clear that 34% of them feel that exclusion disease coverage should be included, 30% of them feel that forted policy, 20% of them feel that maternity benefit, and 16% of them feel that pre existing policy. Majority (34%) of them feel that exclusion disease coverage should be included. 10) Ready ness of the respondents to pay extra premium for already for already existing disease. Options Yes No Total Number of Respondent 40 10 50 Percentage 80 20 100

From the above table it is clear that 80% of them are ready to pay extra premium for already existing diseases, 20% of them are not ready to pay extra premium hour already existing diseases.

11) Awareness about TO PUP and super top up medic aim policy Options Yes No Total Number of Respondent 8 42 50 Percentage 16 84 100

From the above table it is clear that 84% of them are not a warn about TOP UP and super TOP UP mediclaim policy (6%) of them are aware about TOP UP and super TOP UP mediclaim policy. Majority (84%) of them are not awarne about TOP UP and super TOP UP mediclaim policy.