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Customers perception toward health insurance empirical study in Ahmadabad region

A Project Report on
Management Research Project
Of
Customers Perception toward Health Insurance Empirical Study in
Ahmadabad Region
SUBMITTED BY:-

Exam No Name
01

Anand Aarti

02

Desai Gunjan

09

Rahul Nisarta

SUBMITTED TO:-

Ganpat University

GANPAT UNIVERSITY
Center for Management Studies
Ahmadabad
MBA (FS) SEM IV

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Customers perception toward health insurance empirical study in Ahmadabad region

Certificate from the Faculty Guide

This is to certify that the dissertation submitted in partial fulfillment for the award of MBA (FS)
of Center For Management Study, Ganpat University is a result of the bonafide research work
carried out by Mr RAHUL NISARTA, Mr GUNJAN DESAI And Miss ANAND AARTI under
my supervision and guidance. No part of this report has been submitted for award of any other
degree, diploma, fellowship or other similar titles or prizes. The work has also not been
published in any journals/Magazines.

Signature of the Faculty Guide: ______________

Name of Faculty Guide: Prof. Umesh Pithadiya

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Customers perception toward health insurance empirical study in Ahmadabad region

Students Declaration

I hereby declare that this report, submitted in partial fulfillment of the requirement for the award
for the MBA (FS), to Center For Management Study, Ganpat University is my original work and
not used anywhere for award of any degree or diploma or fellowship or for similar titles or
prizes.
I further certify that without any objection or condition subject to the permission of the company
where I did my summer project, I grant the rights to Center For Management Study, Ganpat
University to publish any part of the project if they deem fit in journals/Magazines and
newspapers etc. without my permission.

Signature:MBA Program (FS) Semester IV

Exam No Name

MBA (FS) SEM IV

01

Anand Aarti

02

Desai Gunjan

09

Rahul Nisarta

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Customers perception toward health insurance empirical study in Ahmadabad region

PREFACE
This Project Report has been prepared in partial fulfillment of the requirement for the Subject:
Project (Financial Services) of the Semester IV in the Semester 2015.
For preparing the Research Project Report, The blend of learning and knowledge acquired
during our practical studies at the company is presented in this Project Report.
Our main focus and study was on Customers Perception toward Health Insurance Empirical
Study on Ahmadabad region.
We have put up my best efforts and enumerated every possible information while collecting
Primary and secondary data.
Lastly, we have tried our level best to prepare the best informative report.

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Customers perception toward health insurance empirical study in Ahmadabad region

ACKNOWLEDGEMENT
It was indeed an opportunity for us to do research Customers Perception toward Health
Insurance Empirical Study on Ahmadabad Region. To Prepare a Project Report on the same
during Semester IV. During our Research study preparation, we learn many interesting things
about the Research, along with the aspects of its process and as a whole.
We would here by take this opportunity to show our gratitude towards all our faculties for
what we have learnt during Research Study. A good response, explanation of concepts and cooperation given by whole staff helped us in gaining knowledge and solving our queries.
I feel immense pleasure to thank Prof. Umesh Pithadiya, C.M.S. Ganpat University. For
making available all faculties in fulfill the requirements for the research report.

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Customers perception toward health insurance empirical study in Ahmadabad region


TABLE OF CONTENTS FOR PROJECT REPORT

Sr.No

Particular

Page
No.

Front Page

Certificate

II

Preface

III

Acknowledgement

IV

Chapter-1
Introduction

Chapter-2
History Of Insurance

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Chapter-6
Data Analysis

50

Anova Test

72

Chapter-7
Finding

33

Chapter-5
Research Methodology

30

Chapter-4
Health Insurance In India

12

Chapter-3
Literature Review

79

Chapter-8

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Customers perception toward health insurance empirical study in Ahmadabad region

Conclusion
9

81

Chapter-9
Bibliography

83

Annexture

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Introduction
1. Background:Over the last 50 years India has achieved a lot in terms of health improvement. But still India is
way behind many fast developing countries such as China, Vietnam and Sri Lanka in health
indicators (Satia et al 1999). In case of government funded health care system, the quality and
access of services has always remained major concern. A very rapidly growing private health
market has developed in India. This private sector bridges most of the gaps between what
government offers and what people need. However, with proliferation of various health care
technologies and general price rise, the cost of care has also become very expensive and
unaffordable to large segment of population. The government and people have started exploring
various health financing options to manage problems arising out of growing set of complexities
of private sector growth, increasing cost of care and changing epidemiological pattern of
diseases.
The new economic policy and liberalization process followed by the Government of India since
1991 paved the way for privatization of insurance sector in the country. Health insurance, which
remained highly underdeveloped and a less significant segment of the product portfolios of the
nationalized insurance companies in India, is now poised for a fundamental change in its
approach and management. The Insurance Regulatory and Development Authority (IRDA) Bill,
recently passed in the Indian Parliament, is important beginning of changes having significant
implications for the health sector.
The privatization of insurance and constitution IRDA envisage to improve the performance of
the state insurance sector in the country by increasing benefits from competition in terms of
lowered costs and increased level of consumer satisfaction. However, the implications of the
entry of private insurance companies in health sector are not very clear. The recent policy
changes will have been far reaching and would have major implications for the growth and
development of the health sector. There are several contentious issues pertaining to development
in this sector and these need critical examination. These also highlight the critical need for policy
formulation and assessment. Unless privatization and development of health insurance is
managed well it may have negative impact of health care especially to a large segment of
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population in the country. If it is well managed then it can improve access to care and health
status in the country very rapidly.
Health insurance as it is different from other segments of insurance business is more complex
because of serious conflicts arising out of adverse selection, moral hazard, and information gap
problems. For example, experiences from other countries suggest that the entry of private firms
into the health insurance sector, if not properly regulated, does have adverse consequences for
the costs of care, equity, consumer satisfaction, fraud and ethical standards. The IRDA would
have a significant role in the regulation of this sector and responsibility to minimize the
unintended consequences of this change.
Health sector policy formulation, assessment and implementation is an extremely complex task
especially in a changing epidemiological, institutional, technological, and political scenario.
Further, given the institutional complexity of our health sector programmes and the pluralistic
character of health care providers, health sector reform strategies in the context of health
insurance that have evolved elsewhere may have very little suitability to our country situation.
Proper understanding of the Indian health situation and application of the principles of insurance
keeping in view the social realities and national objective are important.

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2.1 HISTORY OF INSURANCE IN INDIA


In India, insurance has a 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 loans and
carriers contracts. Insurance in India has evolved over time heavily drawing from other
countries, England in particular.
1818 saw the advent of life insurance business in India with the establishment of the Oriental
Life Insurance Company in Calcutta. This Company however failed in 1834. In 1829, the
Madras Equitable had begun transacting life insurance business in the Madras Presidency. 1870
saw the enactment of the British Insurance Act and in the last three decades of the nineteenth
century, the Bombay Mutual (1871), Oriental (1874) and Empire of India (1897) were started in
the Bombay Residency. This era, however, was dominated by foreign insurance offices which
did good business in India, namely Albert Life Assurance, Royal Insurance, Liverpool and
London Globe Insurance and the Indian offices were up for hard competition from the foreign
companies.
In 1914, the Government of India started publishing returns of Insurance Companies in India.
The Indian Life Assurance Companies Act, 1912 was the first statutory measure to regulate life
business. In 1928, the Indian Insurance Companies Act was enacted to enable the Government to
collect statistical information about both life and non-life business transacted in India by Indian
and foreign insurers including provident insurance societies. In 1938, with a view to protecting
the interest of the Insurance public, the earlier legislation was consolidated and amended by the
Insurance Act, 1938 with comprehensive provisions for effective control over the activities of
insurers.
The Insurance Amendment Act of 1950 abolished Principal Agencies. However, there were a
large number of insurance companies and the level of competition was high. There were also
allegations of unfair trade practices. The Government of India, therefore, decided to nationalize
insurance business.
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An Ordinance was issued on 19th January, 1956 nationalising the Life Insurance sector and Life
Insurance Corporation came into existence in the same year. The LIC absorbed 154 Indian, 16
non-Indian insurers as also 75 provident societies245 Indian and foreign insurers in all. The
LIC had monopoly till the late 90s when the Insurance sector was reopened to the private sector.
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 Associaton of
India. The General Insurance Council framed a code of conduct for ensuring fair conduct and
sound business practices.
In 1968, the Insurance Act was amended to regulate investments and set minimum solvency
margins. The Tariff Advisory Committee was also set up then.
In 1972 with the passing of the General Insurance Business (Nationalisation) Act, general
insurance business was nationalized with effect from 1 st January, 1973. 107 insurers were
amalgamated and grouped into four companies, namely National Insurance Company Ltd., the
New India Assurance Company Ltd., the Oriental Insurance Company Ltd and the United India
Insurance Company Ltd. The General Insurance Corporation of India was incorporated as a
company in 1971 and it commence business on January 1sst 1973.
This millennium has seen insurance come a full circle in a journey extending to nearly 200 years.
The process of re-opening of the sector had begun in the early 1990s and the last decade and
more has seen it been opened up substantially. In 1993, the Government set up a committee
under the chairmanship of RN Malhotra, former Governor of RBI, to propose recommendations
for reforms in the insurance sector.The objective was to complement the reforms initiated in the
financial sector. The committee submitted its report in 1994 wherein , among other things, it
recommended that the private sector be permitted to enter the insurance industry. They stated

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Customers perception toward health insurance empirical study in Ahmadabad region


that foreign companies be allowed to enter by floating Indian companies, preferably a joint
venture with Indian partners.
Following the recommendations of the Malhotra Committee report, in 1999, the Insurance
Regulatory and Development Authority (IRDA) was constituted as an autonomous body to
regulate and develop the insurance industry. The IRDA was incorporated as a statutory body in
April, 2000. The key objectives of the IRDA include promotion of competition so as to enhance
customer satisfaction through increased consumer choice and lower premiums, while ensuring
the financial security of the insurance market.
The IRDA opened up the market in August 2000 with the invitation for application for
registrations. Foreign companies were allowed ownership of up to 26%. The Authority has the
power to frame regulations under Section 114A of the Insurance Act, 1938 and has from 2000
onwards framed various regulations ranging from registration of companies for carrying on
insurance business to protection of policyholders interests.
In December, 2000, the subsidiaries of the General Insurance Corporation of India were
restructured as independent companies and at the same time GIC was converted into a national
re-insurer. Parliament passed a bill de-linking the four subsidiaries from GIC in July, 2002.
Today there are 14 general insurance companies including the ECGC and Agriculture Insurance
Corporation of India and 14 life insurance companies operating in the country.
The insurance sector is a colossal one and is growing at a speedy rate of 15-20%. Together with
banking services, insurance services add about 7% to the countrys GDP. A well-developed and
evolved insurance sector is a boon for economic development as it provides long- term funds for
infrastructure development at the same time strengthening the risk taking ability of the country.

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2.2 MILESTONES IN INDIAN LIFE INSURANCE BUSINESS

1912: The Indian Life Assurance Companies Act came into force for regulating the life
insurance business.

1928: The Indian Insurance Companies Act was enacted for enabling the government to
collect statistical information on both life and non-life insurance businesses.

1938: The earlier legislation consolidated the Insurance Act with the aim of safeguarding
the interests of the insuring public.

1956: 245 Indian and foreign insurers and provident societies were taken over by the
central government and they got nationalized. LIC was formed by an Act of Parliament,
viz. LIC Act, 1956. It started off with a capital of Rs. 5 crore and that too from the
Government of India.

The history of general insurance business in India can be traced back to Triton Insurance
Company Ltd. (the first general insurance company) which was formed in the year 1850 in
Kolkata by the British.

2.3 IMPORTANT MILESTONES IN THE INDIAN INSURANCE


BUSINESS

1907: The Indian Mercantile Insurance Ltd. was set up which was the first company of its
type to transact all general insurance business.

1957: General Insurance Council, an arm of the Insurance Association of India, framed a
code of conduct for guaranteeing fair conduct and sound business patterns.

1968: The Insurance Act improved for regulating investments and set minimal solvency
levels and the Tariff Advisory Committee was set up.

1972: The General Insurance Business (Nationalization) Act, 1972 nationalized the
general insurance business in India. It was with effect from 1st January 1973.

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107 insurers integrated and grouped into four companies viz. the National Insurance Company
Ltd., the New India Assurance Company Ltd., the Oriental Insurance Company Ltd. and the
United India Insurance Company Ltd. GIC was incorporated as a company.

Economic policy context and imperatives of liberalization of insurance sector:


There are several imperatives for opening of the insurance and health insurance sector in India
for private investment. Here we review some of these imperatives. Economic policy reforms
started during late eighties and speeded up in nineties are the context in which liberalization of
insurance sector happened in India. It was very obvious that the liberalization of the real
(productive) and financial sector of the economy has to go hand in hand. It is imperative that
these sectors are consistent with policies of each other and unless both function efficiently and
are in equilibrium, it would be difficult to ensure appropriate economic growth. Given these facts
liberalization of both sectors has to proceed simultaneously.Indian economic system has been
developed on paradigm of mixed economy in which public and private enterprises co-exist. The
past strategies of development based on socialistic thinking were focusing on the premise of
restrictions, regulations and control and less on incentives and market driven forces. This
affected the development process in the country in serious way. After the economic liberalization
the paradigm changed from central planning, command and control to market driven
development. Deregulation, decontrol, privatization, delicensing, globalization became the key
strategies to implement the new framework and encourage competition. The
social sectors did not remain unaffected by this change. The control of government expenditure,
which became a key tool to manage fiscal deficits in early 1990s, affected the social sector
spending in major way. The unintended consequences of controlling the fiscal deficits have been
reduction in capital expenditure and non-salary component of many social sector
programmes.This has led to severe resource constraints in the health sector in respect of nonsalary expenditure and this has affected the capacity and credibility of the government health
care system to deliver good quality care over the years. Given the increasing salaries, lack of
effective monitoring and lack of incentives to provide good quality services the provides in the
government sector became indifferent to the clients. Clients also did not demand good quality
and better access, as government services were free of cost.
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Customers perception toward health insurance empirical study in Ahmadabad region


Under this situation more and more clients turned to the private sector health providers and thus
the private sector healthcare has expanded. Given the socialistic political thinking and populist
policy it has been generally difficult for any government to introduce cost recovery in public
health sector. Given that government is unable to provide more resources for health care, and
institute cost recovery, one of the ways to reduce the under-funding and augment the resources in
the health sector was to encourage the development health insurance.
Another imperative for liberalization of the insurance sector was the need for long-term financial
resources on sustainable basis for the development of infrastructure sector such as roads,
transports etc. It was realized that during the course of economic liberalization, the funds to
development the infrastructure also became a major constraint. Country certainly needed
infrastructure development. For this the finances are major constraint. In these investments the
benefits are more social than private. The major concern was how these finances can be made
available at low costs. In past the development of social sector were financed using government
channeled funds through various semi-government financial institutions. Under the liberalized
economy this may not be possible. One hope is that if the insurance sector develops rapidly
under privatization then it can provide long-term finance to the infrastructure sector.
The financial sector, which consists of banks, financial institutions, insurance companies,
Provident funds schemes, mutual funds were all under government control. There was less
competition across these units. As a result these institutions remained significantly less
developed in their approach and management. Insurance sector has been most affected by the
government controls. Government had significant control on the policies these insurance
companies could offer and utilization of the resources mobilized by insurance companies. One
can see that most of the insurance products (e.g., life insurance products) were promoted as
mechanisms to improve the savings and tax shelters rather as risk coverage instruments. Other
segments of the insurance products grew because of the statutory obligations (e.g., Motor
Vehicle, Marine and Fire) under various acts. The management and organization of insurance
sector companies remained less developed and they neglected new product development and
marketing. Thus one of the hopes in opening of the insurance sector was that the private and
foreign companies would rapidly develop the sector and improve coverage of the population
with insurance using new products and better management.
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Last imperative for opening of the insurance sector was signing the WTO India. After this there
was little choice but to open the entire financial sector - including insurance sector to private and
foreign investors. (Dholakia 1999).

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2.4 LIST OF INSURANCE COMPANIES IN INDIA:LIFE INSURERS

Websites

Public Sector
Life Insurance Corporation of India

www.licindia.com

Private Sector
Allianz Bajaj Life Insurance Company Limited

www.allianzbajaj.co.in

Birla Sun-Life Insurance Company Limited

www.birlasunlife.com

HDFC Standard Life Insurance Co. Limited

www.hdfcinsurance.com

ICICI Prudential Life Insurance Co. Limited

www.iciciprulife.com

ING Vysya Life Insurance Company Limited

www.ingvysayalife.com

Max New York Life Insurance Co. Limited

MetLife Insurance Company Limited

Om Kotak Mahindra Life Insurance Co. Ltd.

SBI Life Insurance Company Limited

MBA (FS) SEM IV

www.maxnewyorklife.co
m
www.metlife.com
www.omkotakmahnidra.
com
www.sbilife.co.in

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Customers perception toward health insurance empirical study in Ahmadabad region

TATA AIG Life Insurance Company Limited

www.tata-aig.com

AMP Sanmar Assurance Company Limited

www.ampsanmar.com

Dabur CGU Life Insurance Co. Pvt. Limited

www.avivaindia.com

GENERAL INSURERS
Public Sector

National Insurance Company Limited

New India Assurance Company Limited

Oriental Insurance Company Limited

United India Insurance Company Limited

www.nationalinsurancein
dia.com
www.niacl.com
www.orientalinsurance.n
ic.in
www.uiic.co.in

Private Sector
Bajaj Allianz General Insurance Co. Limited

www.bajajallianz.co.in

ICICI Lombard General Insurance Co. Ltd.

www.icicilombard.com

IFFCO-Tokio General Insurance Co. Ltd.

www.itgi.co.in

Reliance General Insurance Co. Limited

www.ril.com

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Customers perception toward health insurance empirical study in Ahmadabad region

Royal Sundaram Alliance Insurance Co. Ltd.

www.royalsun.com

TATA AIG General Insurance Co. Limited

www.tata-aig.com

Cholamandalam General Insurance Co. Ltd.

www.cholainsurance.com

Export Credit Guarantee Corporation

www.ecgcindia.com

HDFC Chubb General Insurance Co. Ltd.


REINSURER
General Insurance Corporation of India

www.gicindia.com

2.5 CONCEPT AND FUNCTIONS OF INSURANCE:Insured, are you? The functions of Insurance will give you an idea on how to go ahead with the
approach of insurance and what type of insurance to choose. In a layman's words, insurance
means, a guard against pecuniary loss arising on the happening of an unforeseen event. In
developing economies, the insurance sector still holds a lot of potential which can be tapped.
Majority of the people in the developing countries remains unaware of the functions and benefits
of insurance and it is for this reason that the insurance sector is still to grow.
Tangible or intangible an individual can insure anything! Be it a house, car, factory, or the
voice of a singer, leg of a footballer, and the hand of an author.....etc. It is possible to insure all
these as they have the possibility of becoming non functional by any disaster or an accident.

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2.6 BASIC FUNCTIONS OF INSURANCE:1. Primary Functions


2. Secondary Functions
3. Other Functions
Primary functions of insurance

Providing protection The elementary purpose of insurance is to allow security against


future risk, accidents and uncertainty. Insurance cannot arrest the risk from taking place,
but can for sure allow for the losses arising with the risk. Insurance is in reality a
protective cover against economic loss, by apportioning the risk with others.

Collective risk bearing Insurance is an instrument to share the financial loss. It is a


medium through which few losses are divided among larger number of people. All the
insured add the premiums towards a fund and out of which the persons facing a specific
risk is paid.

Evaluating risk Insurance fixes the likely volume of risk by assessing diverse factors
that give rise to risk. Risk is the basis for ascertaining the premium rate as well.

Provide Certainty Insurance is a device, which assists in changing uncertainty to


certainty.

Secondary functions of insurance

Preventing losses Insurance warns individuals and businessmen to embrace


appropriate device to prevent unfortunate aftermaths of risk by observing safety
instructions; installation of automatic sparkler or alarm systems, etc.

Covering larger risks with small capital Insurance assuages the businessmen from
security investments. This is done by paying small amount of premium against larger
risks and dubiety.

Helps in the development of larger industries Insurance provides an opportunity to


develop to those larger industries which have more risks in their setting up.

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Customers perception toward health insurance empirical study in Ahmadabad region


Other functions of insurance

Is a savings and investment tool Insurance is the best savings and investment option,
restricting unnecessary expenses by the insured. Also to take the benefit of income tax
exemptions, people take up insurance as a good investment option.

Medium of earning foreign exchange Being an international business, any country


can earn foreign exchange by way of issue of marine insurance policies and a different
other ways.

Risk Free trade Insurance boosts exports insurance, making foreign trade risk free
with the help of different types of policies under marine insurance cover.

Insurance provides indemnity, or reimbursement, in the event of an unanticipated loss or disaster.


There are different types of insurance policies under the sun cover almost anything that one
might think of. There are loads of companies who are providing such customized insurance
policies.

2.7 CHALLENGES FACING INSURANCE INDUSTRY:

Threat of New Entrants: The insurance industry has been budding with new entrants
every other day. Therefore the companies should carve out niche areas such that the
threat of new entrants might not be a hindrance. There is also a chance that the big
players might squeeze the small new entrants.

Power of Suppliers: Those who are supplying the capital are not that big a threat. For
instance, if someone as a very talented insurance underwriter is presently working for a
small insurance company, there exists a chance that any big player willing to enter the
insurance industry might entice that person off.

Power of Buyers: No individual is a big threat to the insurance industry and big
corporate houses have a lot more negotiating capability with the insurance companies.
Big corporate clients like airlines and pharmaceutical companies pay millions of dollars
every year in premiums.

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Customers perception toward health insurance empirical study in Ahmadabad region

Availability of Substitutes: There exist a lot of substitutes in the insurance industry.


Majorly, the large insurance companies provide similar kinds of services be it auto,
home, commercial, health or life insurance.

How

to

choose

an

insurance

company?

There are many factors to probe into when an investor chose an insurance company.

The consumers as well as the investors should only focus on the insurer's financial
strength and capability to meet ongoing responsibilities to its policyholders.

The fundamentals of the insurance company should be strong and should not indicate a
poor investment opportunity as this might also deter growth.

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2.8 TOP INSURANCE COMPANIES IN INDIA:LifeInsuranceCorporationofIndiaThe Life Insurance Corporation of India (LIC) is undoubtedly India's largest life insurance
company. Fully owned by government, LIC is also the largest investor of the country. LIC has an
estimated asset of Rs. 8 Trillion. It also funds almost 24.6% of the expenses of Government of
India.
Established in 1956 and headquartered in Mumbai, Life Insurance Corporation of India has 8
zonal offices, 100 divisional offices, 2,048 branch offices and a vast network of 10,02,149 agents
spread

across

the

country.

TataAIGInsuranceSolutionsTata AIG Insurance Solutions, one of the leading insurance providers in India, started its
operation on April 1, 2001. A joint venture between Tata Group (74% stake) and American
International Group, Inc. (AIG) (26% stake), Tata AIG Insurance Solutions has two different
units for life insurance and general insurance. The life insurance unit is known as Tata AIG Life
Insurance Company Limited, whereas the general insurance unit is known as Tata AIG General
Insurance Company Limited.

AVIVALifeInsuranceAVIVA Life Insurance, one of the popular insurance companies in India, is a joint venture
between the renowned business group, Dabur and the largest insurance group in the UK, Aviva
plc. AVIVA Life Insurance has an extensive network of 208 branches and about 40
Bancassurance partnerships, spread across 3,000 cities and towns across the country. There are
more than 30,000 Financial Planning Advisers (FPAs) working for AVIAV Life Insurance. It
offers various plans like Child, Retirement, Health, Savings, Protection and Rural.

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MetLifeInsuranceMetLife India Insurance Company Limited is another popular player in Indian insurance sector.
A joint venture between the Jammu and Kashmir Bank, M. Pallonji and Co. Private Limited and
other private investors and MetLife International Holdings, Inc., MetLife Insurance offers a wide
range of financial solutions to its customers including Met Suraksha, Met Suraksha TROP, Met
Mortgage Protector and Met Suraksha Plus etc. It has its branches situated over 600 locations
across

the

country.

More

than

50,000

Financial

Advisors

work

for

MetLife.

INGVysyaLifeInsuranceING Vysya Life Insurance entered into the Indian insurance industry in September 2001. A joint
venture between ING Group, Ambuja Cements, Exide Industries and Enam Group, ING Vysya
Life Insurance uses its two channels, viz. the Alternate Channel and the Tied Agency Force to
distribute its products. The first channel has branches in 234 cities across the country and has got
366 sales teams. On the other hand, the later one has more than 60,000 advisors. Currently, ING
Vysya

Life

Insurance

has

tie

ups

with

more

than

200

cooperative

banks.

BirlaSunLifeFinancialServicesBirla Sun Life Financial Services is a joint venture between Aditya Birla Group and Sun Life
Financial Inc, Canada. It has got an extensive network of more than 600 branches. More than
1,75,000 empanelled advisors work for Birla Sun Life, which currently covers over 2 million
lives.

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MAXNewYorkLifeMax New York Life Insurance Company Ltd. is one of the top insurance companies in India. A
joint venture between Max India Limited and New York Life International (a part of the Fortune
100 company - New York Life), Max New York Life Insurance Company Ltd. started its
operation in April 2001. It currently has around 715 offices located in 389 cities across the
country. It also has around 75,832 agent advisors. Max New York Life offers 39 products, which
cover

both,

life

and

health

insurance.

BajajAllianzBajaj Allianz is a joint venture between Bajaj Finserv Limited and Allianz SE, where Bajaj
Finserv Limited holds 74% of the stake, whereas Allianz SE holds the rest 26% stake. Bajaj
Allianz has been rated iAAA by ICRA for its ability to pay claims. The company also achieved a
growth of 11% with a premium income of Rs. 2866 crore as on March 31, 2009.

BhartiAXALifeInsuranceBharti AXA Life Insurance, one of the top insurance companies in India, is a joint venture
between Bharti group and world leader AXA. Bharti holds 74% stakes, whereas AXA holds the
rest of 26%. Bharti AXA has its branches located in 12 states across the country. It offers a range
of individual, group and health plans for its customers. Currently more than 8000 employees
work

MBA (FS) SEM IV

for

Bharti

AXA

Life

Insurance.

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Customers perception toward health insurance empirical study in Ahmadabad region

Objective
The main objective of the research is to know the customer perception toward health
insurance and there need and the see the insurance company has completed there
satisfaction level and the customer are willing to continue the policy for a long period of
time
Another objective that survey will make the fix target that all the age limit and the make
the awareness to all the age criteria that how health policy is important and in the that
which criteria of age and occupation and income are preferring more policy and from
number of policy holder how many are satisfied by the company and going to contuse the
policy after ending the current policy holding

Limitations
The study is confined to limited period.
Accuracy of the study is purely based on the Primary and secondary data.
The analysis and conclusion made by me as per my limited understanding and there may
be something variation in the actual situation.

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Customers perception toward health insurance empirical study in Ahmadabad region

MBA (FS) SEM IV

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Customers perception toward health insurance empirical study in Ahmadabad region


Health insurance is a mechanism by which a person protects himself from financial loss caused
due to accident and or disability. Though disability is not fixed, precise and immutable state
affected as it is by numerous influences, both objective and subjective, its significance to society
is that condition of ill health arising from disease or injury that prevents the individual from
pursuing his normal routine of living. The universality of the hazard of disability is everywhere
recognized; just as uncertainty is one of the fundamental facts of life (Knight 1921).
It is may be because of this reason why the earlier society looked into health insurance as a
mechanism to reduce the uncertainty attached to disability. In no line of human endeavor does
the interdependence of men manifest itself more clearly than in insurance. Although the
insurance principle is centuries old, planned achievement of security through transfer or sharing
of risk has developed only with modern society. When man lived alone or in primitive family
groups, insurance in a formal sense was unnecessary. Each family cared for its own as best it
could. When community living became more complex, men recognized the need for a system by
which they could help each other in times of adversity. From this need to have the assurance of
help in the event of misfortune grew the earliest insurance plans (Kelly 1951).
The possible way to fund the financial loss due to ill health could be either through out of pocket
payment, by paying premium to the insurance company or by contribution from the state or
central government. The natural solution is to insure against the possibility of medical illness by
poling risk with others in population. In the case of insurance, the benefit is that the annual
consumption of the family would be reduced only by the premium, the average cost of care. By
paying a fixed amount each term consumers will be able to protect themselves from large
medical cost in future. This argument for instance is based on the expected utility theory and
the premise that people generally prefer certainty to risk (Neumann and Morgenstern 1944).
According to this theory, if consumers are sufficiently averse to financial risk, firms selling
insurance can charge premium that cover the expected coverage losses plus a loading fee, and
still sell insurance.

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Customers perception toward health insurance empirical study in Ahmadabad region


The top ten percent of users account for nearly three quarters of total medical spending (Berk and
Monheit 2001). Therefore, in such a situation, health insurance is one important method which
helps significantly to spread the risk.
it is one of the significant drivers of improvement in the healthcare provision by encouraging
investment and innovation. This mechanism also helps in improving the quality and efficiency of
public health care system by continually benchmarking it (Ahuja 2005).
Wang et al. (2006) examined adverse selection in a subsidized voluntary health insurance
scheme, the Rural Mutual Health Care (RMHC) scheme, in a poor rural area of China. The study
was made possible by a unique longitudinal data set: the total sample includes 3492 rural
residents from 1020 households. Logistic regression was employed for the data analysis. The
results show that although the subsidized scheme achieved a considerable high enrollment rate of
71 percent of rural residents, adverse selection still existed. In general, individuals with worse
health status are more likely to enroll in RMHC than individuals with better health status.
Most Americans purchase health insurance through employers, although the percentage of
employee-sponsored coverage declined from 69% to 60% between 1999 and 2010 (Fewer
employees getting health insurance at work, 2013). Nearly 84% of the 49 million uninsured
come from families with at least one worker; 62% include at least one full-time worker
(American Public Health Association, 2012; Kaiser Family Foundation, 2012a)

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Customers perception toward health insurance empirical study in Ahmadabad region

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4.1 HEALTH INSURANCE IN INDIA: CURRENT SCENARIO


Introduction
The health care system in India is characterised by multiple systems of medicine, mixed
ownership patterns and different kinds of delivery structures. Public sector ownership is divided
between central and state governments, municipal and Panchayat local governments. Public
health facilities include teaching hospitals, secondary level hospitals, first-level referral hospitals
(CHCs or rural hospitals), dispensaries; primary health centres (PHCs), sub-centres, and health
posts. Also included are public facilities for selected occupational groups like organized work
force (ESI), defence, government employees (CGHS), railways, post and telegraph and mines
among others. The private
sector (for profit and not for profit) is the dominant sector with 50 per cent of people seeking
indoor care and around 60 to 70 per cent of those seeking ambulatory care (or outpatient care)
from private health facilities. While India has made significant gains in terms of health indicators
- demographic, infrastructural and epidemiological (See Tables 1 and 2), it continues to grapple
with newer challenges. Not only have communicable diseases persisted over time but some of
them like malaria have also developed insecticide-resistant vectors while others like tuberculosis
are becoming increasingly drug resistant. HIV / AIDS has of late assumed extremely virulent
proportions. The 1990s have also seen an increase in mortality on account of non-communicable
diseases arising as a result of lifestyle changes. The country is now in the midst of a dual disease
burden of communicable and noncommunicable diseases. This is coupled with spiraling health
costs, high financial burden on the poor and erosion in their incomes. Around 24% of all people
hospitalized in India in a single year fall below the poverty line due to
Hospitalization (World Bank, 2002). An analysis of financing of hospitalization shows that large
proportion of people; especially those in the bottom four-income quintiles borrow money or sell
assets to pay for hospitalization (World Bank, 2002)
This situation exists in a scenario where health care is financed through general tax revenue,
community financing, out of pocket payment and social and private health insurance schemes.
India spends about 4.9% of GDP on health (WHR, 2002). The per capita total expenditure on
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Customers perception toward health insurance empirical study in Ahmadabad region


health in India is US$ 23, of which the per capita Government expenditure on health is US$ 4.
Hence, it is seen that the total health expenditure is around 5% of GDP, with breakdown of
public expenditure (0.9%); private expenditure (4.0%). The private expenditure can be further
classified as out-of-pocket (OOP) expenditure (3.6%) and employees/community financing
(0.4%). It is thus
evident that public health investment has been comparatively low. In fact as a percentage of GDP
it has declined from 1.3% in 1990 to 0.9% as at present. Furthermore, the central budgetary
allocation for health (as a percentage of the total Central budget) has been stagnant at 1.3% while
in the states it has declined from 7.0% to 5.5%.

Table 1. Socioeconomic indicators


Land area

2% of world area

Burden of disease (%)

21% of global disease burden

Population

16% of world population

Urban : Rural

28:72

Literacy rate (%)

65.38

Sanitation (%)

Rural 9.0; Urban 49.3

Safe drinking water supply Rural 98; Urban 90.2


(%)

Poverty (%)

Below poverty line 26


Rural 27.09; Urban 23.62

Poverty line (Rs.)

MBA (FS) SEM IV

Rural 327.56; Urban 454.11

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Customers perception toward health insurance empirical study in Ahmadabad region

4.2 Health sector and its financing: present scene and issues for the future:During the last 50 years India has developed a large government health infrastructure with more
than 150 medical colleges, 450 district hospitals, 3000 Community Health Centers, 20,000
Primary Health Care centers and 130,000 Sub-Health Centers. On top of this there are large
number of private and NGO health facilities and practitioners scatters though out the country.
Over the past 50 ears India has made considerable progress in improving its health status. Death
rate has reduced from 40 to 9 per thousand, infant mortality rate reduced from 161 to 71 per
thousand live births and life expectancy increased from 31 to 63 years.
However, many challenges remain and these are: life expectancy 4 years below world average,
high incidence of communicable diseases, increasing incidence of non- communicable diseases,
neglect of women's health, considerable regional variation and threat from environment
degradation. It is estimated that at any given point of time 40 to 50 million people are on
medication for major sickness in India. About 200 million workdays are lost annually due to
sickness. Survey data indicate that about 60% people use private health providers for outpatient
treatment while 60 % use government providers for in-door treatment. The average expenditure
for care is 2-5 times more in private sector than in public sector.
India spends about 6% of GDP on health expenditure. Private health care expenditure is 75% or
4.25% of GDP and most of the rest (1.75%) is government funding. At present, the insurance
coverage is negligible. Most of the public funding is for preventive, promotive and primary care
programmers while private expenditure is largely for curative care. Over the period the private
health care expenditure has grown at the rate of 12.84% per annum and for each one percent
increase in per capital income the private health care expenditure has increased by 1.47%.
Number of private doctors and private clinical facilities are also expanding exponentially. Indian
health financing scene raises number of challenges, which are: increasing health care costs, high
financial burden on poor eroding their incomes, increasing burden of new diseases and health
risks and neglect of preventive and primary care and public health functions due to underfunding
of the government health care. Given the above scenario exploring health-financing options
becomes critical. Health Insurance is considered one of the financing mechanisms to over come
some of the problems of our system.
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Customers perception toward health insurance empirical study in Ahmadabad region

4.3 Consumer and social perspective on health insurance:With the liberalization of insurance and entry of private companies in this business it is very
important that specific interventions are developed which focus on increasing the consumer
awareness about insurance products. One of the major challenges after privatization of insurance
would be how to develop such mechanisms, which help making consumers aware about the
various intricacies of insurance plans. As of now information, knowledge and awareness of
existing insurance plans is very limited. This is also shown by the study of Gumber and Kulkarni
(2000) among the members of SEWA, ESIS and mediclaim schemes. With Consumer Protection
Act coming in force it has become easy for aggrieved consumers to complain and seek redressal
for their problems. Consumer organizations such as CERC of Ahmedabad have been helping
consumers to get due justice in disputes with the insurance companies. Their experience would
be varying valuable in guiding development of health insurance plans that are transparent and
just.
Many a times the insurance claims are rejected due to some small technical reasons. This leads to
disputes. Most of the time the conditions and various points included in insurance policy
contracts is not negotiable and these are binding on consumers. There is no analysis on what is
fair practice and what is unfair practice. Given that insurance companies are large and almost
monopoly setting the consumers is treated as secondary and they do not have opportunity to
negotiate the terms and conditions of a contract. Many times insurance companies do not strictly
follow the conditions in all cases and this create confusion and disputes. (Shah M 1999)
The most important area of dispute and unfair treatment is the knowledge and implications of
pre-exiting conditions. A number of cases of litigation are disagreement on these pre-existing
conditions. These problems also arise because of lack of specification of number of areas and
properly spelling out the conditions. This is also because some chronic conditions such as high
blood pressure and diabetes can increase the risk of may other disease of organs such as heart,
kidney, vascular and eyes diseases. The patients with these pre-existing conditions are denied
claims for treatment of complications. This is not fair and leads to disputes.
Health insurance is typically annual and has to be renewed yearly. Policy, which is not renewed
in time lapses and a new policy has to be taken out. Medical conditions detected during the
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Customers perception toward health insurance empirical study in Ahmadabad region


interim period are treated as pre-existing condition for the new policy, which is not fair. This is
seen as major issue as it changes the conditionalities about what constitutes pre- exiting
conditions. Courts, however, have ruled that even if there is delay in renewing the policies it
should be considered as renewed policy. In case two doctors give different reports one favouring
consumer and other insurance company, the insurance company generally follows the later
opinion. There are several such consumer-related issues, which need to be addressed in health
insurance.
One of the planks on which the insurance has been deregulated is the gain in efficiency and
passing on these benefits to the consumers. It is very unrealistic to assume that insurance
companies will be able to gain efficiency, which helps them to reduce the price of schemes. At
least one should not be expecting this thing happening in the short-run. But providing full
information to the consumer and dealing with claims in a just and expeditious manner is the
minimum expected outcome of the deregulation process. Consumer organizations have to play
very active role in future development of the health insurance sector in India.
There are several social issues such as exclusions of sexually transmitted diseases, AIDS,
delivery and maternal conditions etc. These are not socially and ethically acceptable. "Insurance
companies much take care of all the risks related to health. The companies may charge additional
premium for certain conditions. Secondly the present mediclaim policy premiums are high and
do not differentiate between people living in urban and rural areas where the costs of medical
care are different. Thus the present policy is less attractive to poor and rural people. The tax
subsidy provided to the mediclaim is also going largely to the rich who are the taxpayers.
The newer health insurance policies have to improve upon the shortcoming of the existing
policies.

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Customers perception toward health insurance empirical study in Ahmadabad region

4.4 Impact of Health insurance on structure and quality of private provision:The experiences in liberalizing the private health insurance suggest that it has undesirable effects
on the costs of health care. The costs of care generally go up. Given the present system of fee for
service and current scenario of health infrastructure in private sector, the development of
insurance will need improvements in quality and change in structure. The new investments to
improve quality will result into high cost and therefore increase in prices of insurance products.
There would be developments in the direction of exploring options of managed care, which
would help in reducing the costs. The developments would be needed in the direction of strong
information base and accreditation system for providers. The structure of the health sector will
have to change from multiple-single doctor hospitals and clinics to larger hospitals and
polyclinics, which provide services of multiple specialities and can operate at larger scale. This
will allow them to provide high quality professional care at competitive prices. As one of the
responses to these issues Third Party Administrators (TPA) are rapidly emerging in India. Here
we can learn from the models, which have emerged elsewhere. But their applicability to Indian
situation needs to be examined carefully. These aspects of the health sector will need detailed
study.
We lack adequate information base to operate insurance schemes at large scale. The insurance
mechanism prevalent in many developed countries has their history. Health reforms experiences
in many countries are replete with the suggestion that the systems cannot be replicated easily.
Self-regulation is an important in any market driven system. The regulation from outside does
not work. Implementation of regulation in this sector is difficult. We significantly lack
mechanisms and institutions, which would ensure self- regulation and continuing education of
provides and various stakeholders. The accreditation systems are hard to implement without
mechanisms to self-regulate. For example it took 35 years in US to put the accreditation system
effectively in place. For example, it has been difficult for many States in India to put nursing
homes legislation in place. Given the deterioration on standards in medical education, lack of
regulation by medical council and rising expectations of the community it is difficulty to ensure
quality standards in Indian health care system. Given this situation health insurance systems will
have to deal with this complex issue of quality of care in years to come.
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4.5 Role of regulators:The government has established Insurance Regulatory and Development Authority (IRDA)
which is the statutory body for regulation of the whole insurance industry. They would be
granting licenses to private companies and will regulate the insurance business. As the health
insurance is in its very early phase, the role of IRDA will be very crucial. They have to ensure
that the sector develops rapidly and the benefit of the insurance goes to the consumers. But it has
to guard against the ill effects of private insurance. The main danger in the health insurance
business we see is that the private companies will cover the risk of middle class who can afford
to pay high premiums. Unregulated reimbursement of medical costs by the insurance companies
will push up the prices of private care. So large section of India's population who are not insured
will be at a relative disadvantage as they will, in future, have to pay much more for the private
care. Thus checking increase in the costs of medical care will be very important role of the
IRDA.
Secondly, IRDA will need to evolve mechanisms by which it puts some kind of statue in place
that private insurance companies do not skim the market by focusing on rich and upper- class
clients and in the process neglect a major section of India's population. They must ensure that
companies develop products for such poorer segments of the community and possibly build an
element of cross-subsidy for them. Government companies can take the lead in this matter and
catalyze new products for the poor and lower middle class as they have done in the past.
Thirdly the regulators should also encourage NGOs, Co-operatives and other collectives to inter
into the health insurance business and develop products for the poor as well as for the middle
class employed in the services sector such as education, transportation, retailing etc and the self
employed. This could be run as no-profit-no loss basis similar to the scheme pioneered by Indian
Medical Association for its members. Special licenses will have to be given to NGO for this
purpose without insisting on the minimum capital norms, which are for commercial insurance
companies.

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Customers perception toward health insurance empirical study in Ahmadabad region

4.6 VARIOUS HEALTH INSURANCE PRODUCTS AVAILABLE IN INDIA


The existing health insurance schemes available in India can be broadly categorized as:
Voluntary health insurance schemes or private-for-profit schemes Mandatory health insurance schemes or
government run schemes (namely ESIS, CGHS) Insurance offered by NGOs/Community based health
insurance Employer based schemes

1. Voluntary health insurance schemes or private-for-profit schemes:


In private insurance, buyers are willing to pay premium to an insurance company that pools similar risks
and insures them for health related expenses. The main distinction is that the premiums are set at a level,
which are based on assessment of risk status of the consumer (or of the group of employees) and the level
of benefits provided, rather than as a proportion of consumers income.
In the public sector, the General Insurance Corporation (GIC) and its four subsidiary companies (National
Insurance Corporation, New India Assurance Company, Oriental Insurance Company and United
Insurance Company) provide voluntary insurance schemes.
The most popular health insurance cover offered by GIC is Mediclaim policy

Mediclaim policy: - It was introduced in 1986. It reimburses the hospitalization expenses


owing to illness or injury suffered by the insured, whether the hospitalization is domiciliary or otherwise.
It does not cover outpatient treatments. Government has exempted the premium paid by individuals from
their taxable income.
Because of high premiums it has remained limited to middle class, urban tax payer segment of population.
Some of the various other voluntary health insurance schemes available in the market are :- Asha deep
plan II , Jeevan Asha plan II, Jan Arogya policy, Raja Rajeswari policy, Overseas Mediclaim policy,
Cancer Insurance policy, Bhavishya Arogya policy, Dreaded disease policy, Health Guard, Critical illness
policy, Group Health insurance policy, Shakti Shield etc. At present Health insurance is provided mainly
in the form of riders. There are very few pure health insurance policies under voluntary health insurance
schemes.

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Customers perception toward health insurance empirical study in Ahmadabad region

2. Mandatory health insurance schemes or government run schemes (namely


ESIS,CGHS)
Employer State Insurance Scheme (ESI):- Enacted in 1948, the employers state insurance (ESI)
Act was the first major legislation on social security in India. The scheme applies to power using factories
employing 10 persons or more and non-power & other specified establishments employing 20 persons or
more. It covers employees and the dependents against loss of wages due to sickness, maternity, disability
and death due to employment injury. It also covers funeral expenses and rehabilitation allowance.
Medical care comprises outpatient care, hospitalization, medicines and specialist care. These services are
provided through network of ESIS facilities, public care centers, non-governmental organizations (NGOs)
and empanelled private practitioners. The ESIS is financed by three way contributions from employers,
employees and the state government.
Even though the scheme is formulated well there are problem areas in managing this scheme. Some of the
problems are : Large numbers of posts of medical staff remain vacant due to high turnover and low remuneration
compared to corporate hospitals.
Rising costs and technological advancement in super specialty treatment. Management
information is not satisfactory.
The patients are not satisfied with the services they get Low utilization of the hospitals.

In rural areas, the access to services is also a problem.All these problems indicate an urgent need for
reforms in the ESIS Scheme.

Central Government Health Insurance Scheme (CGHS):-

Established in 1954, the

CGHS covers employees and retirees of the central government and certain autonomous and semi
autonomous and semi-government organizations. It also covers Members of Parliament, Governors,
accredited journalists and members of general public in some specified areas.
Benefits under the scheme include medical care, home visits/care, free medicines and diagnostic services.
These services are provided through public facilities with some specialized treatment (with
reimbursement ceilings) being permissible at private facilities. Most of the expenditure is met by the
central government as only 12% is the share of contribution.

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Customers perception toward health insurance empirical study in Ahmadabad region


The CGHS has been criticized from the point of view of quality and accessibility. Subscribers have
complained of high out of pocket expenses due to slow reimbursement and incomplete coverage for
private health care (as only 80% of the cost is reimbursed if referral is made to private facility, when such
facilities are not available with the CGHS).

Universal Health Insurance Scheme (UHIS):- For providing financial risk protection to the poor,
the government announced UHIS in 2003. Under this scheme, for a premium of Rs. 165 per year per
person, Rs.248 for a family of five and Rs.330 for a family of seven , health care for sum assured of Rs.
30000/- was provided. This scheme has been made eligible for below poverty line families only. To make
the scheme more saleable, the insurance companies provided for a floater clause that made any member
of family eligible as against mediclaim policy which is for an individual member. In spite of all these, the
scheme was not successful.
The reasons for failing to attract rural poor are many :The public sector companies who were required to implement this scheme find it to be
Potentially loss making and do not invest in propagating it. To meet the target, it is
Learnt that several field officers pay the premium under factious names. Identification of eligible families
is a difficult task Poor find it difficult to pay the entire premium at one time for future benefit, foregoing
current consumption needs. Paper work required to settle the claims is cumbersome Deficit in availability
of service providers Set back due to health insurance companies refusing to renew the previous years
policies.
In 2004, the government also provided an insurance product to the Self Help Group (SHG) for a
premium of Rs.120 and sum assured of Rs.10000/-. However, the intake is negligible. The reasons for
poor intake are similar to those cited above.

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Customers perception toward health insurance empirical study in Ahmadabad region

3. Insurance offered by NGOs/Community based health insurance:Community based schemes are typically targeted at poorer population living in communities. Such
schemes are generally run by charitable trusts or non-governmental organizations (NGOs). In these
schemes the members prepay a set amount each year for specified services. The premia are usually flat
rate (not income related) and therefore not progressive. The benefits offered are mainly in terms of
preventive care, though ambulatory and inpatient care is also covered. Such schemes tend to be financed
through patient collection, government grants and donations. Increasingly in India, CBHI schemes are
negotiating with for profit insurers for the purchase of custom designed group insurance policies.
CBHI schemes suffer from poor design and management. Often there is a problem of adverse selection as
premiums are not based on assessment of individual risk status. These schemes fail to include the poorest
of the poor. They have low membership and require extensive financial support. Other issues relate to
sustainability and replication of such schemes.

Some of the popular Community Based Health Insurance schemes are: - Self-Employed
Womens Association (SEWA), Tribuvandas Foundation (TF), The Mullur Milk Co-operative,
Sewagram, Action for Community Organization, Rehabilitation and Development (ACCORD), Voluntary
Health Services (VHS) etc.

4. Employer based schemes:Employers in both public and private sector offers employer based insurance schemes through their own
employer. These facilities are by way of lump sum payments, reimbursement of employees health
expenditure for outpatient care and hospitalization, fixed medical allowance or covering them under the
group health insurance schemes.
The Railways, Defense and Security forces, Plantation sector and Mining sector run their own health
services for employees and their families.

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Customers perception toward health insurance empirical study in Ahmadabad region

4.7 IMPLICATIONS OF PRIVATIZATION ON HEALTH INSURANCE:The privatization of insurance sector and constitution of IRDA envisage improving the
performance of state insurance sector in the country by increasing benefits from competition in
terms of lowered costs and increased level of consumer satisfaction. However, the implications
of the entry of private insurance companies in health sector are not very clear. There are several
contentious issues pertaining to development in this sector and these need critical examination.
Role of private insurance varies depending on the economic, social and institutional settings in a
country or a region.
Critics of private insurance argue that privatization will divert scarce resources away form the
pool, escalate health costs, allow cream skimming and adverse selection. According to this view,
private health insurance largely neglects the social aspect of health protection. In the contrast,
supporters of private health insurance claim that private insurance can bridge financing gaps by
offering consumers value for money and help them avoid waiting lines, low quality care and
under the table payments-problems often observed when households can use public health
facilities for free or participate in mandatory social insurance schemes. Both the arguments are
correct in the sense, private health insurance can be valuable tool to compliment or supplement
existing health financing options only if they are carefully managed and adapted to local needs
and preferences.
India, with relatively developed economy and a strong middle class population, offers most
promising environment for private health insurance development. Currently, private health
insurance plays only a marginal role in health care systems but it is gradually gaining
importance.
Private health insurance is certainly not the only alternative or the ultimate solution to address
alarming health care challenges in India. However, it is an option that warrants- and already
receives-growing consideration by policy makers in the country. Thus the question is not if this
tool will be used in the future but whether it will be applied to the best of its potential to serve
the needs of the countrys health care system.

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Customers perception toward health insurance empirical study in Ahmadabad region

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Customers perception toward health insurance empirical study in Ahmadabad region

RESEARCH METHODOLOGY
Types of Research Design: -Exploratory research design
Exploratory Research: - Descriptive Data.
Primary Data: - Market survey
Secondary data: - External Secondary Data: - Private Secondary Data.
Private Secondary Data: - Internet

Conclusive research: - single cross sectional, descriptive Research.


Data collection method: - Survey (Personal) surveywith the person who has health
insurance policy holder .

Data collection instrument: - Questionnaire.


Sampling Design:- customer perception towards health insurance policy
Target Population Definition: - health insurance policy holder
Target population: -Ahmedabad city health policy holder including all mis company
survey

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Customers perception toward health insurance empirical study in Ahmadabad region

Sampling Elements: Sampling Units: Sampling frame: - Not available.


Sampling Size: - 200
Extent: - Ahmadabad city.
Sampling Techniques: - Non-Probability convenience method.
A study on Investors Behaviour towards Mutual Fund of Corporate Employees in Ahmadabad
city
MBA (FINANCIAL SERVICES) SEM-IV APRIL-JUNE 2015

Sample Size Determination:Calculation:A conducting research on investment behaviour of corporate employees . It is using Likert scale
for measuring service quality & also he allowed 0.11 errors in measurement. Confidence level
is 95%.

Step: - 01 calculation of standard deviation.


Se = Maximum value Minimum value
6 = 5-1
6=4
6 = 0.67

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Customers perception toward health insurance empirical study in Ahmadabad region

Step: - 02 calculation of Z value.

Z = 1.64

Step: - 03 Calculation of sample size.


N = ZS 2
e = 1.64 0.67 2
0.11
N = 199.78 = 200.

Scaling Techniques: Data Analysis: Data Analysis Software: - MS Excel & SPSS.

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Customers perception toward health insurance empirical study in Ahmadabad region


Gender:
Gender

Valid male
femal
e
Total

Frequenc
y
180

Valid
Cumulative
Percent
Percent
90.0
90.0

Percent
90.0

20

10.0

10.0

200

100.0

100.0

100.0

Gender

200

Frequency

150

100

50

0
male

female

Gender

Hear higher value of male is 180 and lower value of female is 20 from 200 respondence there are
less female that has health insurance

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Customers perception toward health insurance empirical study in Ahmadabad region


Age:Age

Valid less 30 years


30-40 years
40-50 years
above 50
years
Total

Frequenc
y
152
39
8

Percent
76.0
19.5
4.0

Valid
Cumulative
Percent
Percent
76.0
76.0
19.5
95.5
4.0
99.5

.5

.5

200

100.0

100.0

100.0

Age

200

Frequency

150

100

50

0
less 30 years

30-40 years

40-50 years

above 50 years

Age

In age criteria there are 152 people has less than 30 years and lowest is above 50 years has 1
health insurance

MBA (FS) SEM IV

Page 51

Customers perception toward health insurance empirical study in Ahmadabad region


Marital Status:Maritial status

Valid single
marrie
d
Total

Frequenc
y
55

Valid
Cumulative
Percent
Percent
27.5
27.5

Percent
27.5

145

72.5

72.5

200

100.0

100.0

100.0

maritial_status

150

Frequency

100

50

0
single

married

maritial_status

In marital status there are145 married has health insurance and 55 are single they has health
insurance

MBA (FS) SEM IV

Page 52

Customers perception toward health insurance empirical study in Ahmadabad region


Family:Type of family

Valid joint
nuclea
r
Total

Frequenc
y
43

Percent
21.5

Valid
Cumulative
Percent
Percent
21.5
21.5

157

78.5

78.5

200

100.0

100.0

100.0

TYP_fmly

200

Frequency

150

100

50

0
joint

nuclear

TYP_fmly

There are nuclear has highest they has insurance and only 43 live in joint has lowest has health
insurance

MBA (FS) SEM IV

Page 53

Customers perception toward health insurance empirical study in Ahmadabad region

Education:Education

Valid

primary
matrix
higher seaconday
graduation
post graduction
vocational
Total

Frequency
2
8
4
101
80
5
200

Percent
1.0
4.0
2.0
50.5
40.0
2.5
100.0

Valid Percent
1.0
4.0
2.0
50.5
40.0
2.5
100.0

Cumulative
Percent
1.0
5.0
7.0
57.5
97.5
100.0

Education

120

100

Frequency

80

60

40

20

0
primary

matrix

higher
seaconday

graduation

post graduction

vocational

Education

The highest value of insurer are graduated and the lowest value primary education they has
health insurance

MBA (FS) SEM IV

Page 54

Customers perception toward health insurance empirical study in Ahmadabad region


Occupation:Occupation

Valid

employed
self employed
house wife
unemployed
professional
family owned business
Total

Frequency
47
37
8
5
25
78
200

Percent
23.5
18.5
4.0
2.5
12.5
39.0
100.0

Valid Percent
23.5
18.5
4.0
2.5
12.5
39.0
100.0

Cumulative
Percent
23.5
42.0
46.0
48.5
61.0
100.0

Occupation

80

Frequency

60

40

20

0
employed

self employed

house wife

unemployed

professional

family owned
business

Occupation

The highest value in occupation 78 family business they has health insurance and the lowest
value has 5 unemployed has has less frequency

MBA (FS) SEM IV

Page 55

Customers perception toward health insurance empirical study in Ahmadabad region

Annual Income:Annual income

Valid

less the 50000


50000-100000
100000-150000
150000-200000
above 200000
Total

Frequency
24
17
18
46
95
200

Percent
12.0
8.5
9.0
23.0
47.5
100.0

Valid Percent
12.0
8.5
9.0
23.0
47.5
100.0

Cumulative
Percent
12.0
20.5
29.5
52.5
100.0

income

100

80

Frequency

60

40

20

0
less the 50000

50000-100000

100000-150000

150000-200000

above 200000

income

The hugest value in 95 income that has above 200000 income has preferring more health
insurance and the lowest value 17 there income come between 500000-100000 preferring less
health insurance

MBA (FS) SEM IV

Page 56

Customers perception toward health insurance empirical study in Ahmadabad region

Q.10 who is your insurer?

Valid

public company
private company
any other
Total

Frequency
42
157
1
200

Percent
21.0
78.5
.5
100.0

Valid Percent
21.0
78.5
.5
100.0

Cumulative
Percent
21.0
99.5
100.0

Who_insurer

200

Frequency

150

100

50

0
public company

private company

any other

Who_insurer

The high value 157 has there health insurance in private company and 42 lowest value has health
insurance in public company

MBA (FS) SEM IV

Page 57

Customers perception toward health insurance empirical study in Ahmadabad region


Q.11 what type of health insurance policy you have?

Frequenc
y
Valid individual health
insurance
group health
insurance
family floater
health insurance
other
Total

Percent

Valid
Percent

Cumulative
Percent

132

66.0

66.0

66.0

32

16.0

16.0

82.0

35

17.5

17.5

99.5

1
200

.5
100.0

.5
100.0

100.0

Type

125

Frequency

100

75

50

25

0
individual health
insurance

group health insurance

family floater health


insurance

other

Type

The highest value 132 has taken individual health insurance and the lowest value 1 prefer in
other

MBA (FS) SEM IV

Page 58

Customers perception toward health insurance empirical study in Ahmadabad region


Q.12 what are the reasons for going in for health insurance policy?

Valid

tax planning measure


travelling abroad
employers contribution
existing illness
avail good quality
medical treatement
risk coverage against
future illness
Total

Frequency
13
7
48
4

Percent
6.5
3.5
24.0
2.0

Valid Percent
6.5
3.5
24.0
2.0

Cumulative
Percent
6.5
10.0
34.0
36.0

42

21.0

21.0

57.0

86

43.0

43.0

100.0

200

100.0

100.0

Reasons

100

Frequency

80

60

40

20

0
tax planning
measure

travelling abroad

employers
contribution

existing illness

avail good
quality medical
treatement

risk coverage
against future
illness

Reasons

The highest value of 88 prefer health insurance for risk covering against future illness and the
lowest 4 existing illness has taken health insurance

MBA (FS) SEM IV

Page 59

Customers perception toward health insurance empirical study in Ahmadabad region


Q.13 who persuaded you to purchase the policy?

Valid insurance officials


relative
friend
advertisment
income tax
advocate
Total

Frequenc
y
126
39
30
4

Valid
Cumulative
Percent
Percent
63.0
63.0
19.5
82.5
15.0
97.5
2.0
99.5

Percent
63.0
19.5
15.0
2.0

.5

.5

200

100.0

100.0

100.0

Persuades_purchse

125

Frequency

100

75

50

25

0
insurance officials

relative

friend

advertisment

income tax
advocate

Persuades_purchse

The highest value 126 has insurance official has health insurance and the lowest value of 1 that
take insurance for income tax advocate

MBA (FS) SEM IV

Page 60

Customers perception toward health insurance empirical study in Ahmadabad region


Q.14 what approach was adopted in seeking health insurance coverage?

Frequency
Valid

insurance agent
seeked you out
you seeked out
insurance agent
Total

Percent

Valid Percent

Cumulative
Percent

144

72.0

72.0

72.0

56

28.0

28.0

100.0

200

100.0

100.0

Apprch_hlth_insu_covg

150

Frequency

100

50

0
insurance agent seeked you out

you seeked out insurance agent

Apprch_hlth_insu_covg

The highest value 144 has insurance agent seeked then out asnd the 56 lowest value you seeked
out insurance agent
MBA (FS) SEM IV

Page 61

Customers perception toward health insurance empirical study in Ahmadabad region


Q.15 Do you agree that the services provided by the insurance companies are delivered
effectively?

Valid

yes
no
indifferent
Total

Frequency
105
67
28
200

Percent
52.5
33.5
14.0
100.0

Valid Percent
52.5
33.5
14.0
100.0

Cumulative
Percent
52.5
86.0
100.0

service_delver

120

100

Frequency

80

60

40

20

0
yes

no

indifferent

service_delver

The highest value 105 has think that service has delivered and lowest 28 has given indifferent
about the health insurance delivered

MBA (FS) SEM IV

Page 62

Customers perception toward health insurance empirical study in Ahmadabad region


Q.16 what is the chance of renewing the service after the health insurance expiry of present
insurance policy?

Valid

100%
50%
25%
0%
Total

Frequency
95
48
43
14
200

Percent
47.5
24.0
21.5
7.0
100.0

Valid Percent
47.5
24.0
21.5
7.0
100.0

Cumulative
Percent
47.5
71.5
93.0
100.0

Renew_police

100

80

Frequency

60

40

20

0
100%

50%

25%

0%

Renew_police

The higest value has of renew 95 respondence will 100% they will renew policy and lowest
value of 14 they will not going to renew the policy

MBA (FS) SEM IV

Page 63

Customers perception toward health insurance empirical study in Ahmadabad region


Q.17 Are you willing to pay more for additional service, which can be included in your
health insurance package?

Valid

Frequency
78
122
200

yes
no
Total

Percent
39.0
61.0
100.0

Valid Percent
39.0
61.0
100.0

Cumulative
Percent
39.0
100.0

Pay_more

120

100

Frequency

80

60

40

20

0
yes

no

Pay_more

The highest value 122 has answer no for additional pay in health insurance and 78 has response
yes pay more for health insurance policy

MBA (FS) SEM IV

Page 64

Customers perception toward health insurance empirical study in Ahmadabad region


Q.18 Do you think the promotional efforts being taken by insurance company are sufficient
?

Valid

Frequency
113
87
200

yes
no
Total

Percent
56.5
43.5
100.0

Valid Percent
56.5
43.5
100.0

Cumulative
Percent
56.5
100.0

promotion_sufficient

120

100

Frequency

80

60

40

20

0
yes

no

promotion_sufficient

The highest value of 113 response yes and lowest value 87 select no for promotional efforts
being taken by insurance company

MBA (FS) SEM IV

Page 65

Customers perception toward health insurance empirical study in Ahmadabad region


Q.19
a. Name and reputation of the insurance company

Valid

Frequency
110
80
10
200

strong agree
agree
indifferent
Total

Percent
55.0
40.0
5.0
100.0

Valid Percent
55.0
40.0
5.0
100.0

Cumulative
Percent
55.0
95.0
100.0

Name_reputation

120

100

Frequency

80

60

40

20

0
strong agree

agree

indifferent

Name_reputation

The highest value 110 has strongly agree will the statement and the lowest values selected
indifferent is 10.

MBA (FS) SEM IV

Page 66

Customers perception toward health insurance empirical study in Ahmadabad region

b. Maximum customer satisfaction.

Valid

strongly agree
agree
indifferent
Total

Frequency
131
63
6
200

Percent
65.5
31.5
3.0
100.0

Valid Percent
65.5
31.5
3.0
100.0

Cumulative
Percent
65.5
97.0
100.0

customer_satisfaction

125

Frequency

100

75

50

25

0
strongly agree

agree

indifferent

customer_satisfaction

The highest value 131 are strongly agree with the statement and 6 are selected indifferent

MBA (FS) SEM IV

Page 67

Customers perception toward health insurance empirical study in Ahmadabad region

c. Minimum co-payment involved

Valid

strongly agree
agree
indifferent
Total

Frequency
47
82
71
200

Percent
23.5
41.0
35.5
100.0

Valid Percent
23.5
41.0
35.5
100.0

Cumulative
Percent
23.5
64.5
100.0

co_payment

100

80

Frequency

60

40

20

0
strongly agree

agree

indifferent

co_payment

The highest value has 82 are agree with the statement and the71

lowest value selected

indifferent

MBA (FS) SEM IV

Page 68

Customers perception toward health insurance empirical study in Ahmadabad region

d. Flexibility of policy offered

Valid

strongly agree
agree
indiffernt
Total

Frequency
50
125
25
200

Percent
25.0
62.5
12.5
100.0

Valid Percent
25.0
62.5
12.5
100.0

Cumulative
Percent
25.0
87.5
100.0

flexibility

120

100

Frequency

80

60

40

20

0
strongly agree

agree

indiffernt

flexibility

The highest value 125 has agree with the statement and lowest value 25 has selected indifferent

MBA (FS) SEM IV

Page 69

Customers perception toward health insurance empirical study in Ahmadabad region


e. Easy accessibility of linked hospitals

Valid

strongly agree
agree
indifferent
Total

Frequency
92
45
63
200

Percent
46.0
22.5
31.5
100.0

Valid Percent
46.0
22.5
31.5
100.0

Cumulative
Percent
46.0
68.5
100.0

linked_hospital

100

80

Frequency

60

40

20

0
strongly agree

agree

indifferent

linked_hospital

The highest value 92 has are strongly agree with the statement and lowest value 45 are agree
with the statement

MBA (FS) SEM IV

Page 70

Customers perception toward health insurance empirical study in Ahmadabad region

f. Easy availability of services in hospital

Valid

strongly agree
agree
Total

Frequency
154
46
200

Percent
77.0
23.0
100.0

Valid Percent
77.0
23.0
100.0

Cumulative
Percent
77.0
100.0

easy_services

200

Frequency

150

100

50

0
strongly agree

agree

easy_services

The highest value 154 are strongly agree with the statement and lowest are 46 are agree with the
statement
MBA (FS) SEM IV

Page 71

Customers perception toward health insurance empirical study in Ahmadabad region

ANOVA Test
1. Age group, Occupation, Income & Customer Satisfaction toward Health
Insurance Policy.

Sum

of

Squares
Age

Occupation

income

MBA (FS) SEM IV

Mean
df

Square

Sig.

Between Groups .148

.074

.231

.794

Within Groups

63.032

197

.320

Total

63.180

199
.137

.872

3.397

.035

Between Groups 1.873

.936

Within Groups

1348.747

197

6.846

Total

1350.620

199

Between Groups 13.095

6.547

Within Groups

379.700

197

1.927

Total

392.795

199

Page 72

Customers perception toward health insurance empirical study in Ahmadabad region

Interpretation:H0 : There is no impact of various age group in Customer satisfaction towards Health
Insurance Policy.
H1 : There is impact of various age group in Customer satisfaction towards Health
Insurance Policy.
P value of Age is 0.794 is greater than 0.05 So I accept Null Hypothesis and reject Alternative
Hypothesis.
So there is no impact of various group of Age on Customer Satisfaction towards Health
Insurance Policy.
H0 : There is no impact of various Occupation group on Customer Satisfaction Health
Insurance Policy.
H1 : There is impact of various Occupation group on Customer Satisfaction towards
Health Insurance Policy.
P value of occupation is 0.872 is greater than 0.05 So I accept Null Hypothesis and reject
Alternative Hypothesis.
So there is no impact of various group of Occupation on Customer Satisfaction towards Health
Insurance Policy.
H0 : There is no impact of various Income group on Customer Satisfaction towards Health
Insurance Policy.
H1 : There is impact of various Income group on Customer Satisfaction towards Health
Insurance Policy.
P value of income is 0.035 is lesser than 0.05 So I reject Null Hypothesis and accept Alternative
Hypothesis.
So there is impact of various group of Income on Customer Satisfaction towards Health
Insurance Policy.

MBA (FS) SEM IV

Page 73

Customers perception toward health insurance empirical study in Ahmadabad region

2. Age group, Occupation, Income & Flexibility toward Health Insurance Policy.

Sum

Age

Occupation

income

MBA (FS) SEM IV

of

Mean

Squares

df

Square

Sig.

Between Groups

.828

.414

1.308

.273

Within Groups

62.352

197

.317

Total

63.180

199

Between Groups

112.108

56.054

8.916

.000

Within Groups

1238.512

197

6.287

Total

1350.620

199

Between Groups

2.283

1.142

.576

.563

Within Groups

390.512

197

1.982

Total

392.795

199

Page 74

Customers perception toward health insurance empirical study in Ahmadabad region

Interpretation:H0 : There is no impact of various age group in satisfaction towards health insurance.
H1 : There is impact of various age group in satisfaction towards health insurance.
P value of Age is 0.273 is lesser than 0.05 So I reject Null Hypothesis and accept Alternative
Hypothesis.
So there is impact of various group of Age on Overall Satisfaction towards health insurance.

H0 : There is no impact of various Occupation group on Overall Satisfaction towards


health insurance.
H1 : There is impact of various Occupation group on Overall Satisfaction towards health
insurance.

P value of occupation is 0.00 is lesser than 0.05

So I reject Null Hypothesis and accept

Alternative Hypothesis.
So there is impact of various group of Occupation on flexibility towards health insurance.

H0 : There is no impact of various Income group on Overall Satisfaction towards health


insurance.
H1 : There is impact of various Income group on Overall Satisfaction towards health
insurance.

P value of income is 0.563 is greater than 0.05 So I accept Null Hypothesis and reject Alternative
Hypothesis.
So there is no impact of various group of Income on flexibility towards health insurance.

MBA (FS) SEM IV

Page 75

Customers perception toward health insurance empirical study in Ahmadabad region

3. Age group, Occupation, Income & co-payment toward Health Insurance Policy.

Sum of
Squares
Age

Between
Groups
Within Groups
Total

Occupatio
n

Between
Groups
Within Groups
Total

income

Between
Groups
Within Groups
Total

MBA (FS) SEM IV

Mean
Square

df

.070

.035

63.110

197

.320

63.180

199

39.436

19.718

1311.184

197

6.656

1350.620

199

23.079

11.539

369.716

197

1.877

392.795

199

Sig.
.109

.897

2.963

.054

6.149

.003

Page 76

Customers perception toward health insurance empirical study in Ahmadabad region


Interpretation:H0 : There is no impact of various age group in satisfaction towards health insurance.
H1 : There is impact of various age group in satisfaction towards health insurance.
P value of Age is 0.897 is greater than 0.05 So I accept Null Hypothesis and reject Alternative
Hypothesis.
So there is no impact of various group of Age on Overall Satisfaction towards health insurance .

H0 : There is no impact of various Occupation group on Overall Satisfaction towards


health insurance .
H1 : There is impact of various Occupation group on Overall Satisfaction towards health
insurance

P value of occupation is 0.054 is greater than 0.05 So I accept Null Hypothesis and reject
Alternative Hypothesis.
So there is no impact of various group of Occupation on co-payment towards health insurance

H0 : There is no impact of various Income group on Overall Satisfaction towards health


insurance.
H1 : There is impact of various Income group on Overall Satisfaction towards health
insurance.

P value of income is 0.003 is lesser than 0.05 So I reject Null Hypothesis and accept Alternative
Hypothesis.
So there is impact of various group of Income on co-payment towards health insurance.

MBA (FS) SEM IV

Page 77

Customers perception toward health insurance empirical study in Ahmadabad region

MBA (FS) SEM IV

Page 78

Customers perception toward health insurance empirical study in Ahmadabad region

FINDING
1.In research project we find that male has higher adopting insurance policy and female
Are has less number that has health insurance policy only 20 respondence are female and
male are180 in 200 respondence and single are more and they has insurance policy
2. In research the age of 30 and less then 30 has are 157 respondence and above 50 year
of age they has less number of insurer they has health insurance
In research we found that employed and self employed respondence are less they the
family business respondents are has health insurance and the respondence they are
selecting more private then public company as preference are given more to the private .
In research we see that more ever the policy holder are take there on policy either
selective the family police or then group policy.
In research we found the company are has delivery 105 are positive in 200 sample that
are satisfied with the health insurance and from that 95 respondences will renew the
policy again
Customer perception the health insurance policy to purchase from good reputation of
company and flexibility and strongly satisfaction and linked hospital required and they
select that kind of company that they provide the service.

MBA (FS) SEM IV

Page 79

Customers perception toward health insurance empirical study in Ahmadabad region

MBA (FS) SEM IV

Page 80

Customers perception toward health insurance empirical study in Ahmadabad region

CONCLUSION
Here in health insurance more ever the single are selecting the less health insurance and the
to approach single are more important and the importance of health insurance has to give the
knowledge and the research says that female are has less preferring health insurance they are
also equal that they must take health insurance and they age are not more important in the
health insurance policy that they all age criteria are importance they can take the insurance
policy and they select of the policy we see in research that the adopting of individual policy
scheme are selecting more they must select they policy with the family they will cover the
hole family and they are also all are equal important and they renew of the policy are also
important that In future that will help to cover and they can live risk free life that some of
amount will be collected from the insurance company and the at will make the help in the
hand in all the time and the some of hug amount will pay by the company in less payment in
the year as instalment
Customer is selecting the high reputation company they must provide the flexibility to the
customer and that will make customer attraction and satisfaction power will increase.

MBA (FS) SEM IV

Page 81

Customers perception toward health insurance empirical study in Ahmadabad region

MBA (FS) SEM IV

Page 82

Customers perception toward health insurance empirical study in Ahmadabad region

Bibliography
www.wikipedia.com
www.eurojournal.com
www.isec.ac.in
www.theglobaljournal.com

MBA (FS) SEM IV

Page 83