The aim of the field visit was to get a full idea about the reality at the ground level in order to prepare the research design.
Two focused group discussions were held.
The FGD was initiated by the question on the practices followed before insurance was taken. Most of the SHG members responded by saying that they met their medical expenses by:-
a) Getting loans from a moneylender at high rates of interest
b) Selling their jewels or keeping them on mortgage
c) Getting a formal loan from SHG
d) Selling their assets
e) Going to a government hospital because it is cheaper.
There was a particular case in the first FGD, where land had to be sold because the member’s son had met with an accident.
Common ailments that people suffer from in this area are mostly viral fever, Dengue, chicken guinea, Jaundice, typhoid, cold and cough, pneumonia, diabetes, rheumatic arthritis, uterus problem in women, cholesterol and blood pressure. Most diseases caused are water borne. Hence, we need to devise ways to make the members more informed about the benefits of clean drinking water.
An important observation with respect to the area is that unorganized sectors like weaving and cashew nut business are enrolled under a health insurance scheme. Hence, a few SHG’s could not enroll themselves to our health insurance scheme because more than 25% of the group did not need insurance. Hence, it was decided that the 75% of the group would be taken after accounting for those who already had insurance cover. Hence, we realize the intricacies of being on the field and the solutions to problems that can be devised only while a visit on the field and interacting at the ground level.
In another insurance scheme available in the region, for a cover of rupees 50,000, a sum of rupees 565 had to be paid per person as premium while our scheme has a lesser premium and a higher cover even in case the whole family is enrolling.
Another question that was asked in the FGD was if they faced any problems in the enrolment process and their expectations from the same. To this, most participants said that they didn’t face any problem as such in the process of enrolment. Also they said that they expected the insurance to help them in all their hospital visits, financially. Also, a few had the feeling and faith that if they joined the insurance programme, nothing would happen to them. Since, the group structure is present, risk pooling takes place and the whole group supports individual facing adversities. It wasn’t because of compulsion of IP or IC that they opted for insurance.
On being asked, why they had opted for the product with copayment, they replied that since they pay lesser premium on this product. Also, most of the participants felt that in case they didn’t have any claims, the premium that they paid would be a waste and hence the product without copayment meant that they lose less money.
The major concerns for most of the members were
a) The money they pay as premium in case they don’t make claims
b) Membership for individual person
c) Personal Accident and Death should be included.
d) Insurance provision for people above 60 years because that’s when they need more help
On being asked for their satisfaction level, it was too early for them to comment. In the second FGD, we came across a case where reimbursement had been made for a member whose husband was unwell. The claim was successfully given after relevant bills and documents were produced.
The member card had details name, age, gender, card number, policy number and validity on them.
The Insurance coordinator’s office was also visited. It was very organized with all documents in place. Records were kept for all insurance promoters with member details. The IPs completed documentation in hard copy while the IC maintained softcopies of the same.
A few suggestions:
It would be good if we can devise an incentive mechanism for all those who don’t put forth a claim. We could probably offer them a lower premium in case of renewal or maybe give them a percentage of the premium paid back.
Also, we need to see if it is plausible to include personal accident and death cover in the scheme. We also need to explore if it is possible to have some cover for people above 60 years of age. As Dr Amarnath, CEO, Bharti Axa rightly pointed out “Those who can pay for illnesses have insurance and those who can’t don’t have it.” Thus, we need to reach out to people who really need insurance.
