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PROJECT REPORT
ON
“Consumer Perception towards Health insurance Product in this
Covid Era”
SUBMITTED IN PARTIAL FULFILLMENT OF THE
REQUIREMENT FOR
MASTER OF BUSINESS ADMINISTRATION
Under the guidance of: SUBMITTED BY:
Affiliated to APJ Abdul Kalam Technical University, Lucknow
 
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CERTIFICATE OF ORIGINALITY
I hereby declare that this project is my own work and that, to best of my knowledge and belief,
it reproduces no material previously published or written that has been accepted for the award
of any other degree of diploma, except where due acknowledgement has been made in the text
(Student name):
Enrolment No:
Date:
 
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ACKNOWLEDGMENT
It is pleasure to acknowledge many people who knowingly and unwittingly helped
me, to complete my project. First of all, let me praise god for all the blessing, who
carried me through all those years. I am particularly indebted to who inculcated in me
utmost need for human values and groomed me up in the field of Management to take
on the challenges of the competitive world.
I extend my sincere gratitude to all my teachers and mentors who made unforgettable
contribution. Due to their sincere efforts I was able to excel in the work entrusted upon
me.
NAME:
ROLL NO -
 
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LIST OF CONTENTS
S.NO DETAIL OF DOCUMENTS PAGE NO.
1 EXECUTIVE SUMMARY 6-8
2 Introduction 9-11
3 INDUSTRY PROFILE 12-42
4 Objectives & Methodology 43-46
5 DATA ANALYSIS & INTEREPREATION 47-77
6 SUMMARY OF FINDINGS 78-80
7 SUGGESTION & RECOMMENDATION 81-82
8 CONCLUSION 83-84
9 BIBLOGRAPHY 85-86
10 ANNEXURE 87-94
 
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CHAPTER: 1
EXECUTIVE
SUMMARY
 
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EXECUTIVE SUMMARY
This is an attempt to know how the theories can be applied to practical situation.
As a student of MBA, it is a part of study for everyone to undergo summer project
at some good institute or organisation. So, for this purpose, I got the opportunity
of summer training at Lancers Counsel Services Pvt. Ltd.
Lancers Counsel Services Pvt. Ltd. provided me the real time experience of
generating leads, dealing with the clients, marketing of financial products, and
understanding the position in the market along with consumer perception.
The internship report is based on the two months long Virtual internship program
that I had experienced in this company from 25th May 2020 to 24th July 2020 as
a requirement of my MBA program under Institute of Technology & Science,
Mohan Nagar Ghaziabad. The title of the report is “Consumer Perception towards
Health insurance Product in this Covid Era”
This report is based on how consumer reacts on Health Insurance Products.
While claiming and purchasing those products.
This study includes the performance of Health Insurance Companies in this
Covid era. It includes a research as well, which is conducted to ascertain the
consumer perception towards the Health Insurance sector. This is done with a
help of a questionnaire (Primary source).
 
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The main objective of the research is to identify the thinking of consumer and
their behaviour towards Health Insurance. There are secondary objectives as well,
which are:
o To find out the important criteria that people think about before investing
in a health insurance policy.
o To know about the various investment alternatives that is mostly preferred
by the people.
o To identify the consumer’s perception about the product (Smart Lifestyle).
o To identify the awareness about health insurance.
o To know health insurance is important in today world.
 
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CHAPTER 2:
INTRODUCTION
 
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Introduction
The newly discovered and highly contagious disease COVID-19 has taken the
world by storm. Assumed to have originated from China, the virus has impacted
over four million people across 205 countries as per records. The lack of specific
vaccines and treatments for the virus is the reason for the global frenzy and
therefore, getting through the pandemic safely is the need of the hour for all
humankind. Amidst the apprehension and uncertainty concerning the present
scenario, we must evaluate the risks and assess if the worst comes to pass.
Evaluating the risk also involves creating enough financial contingency to pay
off if you fall prey to the virus. Whether or not your standard health insurance
covers COVID-19 is a common dilemma. Therefore, it is imperative to know if
you are covered in case you succumb to the virus
During times like these, having a health insurance comes handy in times of
medical emergencies. Many individuals often have to use funds from their
savings in case of a medical emergency, which not only impacts their financial
health but also jeopardises personal goals. By assessing his or her financial
position and requirement closely, one can plan and financially prepare against
medical emergencies through a medical insurance plan.
Whether you're married, single, have children, young, or old, you need some level
of health insurance to protect yourself against financial disaster in the event of a
serious illness or accident. Whether you choose a group plan or an individual
plan, there are important choices to be made that will affect not only the quality
of your health care but also your wallet.
Health Insurance for Senior Citizens
Healthcare continues to remain a crucial lifeline for elderly citizens who need
healthcare as they age. However, as per the latest study, over the next two
decades, out-of-pocket medical costs for older adults are likely to rise
significantly. Considering the current rate of medical inflation in India, adequate
health insurance has become a must-have for each and every individual, and if
the individual happens to be your parents, the need of buying a senior citizen
health insurance becomes all the more important. We all must accept the fact of
life that as we age, it’s not just our experience that increases, the list of medical
ailments also witnesses a substantial increase.
 
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Considering the given scenario, buying an individual cover for your elderly
parents is a sensible thing to do. In the event of your parents falling ill and
requiring hospitalisation, the major part of the medical expenses will be taken
care of by your parents’ medical cover plan, without burning a hole in your
pocket.
Senior Citizens are better off buying a feature packed comprehensive health
insurance plan with no limitations like co-pay or room rent limits. These may be
slightly expensive but are worth it for the peace of mind they offer. Some of the
popular health insurance plans available for the senior citizens include Religare’s
NCB Super Premium, HDFC Ergo’s Health Suraksha – Silver, Star Health’s
Health Optima and Max Bupa’s Go Active. However, in case somebody wants to
buy a cheaper plan, there are options which are specifically designed for Senior
Citizens. The offered plans in the category include Religare’s Red Carpet and
Care Senior.
Health Insurance for People with Pre-existing Diseases
Many a people nowadays don’t end up buying Health Insurance if they are
suffering from some ailments like Diabetes or High BP or some heart related
issues. They are worried that since they are suffering some pre-existing
conditions, the insurance companies won’t cover them or otherwise the cover
provided in case of any hospitalisation will be nominal. This is a total myth which
people have set in their minds that no companies will cover them. Fortunately,
insurance companies have now opened up their underwriting significantly in the
past few years and made the entire process quite simpler. Also, the Insurance
Regulatory and Development Authority of India (IRDAI) has issued several
guidelines to insurers stating all pre-existing disease will be covered under a
health insurance cover after a certain waiting period. Adhering to IRDAI
guidelines, insurers have come up with plans that cover all pre-existing diseases
after a limited time waiting period.
However, you must choose the best medical insurance for pre-existing conditions
to suit your needs. It is the duty of the person who is opting for health insurance
with pre-existing conditions like diagnosed illnesses, medical history of
illness/hospitalization/surgery or major accidental injury, to inform the health
policy issuing executive about the same and get all necessary checks and tests
done before buying the policy. It is also important to read the type of diseases
which the insurance companies define as Pre-existing conditions to avoid
problems when the time comes to raise a claim.
 
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CHAPTER 3: -
INDUSTRYPROFILE
 
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INDUSTRY PROFILE
Health insurance, like other forms of insurance, is a form of collectivism by
means of which people collectively pool their risk, in this case the risk of
incurring medical expenses. The collective is usually publicly owned or else is
organized on a non-profit basis for the members of the pool, though in some
countries health insurance pools may also be managed by for-profit companies.
It is sometimes used more broadly to include insurance covering disability or
long-term nursing or custodial care needs. It may be provided through a
government-sponsored social insurance program, or from private insurance
companies. It may be purchased on a group basis (e.g., by a firm to cover its
employees) or purchased by an individual. In each case, the covered groups or
individuals pay premiums or taxes to help protect themselves from unexpected
healthcare expenses. Similar benefits paying for medical expenses may also be
provided through social welfare programs funded by the government.
By estimating the overall risk of healthcare expenses, a routine finance
structure (such as a monthly premium or annual tax) can be developed, ensuring
that money is available to pay for the healthcare benefits specified in the
insurance agreement. The benefit is administered by a central organization such
as a government agency, private business, or not-for-profit entity.
History and Evolution
The concept of health insurance was proposed in 1694 by Hugh the Elder
Chamberlin from the Peter Chamberlin family. In the late 19th century, "accident
insurance" began to be available, which operated much like modern disability
insurance. This payment model continued until the start of the 20th century in
some jurisdictions (like California), where all laws regulating health insurance
actually referred to disability insurance. Accident insurance was first offered in
 
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the United States by the Franklin Health Assurance Company of Massachusetts.
This firm, founded in 1850, offered insurance against injuries arising from
railroad and steamboat accidents. Sixty organizations were offering accident
insurance in the U.S. by 1866, but the industry consolidated rapidly soon
thereafter. While there were earlier experiments, the origins of sickness coverage
in the U.S. effectively date from 1890. The first employer-sponsored group
disability policy was issued in 1911.
Before the development of medical expense insurance, patients were expected to
pay all other health care costs out of their own pockets, under what is known as
the fee-for-service business model. During the middle to late 20th century,
traditional disability insurance evolved into modern health insurance programs.
Today, most comprehensive private health insurance programs cover the cost of
routine, preventive, and emergency health care procedures, and most prescription
drugs, but this is not always the case.
Hospital and medical expense policies were introduced during the first half of the
20th century. During the 1920s, individual hospitals began offering services to
individuals on a pre-paid basis, eventually leading to the development of Cross
organizations. The predecessors of today's Health Maintenance Organizations
(HMOs) originated beginning in 1929, through the 1930s and on during World
War II.
How It Works
A health insurance policy is a contract between an insurance company and an
individual or his sponsor (e.g. an employer). The contract can be renewable
annually or monthly. The type and amount of health care costs that will be
covered by the health insurance company are specified in advance, in the member
 
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contract or "Evidence of Coverage" booklet. The individual insured person's
obligations may take several forms:
 Premium: The amount the policy-holder or his sponsor (e.g. an employer)
pays to the health plan each month to purchase health coverage.
 Deductible: The amount that the insured must pay out-of-pocket before the
health insurer pays its share. For example, a policy-holder might have to
pay a $500 deductible per year, before any of their health care is covered
by the health insurer. It may take several doctor's visits or prescription
refills before the insured
 person reaches the deductible and the insurance company starts to pay for
care.
 Co-payment: The amount that the insured person must pay out of pocket
before the health insurer pays for a particular visit or service. For example,
an insured person might pay a $45 co-payment for a doctor's visit, or to
obtain a prescription. A co-payment must be paid each time a particular
service is obtained.
 Coinsurance: Instead of, or in addition to, paying a fixed amount up front
(a co-payment), the co-insurance is a percentage of the total cost that
insured person may also pay. For example, the member might have to pay
20% of the cost of a surgery over and above a co-payment, while the
insurance company pays the other 80%. If there is an upper limit on
coinsurance, the policy-holder could end up owing very little, or a great
deal, depending on the actual costs of the services they obtain.
 Exclusions: Not all services are covered. The insured person is generally
expected to pay the full cost of non-covered services out of their own
pocket.
 
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 Coverage limits: Some health insurance policies only pay for health care
up to a certain dollar amount. The insured person may be expected to pay
any charges in excess of the health plan's
 maximum payment for a specific service. In addition, some insurance
company schemes have annual or lifetime coverage maximums. In these
cases, the health plan will stop payment when they reach the benefit
maximum, and the policy-holder must pay all remaining costs.
 Out-of-pocket maximums: Similar to coverage limits, except that in this
case, the insured person's payment obligation ends when they reach the
out-of-pocket maximum, and the health company pays all further covered
costs. Out-of-pocket maximums can be limited to a specific benefit
category (such as prescription drugs) or can apply to all coverage provided
during a specific benefit year.
 Capitation: An amount paid by an insurer to a health care provider, for
which the provider agrees to treat all members of the insurer.
 In-Network Provider: (U.S. term) A health care provider on a list of
providers preselected by the insurer. The insurer will offer discounted
coinsurance or co-payments, or additional benefits, to a plan member to
see an in-network provider. Generally, providers in network are providers
who have a contract with the insurer to accept rates further discounted from
the "usual and customary" charges the insurer pays to out-of-network
providers.
 Prior Authorization: A certification or authorization that an insurer
provides prior to medical service occurring. Obtaining an authorization
means that the insurer is obligated to pay for the service, assuming it
 
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matches what was authorized. Many smaller, routine services do not
require authorization.
 Explanation of Benefits: A document sent by an insurer to a patient
explaining what was covered for a medical service, and how they arrived
at the payment amount and patient responsibility amount.
Prescription drug plans are a form of insurance offered through some employer
benefit plans in the U.S., where the patient pays a co-payment and the prescription
drug insurance part or all of the balance for drugs covered in the formulary of the
plan. Some, if not most, health care providers in the United States will agree to
bill the insurance company if patients are willing to sign an agreement that they
will be responsible for the amount that the insurance company doesn't pay. The
insurance company pays out of network providers according to "reasonable and
customary" charges, which may be less than the provider's usual fee. The provider
may also have a separate contract with the insurer to accept what amounts to a
discounted rate or capitation to the provider's standard charges. It generally costs
the patient less to use an in-network provider.
Health Care and The World
The Commonwealth Fund, in its annual survey, "Mirror, Mirror on the Wall",
compares the performance of the health care systems in Australia, New Zealand,
the United Kingdom, Germany, Canada and the U.S. Its 2007 study found that,
although the U.S. system is the most expensive, it consistently under-performs
compared to the other countries. One difference between the U.S. and the other
countries in the study is that the U.S. is the only country without universal health
insurance coverage.
Australia
 
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The public health system is called Medicare. It ensures free universal access to
hospital treatment and subsidized out-of-hospital medical treatment. It is funded
by a 1.5% tax levy on all taxpayers, an extra 1% levy on high income earners, as
well as general revenue.
The private health system is funded by a number of private health insurance
organizations. The largest of these is Medibank Private, which is government-
owned, but operates as a government business enterprise under the same
regulatory regime as all other registered private health funds. The Coalition
Howard government had announced that Medibank would be privatized if it won
the 2007 election, however they were defeated by the Australian Labour Party
under Kevin Rudd which had already pledged that it would remain in government
ownership.
Some private health insurers are 'for profit' enterprises such as Australian Unity ,
and some are non-profit organizations such as HCF Health Insurance and
GMHBA Health Insurance.
Some have membership restricted to particular groups, but the majority has open
membership. Membership to most health funds is now also available through
comparison websites like money time, select or the decision assistance sites Help
Me Choose and the latest entry You Compare. These comparison sites operate on
a commission-basis by agreement with their participating health funds.
Most aspects of private health insurance in Australia are regulated by the Private
Health Insurance Act 2007. Complaints and reporting of the private health
industry is carried out by an independent government agency, the Private Health
Insurance Ombudsman . The ombudsman publishes an annual report that outlines
the number and nature of complaints per health fund compared to their market
share [ The private health system in Australia operates on a "community rating"
basis, whereby premiums do not vary solely because of a person's previous
 
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medical history, current state of health, or (generally speaking) their age (but see
Lifetime Health Cover below). Balancing this are waiting periods, in particular
for pre-existing conditions (usually referred to within the industry as PEA, which
stands for "pre-existing ailment"). Funds are entitled to impose a waiting period
of up to 12 months on benefits for any medical condition the signs and symptoms
of which existed during the six months ending on the day the person first took out
insurance. They are also entitled to impose a 12-month waiting period for benefits
for treatment relating to an obstetric condition, and a 2-month waiting period for
all other benefits when a person first takes out private insurance.
Funds have the discretion to reduce or remove such waiting periods in individual
cases. They are also free not to impose them to begin with, but this would place
such a fund at risk of "adverse selection", attracting a disproportionate number of
members from other funds, or from the pool of intending members who might
otherwise have joined other funds. It would also attract people with existing
medical conditions, who might not otherwise have taken out insurance at all
because of the denial of benefits for 12 months due to the PEA Rule. The benefits
paid out for these conditions would create pressure on premiums for all the fund's
members, causing some to drop their membership, which would lead to further
rises in premiums, and a vicious cycle of higher premiums-leaving members
would ensue.
There are a number of other matters about which funds are not permitted to
discriminate between members in terms of premiums, benefits or membership -
these include racial origin, religion, sex, sexual orientation, nature of
employment, and leisure activities. Premiums for a fund's product that is sold in
more than one state can vary from state to state, but not within the same state.
The Australian government has introduced a number of incentives to encourage
adults to take out private hospital insurance. These include:
 
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 Lifetime Health Cover: If a person has not taken out private hospital cover
by the 1st July after their 31st birthday, then when (and if) they do so after
this time, their premiums must include a loading of 2% per annum for each
year they were without hospital cover.
 Thus, a person taking out private cover for the first time at age 40 will pay
a 20 per cent loading. The loading is removed after 10 years of continuous
hospital cover. The loading applies only to premiums for hospital cover,
not to ancillary (extras) cover.
 Medicare Levy Surcharge: People whose taxable income is greater than a
specified amount (currently $70,000 for singles and $140,000 for couples)
and who do not have an adequate level of private hospital cover must pay
a 1% surcharge on top of the standard 1.5% Medicare Levy. The rationale
is that if the people in this income group are forced to pay more money one
way or another, most would choose to purchase hospital insurance with it,
with the possibility of a benefit in the event that they need private hospital
treatment - rather than pay it in the form of extra tax as well as having to
meet their own private hospital costs.
 The Australian government announced in May 2008 that it proposes to
increase the thresholds, to $100,000 for singles and $150,000 for families.
These changes require legislative approval. A bill to change the law has
been introduced but was not passed by the Senate. An amended version
was passed on 16 October 2008. There have been criticisms that the
changes will cause many people to drop their private health insurance,
causing a further burden on the public hospital system, and a rise in
premiums for those who stay with the private system. Other commentators
believe the effect will be minimal.
 
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 Private Health Insurance Rebate: The government subsidises the premiums
for all private health insurance cover, including hospital and ancillary
(extras), by 30%, 35% or 40%, depending on age. The Rudd Government
announced in May 2009 that as of July 2010, the Rebate would become
means-tested, and offered on a sliding scale.
Canada
Health care is constitutionally mainly a provincial government responsibility in
Canada (the main exceptions being federal government responsibility for services
provided to aboriginal peoples covered by treaties, the Royal Canadian Mounted
Police, the armed forces, and members of parliament). Consequently, each
province administers its own health insurance program. The federal government
influences health insurance by virtue of its fiscal powers - it transfers cash and
tax points to the provinces to help cover the costs of the universal health insurance
programs. Under the Canada Health Act, the federal government mandates and
enforces the requirement that all people have free access to what are termed
"medically necessary services," defined primarily as care delivered by physicians
or in hospitals, and the nursing component of long-term residential care. If
provinces allow doctors or institutions to charge patients for medically necessary
services, the federal government reduces its payments to the provinces by the
amount of the prohibited charges. Collectively, the public provincial health
insurance systems in Canada are frequently referred to as Medicare.
This public insurance is tax-funded out of general government revenues, although
British Columbia and Ontario levy a mandatory premium with flat rates for
individuals and families to generate additional revenues - in essence a surtax.
Private health insurance is allowed, but in six provincial governments only for
services that the public health plans do not cover, for example, semi-private or
private rooms in hospitals and prescription drug plans. Four provinces allow
 
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insurance for services also mandated by the Canada Health Act, but in practice
there is no market for it. All Canadians are free to use private insurance for
elective medical services such as laser vision correction surgery, cosmetic
surgery, and other non-basic medical procedures. Some 65% of Canadians have
some form of supplementary private health insurance; many of them receive it
through their employers. Private-sector services not paid for by the government
account for nearly 30 percent of total health care spending.
In 2005, the Supreme Court of Canada ruled, in Chaoulli v. Quebec, that the
province's prohibition on private insurance for health care already insured by the
provincial plan violated the Quebec Charter of Rights and Freedoms, and in
particular the sections dealing with the right to life and security, if there were
unacceptably long wait times for treatment, as was alleged in this case. The ruling
has not changed the overall pattern of health insurance across Canada but has
spurred on attempts to tackle the core issues of supply and demand and the impact
of wait times.
France
The national system of health insurance was instituted in 1945, just after the end
of the Second World War. It was a compromise between Gaullist and Communist
representatives in the French parliament. The Conservative Gaullists were
opposed to a state-run healthcare system, while the Communists were supportive
of a complete nationalization of health care along a British Beverage model.
The resulting programme is profession-based: all people working are required to
pay a portion of their income to a not-for-profit health insurance fund, which
mutualisms the risk of illness, and which reimburses medical expenses at varying
rates. Children and spouses of insured people are eligible for benefits, as well.
Each fund is free to manage its own budget, and used to reimburse medical
expenses at the rate it saw fit, however following a number of reforms in recent
 
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years, the majority of funds provide the same level of reimbursement and
benefits.
The government has two responsibilities in this system.
 The first government responsibility is the fixing of the rate at which
medical expenses should be negotiated, and it does this in two ways: The
Ministry of Health directly negotiates prices of medicine with the
manufacturers, based on the average price of sale observed in neighbouring
countries. A board of doctors and experts decides if the medicine provides
a valuable enough medical benefit to be reimbursed (note that most
medicine is reimbursed, including homeopathy).
 In parallel, the government fixes the reimbursement rate for medical
services: this means that a doctor is free to charge the fee that he wishes
for a consultation or an examination, but the social security system will
only reimburse it at a pre-set rate. These tariffs are set annually through
negotiation with doctors' representative organisations.
 The second government responsibility is oversight of the health-insurance
funds, to ensure that they are correctly managing the sums they receive,
and to ensure oversight of the public hospital network.
Today, this system is more-or-less intact. All citizens and legal foreign residents
of France are covered by one of these mandatory programs, which continue to be
funded by worker participation. However, since 1945, a number of major changes
have been introduced. Firstly, the different health-care funds (there are five:
General, Independent, Agricultural, Student, Public Servants) now all reimburse
at the same rate. Secondly, since 2000, the government now provides health care
to those who are not covered by a mandatory regime (those who have never
worked and who are not students, meaning the very rich or the very poor). This
regime, unlike the worker-financed ones, is financed via general taxation and
 
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reimburses at a higher rate than the profession-based system for those who cannot
afford to make up the difference. Finally, to counter the rise in health-care costs,
the government has installed two plans, (in 2004 and 2006), which require insured
people to declare a referring doctor in order to be fully reimbursed for specialist
visits, and which installed a mandatory co-pay of 1 € (about $1.45) for a doctor
visit, 0,50 € (about 80 ¢) for each box of medicine prescribed, and a fee of 16-18
€ (20-25 $) per day for hospital stays and for expensive procedures.
An important element of the French insurance system is solidarity: the more ill a
person becomes, the less the person pays. This means that for people with serious
or chronic illnesses, the insurance system reimburses them 100 % of expenses,
and waives their co-pay charges.
Finally, for fees that the mandatory system does not cover, there is a large range
of private complementary insurance plans available. The market for these
programs is very competitive, and often subsidized by the employer, which means
that premiums are usually modest. 85% of French people benefit from
complementary private health insurance.
Netherlands
In 2006, a new system of health insurance came into force in the Netherlands.
This new system avoids the two pitfalls of adverse selection and moral hazard
associated with traditional forms of health insurance by using a combination of
regulation and an insurance equalization pool. Moral hazard is avoided by
mandating that insurance companies provide at least one policy which meets a
government set minimum standard level of coverage, and all adult residents are
obliged by law to purchase this coverage from an insurance company of their
choice. All insurance companies receive funds from the equalization pool to help
cover the cost of this government-mandated coverage.
 
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This pool is run by a regulator which collects salary-based contributions from
employers, which make up about 50% of all health care funding, and funding
from the government to cover people who cannot afford health care, which makes
up an additional 5%.
The remaining 45% of health care funding comes from insurance premiums paid
by the public, for which companies compete on price, though the variation
between the various competing insurers is only about 5%. However, insurance
companies are free to sell additional policies to provide coverage beyond the
national minimum. These policies do not receive funding from the equalization
pool, but cover additional treatments, such as dental procedures and
physiotherapy, which are not paid for by the mandatory policy.
Funding from the equalization pool is distributed to insurance companies for each
person they insure under the required policy. However, high-risk individuals get
more from the pool, and low-income persons and children under 18 have their
insurance paid for entirely. Because of this, insurance companies no longer find
insuring high-risk individuals an unappealing proposition, avoiding the potential
problem of adverse selection.
Insurance companies are not allowed to have co-payments, caps, or deductibles,
or to deny coverage to any person applying for a policy, or to charge anything
other than their nationally set and published standard premiums. Therefore, every
person buying insurance will pay the same price as everyone else buying the same
policy, and every person will get at least the minimum level of coverage.
United Kingdom
The UK's National Health Service (NHS) is a publicly funded healthcare system
that provides coverage to everyone normally resident in the UK. It is not strictly
an insurance system because (a) there are no premiums collected, (b) costs are
not charged at the patient level and (c) costs are not pre-paid from a pool.
 
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However, it does achieve the main aim of insurance which is to spread financial
risk arising from ill-health. The costs of running the NHS (est. £104 billion in
2007-8) are met directly from general taxation. The NHS provides the majority
of health care in the UK, including primary care, in-patient care, long-term health
care, ophthalmology and dentistry.
Private health care has continued parallel to the NHS, paid for largely by private
insurance, but it is used by less than 8% of the population, and generally as a top-
up to NHS services. There are many treatments that the private sector does not
provide. For example, health insurance on pregnancy is generally not covered or
covered with restricting clauses. Typical exclusions for Bupa schemes (and many
other insurers) include: ageing, menopause and puberty; AIDS/HIV; allergies or
allergic disorders; birth control, conception, sexual problems and sex changes;
chronic conditions; complications from excluded or restricted conditions/
treatment; convalescence, rehabilitation and general nursing care ; cosmetic,
reconstructive or weight loss treatment; deafness; dental/oral treatment (such as
fillings, gum disease, jaw shrinkage, etc); dialysis; drugs and dressings for out-
patient or take-home use† ;
experimental drugs and treatment; eyesight; HRT and bone densitometry;
learning difficulties, behavioural and developmental problems; overseas
treatment and repatriation; physical aids and devices; pre-existing or special
conditions; pregnancy and childbirth; screening and preventive treatment; sleep
problems and disorders; speech disorders; temporary relief of symptoms (except
in exceptional circumstances)
There are a number of other companies in the United Kingdom which include,
among others, AXA,Aviva, Groupama Healthcare, WPA and PruHealth. Similar
exclusions apply, depending on the policy which is purchased.
 
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Recently (2009) the main representative body of British Medical physicians, the
British Medical Association, adopted a policy statement expressing concerns
about developments in the health insurance market in the UK. In its Annual
Representative Meeting which had been agreed earlier by the Consultants Policy
Group (i.e. Senior physicians) stating that the BMA was "extremely concerned
that the policies of some private healthcare insurance companies are preventing
or restricting patients exercising choice about (i) the consultants who treat them;
(ii) the hospital at which they are treated; (iii) making top up payments to cover
any gap between the funding provided by their insurance company and the cost
of their chosen private treatment." It went in to "call on the BMA to publicise
these concerns so that patients are fully informed when making choices about
private healthcare insurance."
The NHS offers patients a choice of hospitals and consultants and does not charge
for its services. The private sector has been used to increase NHS capacity despite
a large proportion of the British public opposing such involvement. According to
the World Health Organization, government funding covered 86% of overall
health care expenditures in the UK as of 2004, with private expenditures covering
the remaining 14%.
United States
The United States health care system relies heavily on private health insurance,
which is the primary source of coverage for most Americans. According to the
CDC, approximately 58% of Americans have private health insurance. Public
programs provide the primary source of coverage for most senior citizens and for
low-income children and families who meet certain eligibility requirements. The
primary public programs are Medicare, a federal social insurance program for
seniors and certain disabled individuals, Medicaid, funded jointly by the federal
government and states but administered at the state level, which covers certain
 
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very low income children and their families, and SCHIP, also a federal-state
partnership that serves certain children and families who do not qualify for
Medicaid but who cannot afford private coverage. Other public programs include
military health benefits provided through TRICARE and the Veterans Health
Administration and benefits provided through the Indian Health Service. Some
states have additional programs for low-income individuals.
A recent study found that 62 percent of all bankruptcies filed in 2007 were linked
to medical expenses. Of those who filed for bankruptcy, nearly 80 percent had
health insurance. In just three years, the Medicare and Medicaid programs will
account for 50 percent of all national health spending. This has fueled an outcry
for an overhaul of the health care system in the United States. The House of
Representatives passed a health care reform bill by a vote of 220-215 on
November 7, 2009. Currently the fate of the bill rests on the Senate. The
legislation once included changes that would give the government the power to
negotiate policy premiums and to provide a public option, but in an effort to
acquire the necessary votes to prevent a Republican filibuster the public option
was eliminated from the bill. This would have given citizens the option to buy
into public programs like Medicare for which current members pay only $96.40
monthly. Instead the bill now requires that all Americans purchase private health
insurance or be subject to fines. The insurance industry represents a significant
lobbying group in the United States. The major health interests have spent an
average of $1.4 million per day to lobby Congress so far this year and are on track
to spend more than half a billion dollars by the end 2009. On March 21, 2010, the
House of Representatives passed a bill proposed by President Obama, which will
supposedly offer a wide range of coverage and extend it to roughly 32 million
more Americans without coverage.
California
 
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In 2007, 87% of Californians had some form of health insurance. Services in
California range from private offerings:
HMOs, PPOs to public programs: Medi-Cal, Medicare, and Healthy Families
(SCHIP).California developed a solution to assist people across the State and is
one of the only States to have an Office devoted to giving people tips and
resources to get the best care possible. California's Office of the Patient Advocate
was established July 2000 to publish a yearly Health Care Quality Report Card
on the Top HMOs, PPOs, and Medical Groups and to create and distribute helpful
tips and resources to give Californians the tools needed to get the best care.
Additionally, California has a Help Center that assists Californians when they
have problems with their health insurance. The Help Center is run by the
Department of Managed Health Care, the government department that oversees
and regulates HMOs and some PPOs.
Germany
Germany has Europe's oldest universal health care system, with origins dating
back to Otto von Bismarck's Social legislation, which included the Health
Insurance Bill of 1883, Accident Insurance Bill of 1884, and Old Age and
Disability Insurance Bill of 1889. As mandatory health insurance, these bills
originally applied only to low-income workers and certain government
employees; their coverage, and that of subsequent legislation gradually expanded
to cover virtually the entire population.
Currently 85% of the population is covered by a basic health insurance plan
provided by statute, which provides a standard level of coverage. The remainder
opt for private health insurance, which frequently offers additional benefits.
 
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According to the World Health Organization, Germany's health care system was
77% government-funded and 23% privately funded as of 2004.The government
partially reimburses the costs for low-wage workers, whose premiums are capped
at a predetermined value. Higher wage workers pay a premium based on their
salary. They may also opt for private insurance, which is generally more
expensive, but whose price may vary based on the individual's health status.
Reimbursement is on a fee-for-service basis, but the number of physicians
allowed to accept Statutory Health Insurance in a given locale is regulated by the
government and professional societies.
Co-payments were introduced in the 1980s in an attempt to prevent over
utilization. The average length of hospital stay in Germany has decreased in
recent years from 14 days to 9 days, still considerably longer than average stays
in the United States (5 to 6 days).Part of the difference is that the chief
consideration for hospital reimbursement is the number of hospital days as
opposed to procedures or diagnosis. Drug costs have increased substantially,
rising nearly 60% from 1991 through 2005. Despite attempts to contain costs,
overall health care expenditures rose to 10.7% of GDP in 2005, comparable to
other western European nations, but substantially less than that spent in the U.S.
(nearly 16% of GDP).
 
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Development in India
Social security for medical emergencies is not new to the Indian ethos. It is a
common practice for villagers to take a ‘piruvu’ (a collection) to support a
household with a sick patient. However, health insurance, as we know it today,
was introduced only in 1912 when the first Insurance Act was passed (Devadasan
2004). The current version of the Insurance Act was introduced in 1938. Since
then there was little change till 1972 when the insurance industry was
nationalized and 107 private insurance companies were brought under the
umbrella of the General Insurance Corporation (GIC). Private and foreign
entrepreneurs were allowed to enter the market with the enactment of the
Insurance Regulatory and Development Act (IRDA) in 1999.The penetration of
health insurance in India has been low. It is estimated that only about 27% of
Indians are covered under any form of health insurance. In terms of the market
share, the size of the commercial insurance is barely 3.56% of the total health
spending in the country. The Indian health insurance scenario is a mix of
mandatory social health insurance (SHI), voluntary private health insurance and
community-based health insurance (CBHI). Health insurance is thus really a
minor player in the health ecosystem.
The concept of insurance is intimately related to security. Insurance acts as a
protective shield against risk and future uncertainties. Traditionally, a risk-averse
.Behaviours been characteristic feature of Indians who preferred a “low &
certain” disposable income to a “high& uncertain” one.
 
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Hence insurance has become a close associate of Indians since 1818, when
Oriental Life Insurance Company was started by Europeans in Kolkata to cater
to the needs of their own community. The age was characterized by intense racial
discrimination as Indian.
Insurance policy holders were charged higher premiums than their foreign
counterparts. The first Indian Insurance Company to cover Indian lives at normal
rates was Bombay Mutual Life Assurance Society which was established in the
year 1870.By the dawn of the 20. The century, new insurance companies started
mushrooming up. In order to regulate the insurance business in India and to
certify the premium rate tables and periodic valuations of the insurance
companies, the Life Insurance Companies Act and the Provident Fund Act were
passed to regulate the Insurance Business in India in 1912. Such statistical
estimates made by actuaries revealed the disparity that existed between Indiana
foreign companies.
The Indian Insurance Sector went through a full circle of phases from being
unregulated to completely regulate and then being partly deregulated which is the
present situation. Brief on how the events folded up is discussed as follows: The
Insurance Act of 1938 was the first legislation governing all forms of insurance
to provide strict state controls over insurance business.
In 19th January, 1956, the life insurance in India was completely nationalized
through the Life Insurance Corporation Act of 1956.
 
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At that time, there were 245 insurance companies of both Indian and foreign
origin. Government accomplished its policy of nationalization by acquiring the
management of the companies. Bearing this objective in
mind, the Life Insurance Corporation (LIC) of India was created on 1st
September, 1956 which has grown in leaps and bounds henceforth, to become the
largest insurance company in India. The General Insurance Business
(Nationalization) Act of 1972 was formulated with the objective of nationalizing
nearly 100 general insurance companies and subsequently amalgamating them
into four basic companies namely National Insurance, New India Assurance,
Oriental Insurance and United India Insurance which have their headquarters in
four metropolitan cities.
The Insurance Regulatory and Development Authority (IRDA) Act of 1999
deregulated the insurance sector in India and allowed the entry of private
companies into the insurance sector. Moreover, the flow of Foreign Direct
Investment (FDI) was also restricted to 26 % of the total capital held by the Indian
Insurance Companies.
Some of the important milestones in the life insurance business in India
1912: The Indian insurance Companies Act enacted as the first statute to regulate
the insurance business.
1928: The Indian Insurance Companies Act enacted to enable the government to
collect statistical information about both life and non-life insurance businesses.
1938: Earlier legislation consolidated and amended to by the Insurance Act with
the objective of protecting the interests of the insuring public.
 
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1956: Indian and foreign insurers and provident societies taken over by the
central government were nationalized. LIC formed by an Act of Parliament, viz.
LIC Act, 1956, with a capital contribution of Rs. 5 crores from the Government
of India.
Insurance is an Rs.400 billion business in India, and together with banking
services adds about 7% to India’s GDP. Gross premium collection is about 2% of
GDP and has been growing by 15 - 20% per annum. India also has the highest
number of life insurance policies in force in the world, and total investible funds
with the LIC are almost 8% of GDP. Yet more than three-fourths of India's
insurable population has no life insurance or pension cover. Health insurance of
any kind is negligible and other forms of non-life insurance are much below
international standards. To tap the vast insurance potential and to mobilize long -
term savings we need reforms which include revitalizing and restructuring of the
public sector companies, and opening up the sector to private players. A statutory
body needs to be made to regulate the market and promote a healthy market
structure. Insurance Regulatory Authority (IRA) is one such body, which checks
on these tendencies. IRA role comprises of following three functions:
a. Protection of consumer's interest.
b. To ensure financial soundness and solvency of the insurance industry, and
c. To ensure healthy growth of the insurance market.
An insurance policy protects the buyer at some cost against the financial loss
arising from specified risk. Different situations and different people require a
different mix of risk cost combinations. Insurance companies provide these by
offering schemes of different kinds. Unfortunately, the concept of insurance is
not popular in our country. As per the latest estimates, the total premium income
generated by life and general insurance in India is estimated at around a meager
3.56% of GDP. However, India’s share of world insurance market has shown an
 
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increase of 10% from 0.31 in 1996-97 to 0.34% in 1997-98. India's market share
in the life insurance business showed a real growth of 11% thereby outperforming
the global average of 7.7%. Non-life business grew by 3.1against global average
of 0.20%. In India insurance spending per capita was among the
lowest in the world at $7.6 compared to $7 in the previous year. Amongst the
emerging economies, India is one of the least insured countries but the potential
for further growth is phenomenal, as a significant portion of its population is in
services and the life expectancy has also increased over the years.
The nationalized insurance industry has not offered consumers a variety of
products. Opening of the sector to private firms will foster competition,
innovation, and variety of products. It would also generate greater awareness on
the need for buying insurance as a service and not merely for tax exemption,
which is currently done. On the demand side, a strong correlation between
demand for insurance and per capita income level suggests that high economic
growth can spur growth in demand.
 
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Top Health
Insurance
Companies in
India
 
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Religare health insurance is one of the best health insurances in India which
offers coverage for health insurance, critical illness, personal accident, top-up
coverage, international travel insurance, and maternity along with group health
insurance.
The claim settlement ratio of Religare is 93% and a high ICR of 51.97%.
Religare has over 5420 hospitals in its network.
Type: Private
Industry: Health Insurance
Founded: 2012
Headquarter: New Delhi, India
Area served: India
Key people: Mr. Anuj Gulati
Owner: Mr. Anuj Gulati
 
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Tata AIG Insurance is a trusted 20-year-old joint venture between Tata & AIG
Group that carries an iAAA rating by ICRA for the highest claims-paying
ability.
The individual death claim ratio for 2018-19 was 96.12%. The company has
access to 4000+ network hospitals.
Type: Joint venture
 
Industry: Insurance
 
Founded: 2001
 
Headquarter: Mumbai, India
 
Area served: India
 
Key people: Neelesh Garg
 
Owner: Tata Sons 
 
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Max Bupa insurance offers coverage for a number of illnesses, access to
hospital networks and cashless claims.
Claim settlement ratio of Max Bupa is 91.2% and a high ICR of 51.96%. Max
has over 3000 hospitals in its network.
Type: Joint Venture
 
Industry: Health Insurance
 
Founded: 2008
 
Headquarter: New Delhi, India
 
Area served: India
 
Key people: Krishnan Ramachandran {MD}
 
Owner: Bupa, Fettle Tone LLP  
 
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ICICI Lombard has a network of 4500+ hospitals to avail cashless facilities.
According to IRDA, it is supposed to have settled 98.32% of the claims
received.
It has a very high ICR of 80.38% which indicates that people are renewing the
policy and also making claims.
Type: Public
 
Industry: Insurance
 
Founded: 2001
 
Headquarter: Mumbai, India
 
Area served: Worldwide
 
Key people: Bhargav Dasgupta
 
Owner: ICICI Bank 
 
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Star Health Insurance company provides a wide range of health insurance
policies for individuals, families, senior citizens and for those who need
specialized care like heart patients and cancer patients. Star has a high claims
settlement percentage of 98.72% and ICR of 60.51% with a whopping 8200+
hospitals are on its network.
Type: Private
 
Industry: Insurance
 
Founded: 2006
 
Headquarter: Chennai, India
 
Area served: India
 
Key people: V Jagannathan, Anand Roy
 
Owner: Dr. S Prakash  
 
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Iffco Tokio General Insurance Company was founded in the year 2000. It is an
effective health insurance company and a joint venture between Indian Farmers
F (IFFCO) and its associates with Nichido Fire Group (biggest listed insurer of
Japan) & Tokio Marine. You will get a wide range of general insurance products
which c tough times.
Type: Private
 
Industry: Insurance
 
Founded: 2000
 
Headquarter: Gurugram
 
Area served: Worldwide
 
Key people: Anamika Roy Rashtrawar
 
Owner: B.S Nakai  
 
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CHAPTER 4:
OBJECTIVES
&
METHODOLOGY
 
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Objective of study:
1.To analyse the investors perception on investing in private
insurance company.
2.To analyse the various investment options of the investors.
3. To analyse preference of investors between public and
private insurance company.
4. To analysing, the investing habits of the investors and the
factors influencing the investor in investing in insurance.
5. To study the important parameters that investors think about
before investing in insurance products.
6. To know about the factors contributing to
satisfaction and dissatisfaction of customers.
7.To analyse investors attitude towards insurance products on
selected factors.
 
45 | P a g e  
 
Methodology:
TITLE OF THE STUDY:
The title of the study is “Consumer Perception towards Health
insurance in this Covid Era.”
RESEARCH DESIGN:
A research design is simply a plan for study in collection and analysis
the data.
The report is exploratory and descriptive in nature.
It is a descriptive in nature but it suggests some important points to
improve the services, so it is exploratory in nature also.
DATA COLLECTION:
For the purpose of project data is very much required which works as
a food for process which will ultimately give output in the form of
information. So before mentioning the source of data for the project I
would like to mention that what type of data I have collected for the
purpose of project and what it is exactly.
During preparation of the project report many different kinds of data
were required which includes both primary and secondary sources.
SOURCES OF DATA COLLECTION: PRIMARY DATA: -
 
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Primary data is basically the live data which I collected
-Questionnaire
SECONDARY DATA:
Secondary data is already published data. It is the data which is
funded or collected by someone else before and presently used by
further research work. Secondary data for the base of the project, I
collect the data from: -
-internet
-journals
- Referring different books & previous project report.
SAMPLE SIZE:
The sample size selected from universe to constitute my study is 80.
SAMPLE UNIT:
Study is conducted by the survey of self-employed persons and
business men.
 
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CHAPTER 5: -
DATA ANALYSIS
&
INTEREPREATION
 
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DATA ANALYSIS & INTEREPREATION
TABLE 1
Table 1: showing the occupation of respondents
OCCUPATION
NO. OF
RESPONDENTS
% OF
RESPONDENTS
GOVERNMENT
EMPLOYEE
9 11.3%
PRIVATE EMPLOYEE 12 15%
BUSINESSMAN 23 28.8%
PROFESSIONAL 10 12.5%
OTHERS 46 32.4%
TOTAL 80 100%
Analysis
From the above table, it can be analysed that out of 80 respondents 26.3% of the
respondents are employed, 28.8% of the respondents are belonging to business,
12.5% of the respondents are professional and 32.4% are belongs to others.
 
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GRAPH 1
Graph 1: showing the occupation of respondents
Interpretation
It can be inferred from the data that a greater number of others people take
insurance. So, the companies should emphasize and formulate products
appropriate to employed customers.
0
5
10
15
20
25
30
35
40
45
50
Govt. Employee Private Employee Businessman Professional Others
No. of Respondents
No. of Respondents
 
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TABLE 2
Table 2: showing the age group of respondents
Analysis
From the above table we can infer that, highest percentages of respondents belong
to the age group of 21-30 years.
AGE GROUPS NO. OF
RESPONDENTS
% OF RESPONDENTS
Below 20 years 10 12.5%
21 - 30 years 31 38.7%
31 - 40 years 24 30%
41 - 60 years 08 08%
Above 60 years 07 8.8%
Total 80 100%
 
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GRAPH 2
Graph 2: showing the age group of the respondents.
Interpretation
From the analysis we can infer that people in the age group of 21-30 take
insurance services. They have sufficient funds to invest. Therefore, the companies
should target the potential customer in this age group.
0.00%
5.00%
10.00%
15.00%
20.00%
25.00%
30.00%
35.00%
40.00%
45.00%
Below 20 years 21‐30 years 31‐40 years 41‐60 years Above 60 years
% of Respondents
% of Respondents
 
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TABLE 3
Table 3: showing the gender of the respondents
Analysis
From the above table we can infer that, highest percentages of respondents belong
to the Female category 61.3%
Gender NO. OF
RESPONDENTS
% OF RESPONDENTS
Male 31 38.7%
Female 49 61.3%
Total 80 100%
 
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GRAPH 3
Graph 3: showing the gender of the respondents
Interpretation
From the analysis we can infer that Female category take insurance services. They
have sufficient funds to invest. Therefore, the companies should target the
potential customer.
% of Respondents
0.00%
20.00%
40.00%
60.00%
80.00%
Male Female
% of Respondents
% of Respondents
 
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TABLE 4
Table 4: showing the kind of investment consumer prefer in this
pandemic
Analysis
From the above table we found which type of investment prefer. So out of 100%
candidates prefer medium-term investment which is 41.3%.
Investment NO. OF
RESPONDENTS
% OF RESPONDENTS
Long-term 31 38.8%
Medium-term 33 41.3%
Short-term 16 20%
Total 80 100%
 
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GRAPH 4
Graph 4: showing the kind of investment consumer prefer in this
pandemic
Interpretation
It can be inferred from the data that a greater number of people take insurance in
medium term. So, the companies should emphasize and focus on medium term
investment.
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Long‐term medium‐term Short‐term
No. of Respondents
No. of Respondents
 
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TABLE 5
Table 5: showing the awareness about Health insurance
Analysis
From the above table we can infer that, 62.5% of consumer are aware/ exposed
and subscribed to health insurance out of 100%
Awareness about Health
insurance
NO. OF
RESPONDENTS
% OF RESPONDENTS
Not Aware / not exposed 06 07.5%
Aware/ exposed and
subscribed
50 62.5%
Aware/ exposed and
unsubscribed
24 30%
Total 80 100%
 
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GRAPH 5
Graph 5: showing the awareness about Health insurance
Interpretation
It can be inferred from the data that a greater number of people are aware/ exposed
and subscribed which shown in graph orange colour. So, companies should create
more awareness by giving benefits like cashless treatment to consumers.
No. of Respondents
Not Aware / not exposed Aware/ exposed and subscribed Aware/ exposed and unsubscribed
 
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TABLE 6
Table 6: showing the Source of Awareness
Analysis
From the above table we can infer that, most of the consumer awareness source
are family & friends 28.7%.
Sources of Awareness NO. OF
RESPONDENTS
% OF RESPONDENTS
Self-decision 14 17.5%
Advertisement in TV 11 13.8%
Newspaper or
Magazines
04 05%
Internet 09 11.2%
Insurance Agents 07 8.8%
Family/
Friends suggestion
23 28.7%
Employee of insurance
company
08 10%
Tax consultants &
Doctors
04 05%
Total 80 100%
 
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GRAPH 6
Graph 6: showing the Source of Awareness
Interpretation
It can be inferred from the data that a greater number of people are created
awareness by taking the suggestions from family & friends. So, companies should
focus on creating awareness by showing the importance of health insurance.
% of Respondents
0.00%
5.00%
10.00%
15.00%
20.00%
25.00%
30.00%
% of Respondents
% of Respondents
 
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TABLE 7
Table 7: showing the which Health Insurance policy prefer most
Analysis
From the above table we can infer that, most of the consumer prefer private health
insurance 56.3% as comparison to public sector insurance which is 43.8%.
Sector NO. OF
RESPONDENTS
% OF RESPONDENTS
Private Sector 45 56.3%
Public Sector 35 43.8%
Total 80 100%
 
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GRAPH 7
Graph 7: showing the which Health Insurance policy prefer most
Interpretation
It can be inferred from the data that a greater number of people are taking the
health insurance services of private companies instead of public health insurance.
So, private sector should create more customers by giving importance of
insurance by private sector.
% of Respondents 
Private Sector Public Sector
 
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TABLE 8
Table 8: showing how many people have health insurance policy, if
yes then in which health insurance company
Analysis
From the above table we can infer that, most of the consumer doesn’t taken the
health insurance policy which is 27.5%
Insurance Company NO. Of RESPONDENTS % OF RESPONDENTS
Don't have health
Insurance policy
22 27.5%
Apollo Munich Health
Insurance Company
Limited.
7 8.7%
IFFCO Tokio 7 8.8%
Star Health & Allied
Insurance Company
Limited.
10 12.5%
ICICI Lombard General
Insurance Company
Limited.
18 12.5%
National Insurance
Company Limited.
12 15%
Others 4 15%
Total 80 100%
 
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GRAPH 8
Graph 8: showing how many people have health insurance policy, if
yes then in which health insurance company
Interpretation
It can be inferred from the data that out of 80 consumers 22 consumer doesn’t
have any insurance policy out of which 18 consumers taken the policy of ICICI
Lombard General Insurance Company Limited. So, companies should create
more availability of services through which people can create interest and buy
health insurance.
No. of Respondents
0
5
10
15
20
25
Don't
have
health
Insurance
policy
Apollo
Munich
Health
Insurance
Company
Limited
IFFCO
Tokio
Star
Health &
Allied
Insurance
Company
Limited.
ICICI
Lombard
General
Insurance
Company
Limited.
National
Insurance
Company
Limited.
Others
No. of Respondents
No. of Respondents
 
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TABLE 9
Table 9: showing how many people has got a health insurance plan for
himself/herself and his/her family?
Analysis
From the table above we can say that 62.5% of the respondents has taken the
insurance for ourself and families.
Plans taken NO. OF
RESPONDENTS
% OF RESPONDENTS
Yes 50 62.5%
No 30 37.5%
Total 80 100%
 
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GRAPH 9
Graph 9: showing how many people has got a health insurance plan for
himself/herself and his/her family?
Interpretation
From the analysis we can infer that out of 80 respondents 50 has taken insurance.
So, companies should more focus on creating more customer by organizing a
campaign.
0
5
10
15
20
25
30
35
40
45
50
Yes No
No. of Respondents
No. of Respondents
 
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TABLE 10
Table 10: showing Company provides cashless treatment or not.
Analysis
From the table above we can say that 61.3% of the companies provides cashless
treatment to their consumers.
Cashless treatment NO. OF
RESPONDENTS
% OF RESPONDENTS
Yes 49 61.3%
No 31 38.7%
Total 80 100%
 
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GRAPH 10
Graph 10: showing Company provides cashless treatment or not.
Interpretation
From the analysis we can infer that out of 80 respondents 49 get a cashless
treatment from their companies. So, these companies can create more trust with
their customers by provides a need while they need it.
NO. OF RESPONDENTS
Yes No
 
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TABLE 11
Table 11: showing health insurance is important in today world or not.
Analysis
From the table above we can say that 62.5% yes health insurance is important in
today’s world.
Importance of Health
Insurance
NO. OF
RESPONDENTS
% OF RESPONDENTS
Yes 50 62.5%
No 15 18.8%
Maybe 15 18.8%
Total 80 100%
 
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GRAPH 11
Graph 11: showing health insurance is important in today world or not.
Interpretation
From the analysis we can infer that out of 80 respondents 50 respondents says
that health insurance is important in today’s world, because of this Corona
pandemic more and more consumers buy health insurance and most of the
consumers claims their existing health insurance.
0
10
20
30
40
50
60
yes No Maybe
NO. OF RESPONDENTS
NO. OF RESPONDENTS
 
70 | P a g e  
 
TABLE 12
Table 12: showing that what should be minimum sum insured.
Analysis
From the table above we can say that 52.5% of respondents prefer 5 lacs insurance
policy. Rest 28.5% prefer 10 lacs policy.
Minimum Sum Insured NO. OF
RESPONDENTS
% OF RESPONDENTS
3 lacs 10 12.5%
5 lacs 42 52.5%
10 lacs 23 28.7%
15 lacs 4 5%
Don't know 1 1.2%
Total 80 100%
 
71 | P a g e  
 
GRAPH 12
Graph 12: showing that what should be minimum sum insured.
Interpretation
From the analysis we can infer that out of 80 respondents 42 respondents thinks
that 5 lacs policy is enough for claiming. But 23 respondents think that 10 lacs
will be enough for getting the claim.
0
5
10
15
20
25
30
35
40
45
3 lacs 5 lacs 10 lacs 15 lacs Don’t Know
No. of Respondents
No. of Respondents
 
72 | P a g e  
 
TABLE 13
Table 13: showing Term of Health Insurance Policy.
Analysis
From the table above we can say that 51.2% respondents think the terms of health
insurance policy should be 2-5 years.
Term of Policy NO. OF
RESPONDENTS
% OF RESPONDENTS
Less than – 2 years 07 8.8%
Between 2-5 years 41 51.2%
Between 5-7 years 18 22.5%
Between 7-10 years 10 12.5%
More than 10 years 04 05%
Total 80 100%
 
73 | P a g e  
 
GRAPH 13
Graph 13: showing Term of Health Insurance Policy.
Interpretation
From the analysis we can infer that out of 80 respondents 41 respondents tick the
option of between 2-5 years. So, with this term of policy companies can avail
more health insurance products.
No. of Respondents
0
10
20
30
40
50
Less than – 2 
years
Between 2‐5
years
Between 5‐7
years
Between 7‐10
years
More than 10
years
No. of Respondents
No. of Respondents
 
74 | P a g e  
 
TABLE 14
Table 14: showing which time period prefer most to pay health-
insurance premium amount.
Analysis
From the table above we can say that 35% of respondents thinks that Half yearly
payment of premium is best then quarterly or annual/ yearly.
Time-period NO. OF
RESPONDENTS
% OF RESPONDENTS
Monthly 09 11.3%
Quarterly 17 21.3%
Half Yearly 28 35%
Annual / Yearly 26 32.5%
Total 80 100%
 
75 | P a g e  
 
GRAPH 14
Graph 14: showing which time period prefer most to pay health-
insurance premium amount.
Interpretation
From the analysis we can infer that out of 80 respondents 28 respondents pays
their premium amount half yearly rest 26 respondents pays annually. So, it shows
that consumer prefer half yearly payment.
NO. OF RESPONDENTS
0
10
20
30
Monthly Quarterly Half yearly Annual/ Yearly
NO. OF RESPONDENTS
NO. OF RESPONDENTS
 
76 | P a g e  
 
TABLE 15
Table 15: showing the Objective of taking Health Insurance Policy.
Analysis
From the table above we can say that 41.3% of respondents buys health insurance
for Medical emergencies.
Objectives NO. OF
RESPONDENTS
% OF RESPONDENTS
Risk Coverage 10 12.5%
To Protect against high
and unexpected
27 33.8%
Medical Emergencies 33 41.3%
Tax Benefits 10 12.5%
Total 80 100%
 
77 | P a g e  
 
GRAPH 15
Graph 15: showing the Objective of taking Health Insurance Policy.
Interpretation
From the analysis we can infer that out of 80 respondents 33 of them buys health
policy for medical emergencies rest 27 buys for to protect against high and
unexpected difficulties. So, it is clear that COVID change the mindset of the
consumer to buy policy for medical emergencies.
NO. OF RESPONDENTS
0
10
20
30
40
Risk Coverage To Protect
against high and
unexpected
Medical
Emergencies
Tax Benefits
NO. OF RESPONDENTS
NO. OF RESPONDENTS
 
78 | P a g e  
 
CHAPTER 6: -
SUMMARY OF
FINDINGS
 
79 | P a g e  
 
SUMMARY OF FINDINGS
 The majority of the respondents 15% are Private employees, 11.3% are
Government employees 12.5% are Professional, 28.8% are Businessman
and 61.2% are Farmers and students and old age people.
 30% percentage of respondents belongs to the age group between 31-40
years.
 Majority of respondents 13.8% feel that TV is the best media for insurance
companies to reach customers.
 Other than TV, people feel that newspaper 05% is the next best media to
reach customers.
 Majority 28.7% People share interesting ads with family and friends.
 Majority of the respondents 62.5% are aware of health insurance.
 Majority of the respondents 13.8% have watched insurance advertisement
on news channels.
 ICICI is the most popular in terms of advertisement 22.5% followed by
National Insurance Company Limited 15%.
 Almost 62.5% of People have got a health insurance plan for
himself/herself and his/her family.
 
80 | P a g e  
 
 Nearly 28.7% of the respondents believe that the Family/ Friends
suggestion clearly convey their message.
 Majority of 38.8% People prefer long-term investment in this pandemic.
 Nearly 56.3% people believe that Private sector Insurance is quite good
then Public sector insurance.
 Majority of 51.2% people believe Term of Health Insurance Policy
should be between 2-5 years.
 
81 | P a g e  
 
CHAPTER 7: -
SUGGESTION
AND
RECOMMENDATIONS
 
82 | P a g e  
 
SUGGESTIONS
 Taking health policy at very young age and covering all members of
the family.
 Customers should be fully aware of the various health coverages
available.
 Customers should know about the various health insurance schemes
and companies providing these schemes.
 The attitude of customers should be always towards the preventive
health care.
 Customers should take decisions relating to the features of the
policy, sum assured, premium paid, persons covered, after careful
analysis.
 They must be aware of the conditions and exclusions in the policy.
 They have to pay the premium in time and file the claims if any
strictly as per rules and regulations.
 Take at most care towards ethics in reveling the preexisting disease.
 Make use of the grievances cell in the case of any dissatisfaction
relating to health insurance.
 
83 | P a g e  
 
CHAPTER 8: -
CONCLUSION
 
84 | P a g e  
 
CONCLUSION
“Health coverage to all” should be the motto of the health insurance
sector. There should be easy access to healthcare facilities and cost
control measures should be in place. Health insurance is going to
develop more in the current liberal economic scenario. But, a
completely unregulated or very less regulated health insurance sector
may concentrate only on those who have the ability to pay for the
insurance cover. So, the challenge is in helping the benefits percolate
to the economically weaker sections of the population. Transparent and
accountable government and non-government participation should be
encouraged.
Developing and marketing social health insurance schemes through
cooperatives and rural association would go a long way in benefiting
the vast unorganized employment sectors currently neglected under the
existing schemes. Also, a thorough revamp of schemes like ESIS and
CGHS is necessary for them to be more purposeful and efficient. If the
government, service provider, health care industry and the health
insurance customers can incorporate all these suggestions given in the
study, then the concept of health insurance will reach new heights in
the near future and Mother India will be definitely, the healthiest nation
in the world.
 
85 | P a g e  
 
CHAPTER 10: -
BIBLIOGRAPHY
 
86 | P a g e  
 
BIBLIOGRAPHY
WEBSITES:
1. Scribd.com.
2. irdai.gov.in
3. www.google.com.
4. www.ibef.org
5. www.facebook.com
6. www.hdfcergo.com
 
87 | P a g e  
 
CHAPTER 11: -
ANNEXURE
 
88 | P a g e  
 
Annexure
Hello Sir/Madam,
I, ___________, student of 3th
semester MBA am conducting a
research on the "A Study on Consumer Perception towards
Health Insurance Products in COVID era". The purpose of
this study is to understand, capture, assesses and evaluate the
effectiveness of the Health Insurance Product. I would appreciate
if you could spend about 15 Min. and communicate your feelings,
expression, comments. Please give your honest opinion and be
sure that this information collected will be purely confidential and
not be shared with any other entity in term of commercialization.
Q1. Occupation:
A. Government Employee
B. Private Employee
C. Professional
D. Businessman
E. Others
 
89 | P a g e  
 
Q2. Age:
A. Below 20 years
B. 21-30 years
C. 31-40 years
D. 41-60 years
E. Above 60 years
Q3. What kind of investment do you prefer in this pandemic?
A. Long-term
B. Medium-term
C. Short-term
Q4. Are you aware about Health insurance?
A. Not Aware / not exposed
B. Aware/ exposed and subscribed
C. Aware/ exposed and unsubscribed
Q5. Source of Awareness?
A. Self-decision
B. Advertisement in TV
C. Newspaper or Magazines
D. Internet
E. Insurance Agents
F. Family/ Friends suggestion
G. Employee of insurance company
H. Tax consultants & Doctors
I. Others
 
90 | P a g e  
 
Q6. Which Health Insurance policy you prefer most?
A. Private Sector
B. Public Sector
Q7. Do you have health insurance policy, if yes then?
A. No, I don't have health Insurance policy
B. IFFCO Tokio
C. Apollo Munich Health Insurance Company Limited.
D. Star Health & Allied Insurance Company Limited.
E. ICICI Lombard General Insurance Company Limited.
F. National Insurance Company Limited.
G. Other
Q8. Have you got a health insurance plan for you and your family?
A. Yes
B. No
Q9. If yes, whether your Company provides cashless treatment?
A. Yes
B. No
 
91 | P a g e  
 
Q10. Do you think health insurance is important in today world?
A. Yes
B. No
C. Maybe
Q11. If yes, what according to you should be minimum sum insured?
A. 3 lacs
B. 5 lacs
C. 10 lacs
D. 15 lacs
E. Other
Q12. Do you consult insurance agent while taking a health insurance policy?
A. Every Time
B. Often
C. Sometime
D. Never
 
92 | P a g e  
 
Q13. Term of Health Insurance Policy?
A. Less than – 2 years
B. Between 2-5 years
C. Between 5-7 years
D. Between 7-10 years
E. More than 10 years
Q14. How you would prefer most to pay health-insurance premium amount?
A. Monthly
B. Quarterly
C. Half Yearly
D. Annual / Yearly
Q15. Objective of taking Health Insurance Policy?
A. Risk Coverage
B. To Protect against high and unexpected Medical cost
C. Tax Benefits
D. Medical Emergencies
E. Other
 
93 | P a g e  
 
Q16. Barriers in the Subscription of Health Insurance.
 
94 | P a g e  
 

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Project report for Management

  • 1.   1 | P a g e     PROJECT REPORT ON “Consumer Perception towards Health insurance Product in this Covid Era” SUBMITTED IN PARTIAL FULFILLMENT OF THE REQUIREMENT FOR MASTER OF BUSINESS ADMINISTRATION Under the guidance of: SUBMITTED BY: Affiliated to APJ Abdul Kalam Technical University, Lucknow
  • 2.   2 | P a g e     CERTIFICATE OF ORIGINALITY I hereby declare that this project is my own work and that, to best of my knowledge and belief, it reproduces no material previously published or written that has been accepted for the award of any other degree of diploma, except where due acknowledgement has been made in the text (Student name): Enrolment No: Date:
  • 3.   3 | P a g e    
  • 4.   4 | P a g e     ACKNOWLEDGMENT It is pleasure to acknowledge many people who knowingly and unwittingly helped me, to complete my project. First of all, let me praise god for all the blessing, who carried me through all those years. I am particularly indebted to who inculcated in me utmost need for human values and groomed me up in the field of Management to take on the challenges of the competitive world. I extend my sincere gratitude to all my teachers and mentors who made unforgettable contribution. Due to their sincere efforts I was able to excel in the work entrusted upon me. NAME: ROLL NO -
  • 5.   5 | P a g e     LIST OF CONTENTS S.NO DETAIL OF DOCUMENTS PAGE NO. 1 EXECUTIVE SUMMARY 6-8 2 Introduction 9-11 3 INDUSTRY PROFILE 12-42 4 Objectives & Methodology 43-46 5 DATA ANALYSIS & INTEREPREATION 47-77 6 SUMMARY OF FINDINGS 78-80 7 SUGGESTION & RECOMMENDATION 81-82 8 CONCLUSION 83-84 9 BIBLOGRAPHY 85-86 10 ANNEXURE 87-94
  • 6.   6 | P a g e     CHAPTER: 1 EXECUTIVE SUMMARY
  • 7.   7 | P a g e     EXECUTIVE SUMMARY This is an attempt to know how the theories can be applied to practical situation. As a student of MBA, it is a part of study for everyone to undergo summer project at some good institute or organisation. So, for this purpose, I got the opportunity of summer training at Lancers Counsel Services Pvt. Ltd. Lancers Counsel Services Pvt. Ltd. provided me the real time experience of generating leads, dealing with the clients, marketing of financial products, and understanding the position in the market along with consumer perception. The internship report is based on the two months long Virtual internship program that I had experienced in this company from 25th May 2020 to 24th July 2020 as a requirement of my MBA program under Institute of Technology & Science, Mohan Nagar Ghaziabad. The title of the report is “Consumer Perception towards Health insurance Product in this Covid Era” This report is based on how consumer reacts on Health Insurance Products. While claiming and purchasing those products. This study includes the performance of Health Insurance Companies in this Covid era. It includes a research as well, which is conducted to ascertain the consumer perception towards the Health Insurance sector. This is done with a help of a questionnaire (Primary source).
  • 8.   8 | P a g e     The main objective of the research is to identify the thinking of consumer and their behaviour towards Health Insurance. There are secondary objectives as well, which are: o To find out the important criteria that people think about before investing in a health insurance policy. o To know about the various investment alternatives that is mostly preferred by the people. o To identify the consumer’s perception about the product (Smart Lifestyle). o To identify the awareness about health insurance. o To know health insurance is important in today world.
  • 9.   9 | P a g e     CHAPTER 2: INTRODUCTION
  • 10.   10 | P a g e     Introduction The newly discovered and highly contagious disease COVID-19 has taken the world by storm. Assumed to have originated from China, the virus has impacted over four million people across 205 countries as per records. The lack of specific vaccines and treatments for the virus is the reason for the global frenzy and therefore, getting through the pandemic safely is the need of the hour for all humankind. Amidst the apprehension and uncertainty concerning the present scenario, we must evaluate the risks and assess if the worst comes to pass. Evaluating the risk also involves creating enough financial contingency to pay off if you fall prey to the virus. Whether or not your standard health insurance covers COVID-19 is a common dilemma. Therefore, it is imperative to know if you are covered in case you succumb to the virus During times like these, having a health insurance comes handy in times of medical emergencies. Many individuals often have to use funds from their savings in case of a medical emergency, which not only impacts their financial health but also jeopardises personal goals. By assessing his or her financial position and requirement closely, one can plan and financially prepare against medical emergencies through a medical insurance plan. Whether you're married, single, have children, young, or old, you need some level of health insurance to protect yourself against financial disaster in the event of a serious illness or accident. Whether you choose a group plan or an individual plan, there are important choices to be made that will affect not only the quality of your health care but also your wallet. Health Insurance for Senior Citizens Healthcare continues to remain a crucial lifeline for elderly citizens who need healthcare as they age. However, as per the latest study, over the next two decades, out-of-pocket medical costs for older adults are likely to rise significantly. Considering the current rate of medical inflation in India, adequate health insurance has become a must-have for each and every individual, and if the individual happens to be your parents, the need of buying a senior citizen health insurance becomes all the more important. We all must accept the fact of life that as we age, it’s not just our experience that increases, the list of medical ailments also witnesses a substantial increase.
  • 11.   11 | P a g e     Considering the given scenario, buying an individual cover for your elderly parents is a sensible thing to do. In the event of your parents falling ill and requiring hospitalisation, the major part of the medical expenses will be taken care of by your parents’ medical cover plan, without burning a hole in your pocket. Senior Citizens are better off buying a feature packed comprehensive health insurance plan with no limitations like co-pay or room rent limits. These may be slightly expensive but are worth it for the peace of mind they offer. Some of the popular health insurance plans available for the senior citizens include Religare’s NCB Super Premium, HDFC Ergo’s Health Suraksha – Silver, Star Health’s Health Optima and Max Bupa’s Go Active. However, in case somebody wants to buy a cheaper plan, there are options which are specifically designed for Senior Citizens. The offered plans in the category include Religare’s Red Carpet and Care Senior. Health Insurance for People with Pre-existing Diseases Many a people nowadays don’t end up buying Health Insurance if they are suffering from some ailments like Diabetes or High BP or some heart related issues. They are worried that since they are suffering some pre-existing conditions, the insurance companies won’t cover them or otherwise the cover provided in case of any hospitalisation will be nominal. This is a total myth which people have set in their minds that no companies will cover them. Fortunately, insurance companies have now opened up their underwriting significantly in the past few years and made the entire process quite simpler. Also, the Insurance Regulatory and Development Authority of India (IRDAI) has issued several guidelines to insurers stating all pre-existing disease will be covered under a health insurance cover after a certain waiting period. Adhering to IRDAI guidelines, insurers have come up with plans that cover all pre-existing diseases after a limited time waiting period. However, you must choose the best medical insurance for pre-existing conditions to suit your needs. It is the duty of the person who is opting for health insurance with pre-existing conditions like diagnosed illnesses, medical history of illness/hospitalization/surgery or major accidental injury, to inform the health policy issuing executive about the same and get all necessary checks and tests done before buying the policy. It is also important to read the type of diseases which the insurance companies define as Pre-existing conditions to avoid problems when the time comes to raise a claim.
  • 12.   12 | P a g e     CHAPTER 3: - INDUSTRYPROFILE
  • 13.   13 | P a g e     INDUSTRY PROFILE Health insurance, like other forms of insurance, is a form of collectivism by means of which people collectively pool their risk, in this case the risk of incurring medical expenses. The collective is usually publicly owned or else is organized on a non-profit basis for the members of the pool, though in some countries health insurance pools may also be managed by for-profit companies. It is sometimes used more broadly to include insurance covering disability or long-term nursing or custodial care needs. It may be provided through a government-sponsored social insurance program, or from private insurance companies. It may be purchased on a group basis (e.g., by a firm to cover its employees) or purchased by an individual. In each case, the covered groups or individuals pay premiums or taxes to help protect themselves from unexpected healthcare expenses. Similar benefits paying for medical expenses may also be provided through social welfare programs funded by the government. By estimating the overall risk of healthcare expenses, a routine finance structure (such as a monthly premium or annual tax) can be developed, ensuring that money is available to pay for the healthcare benefits specified in the insurance agreement. The benefit is administered by a central organization such as a government agency, private business, or not-for-profit entity. History and Evolution The concept of health insurance was proposed in 1694 by Hugh the Elder Chamberlin from the Peter Chamberlin family. In the late 19th century, "accident insurance" began to be available, which operated much like modern disability insurance. This payment model continued until the start of the 20th century in some jurisdictions (like California), where all laws regulating health insurance actually referred to disability insurance. Accident insurance was first offered in
  • 14.   14 | P a g e     the United States by the Franklin Health Assurance Company of Massachusetts. This firm, founded in 1850, offered insurance against injuries arising from railroad and steamboat accidents. Sixty organizations were offering accident insurance in the U.S. by 1866, but the industry consolidated rapidly soon thereafter. While there were earlier experiments, the origins of sickness coverage in the U.S. effectively date from 1890. The first employer-sponsored group disability policy was issued in 1911. Before the development of medical expense insurance, patients were expected to pay all other health care costs out of their own pockets, under what is known as the fee-for-service business model. During the middle to late 20th century, traditional disability insurance evolved into modern health insurance programs. Today, most comprehensive private health insurance programs cover the cost of routine, preventive, and emergency health care procedures, and most prescription drugs, but this is not always the case. Hospital and medical expense policies were introduced during the first half of the 20th century. During the 1920s, individual hospitals began offering services to individuals on a pre-paid basis, eventually leading to the development of Cross organizations. The predecessors of today's Health Maintenance Organizations (HMOs) originated beginning in 1929, through the 1930s and on during World War II. How It Works A health insurance policy is a contract between an insurance company and an individual or his sponsor (e.g. an employer). The contract can be renewable annually or monthly. The type and amount of health care costs that will be covered by the health insurance company are specified in advance, in the member
  • 15.   15 | P a g e     contract or "Evidence of Coverage" booklet. The individual insured person's obligations may take several forms:  Premium: The amount the policy-holder or his sponsor (e.g. an employer) pays to the health plan each month to purchase health coverage.  Deductible: The amount that the insured must pay out-of-pocket before the health insurer pays its share. For example, a policy-holder might have to pay a $500 deductible per year, before any of their health care is covered by the health insurer. It may take several doctor's visits or prescription refills before the insured  person reaches the deductible and the insurance company starts to pay for care.  Co-payment: The amount that the insured person must pay out of pocket before the health insurer pays for a particular visit or service. For example, an insured person might pay a $45 co-payment for a doctor's visit, or to obtain a prescription. A co-payment must be paid each time a particular service is obtained.  Coinsurance: Instead of, or in addition to, paying a fixed amount up front (a co-payment), the co-insurance is a percentage of the total cost that insured person may also pay. For example, the member might have to pay 20% of the cost of a surgery over and above a co-payment, while the insurance company pays the other 80%. If there is an upper limit on coinsurance, the policy-holder could end up owing very little, or a great deal, depending on the actual costs of the services they obtain.  Exclusions: Not all services are covered. The insured person is generally expected to pay the full cost of non-covered services out of their own pocket.
  • 16.   16 | P a g e      Coverage limits: Some health insurance policies only pay for health care up to a certain dollar amount. The insured person may be expected to pay any charges in excess of the health plan's  maximum payment for a specific service. In addition, some insurance company schemes have annual or lifetime coverage maximums. In these cases, the health plan will stop payment when they reach the benefit maximum, and the policy-holder must pay all remaining costs.  Out-of-pocket maximums: Similar to coverage limits, except that in this case, the insured person's payment obligation ends when they reach the out-of-pocket maximum, and the health company pays all further covered costs. Out-of-pocket maximums can be limited to a specific benefit category (such as prescription drugs) or can apply to all coverage provided during a specific benefit year.  Capitation: An amount paid by an insurer to a health care provider, for which the provider agrees to treat all members of the insurer.  In-Network Provider: (U.S. term) A health care provider on a list of providers preselected by the insurer. The insurer will offer discounted coinsurance or co-payments, or additional benefits, to a plan member to see an in-network provider. Generally, providers in network are providers who have a contract with the insurer to accept rates further discounted from the "usual and customary" charges the insurer pays to out-of-network providers.  Prior Authorization: A certification or authorization that an insurer provides prior to medical service occurring. Obtaining an authorization means that the insurer is obligated to pay for the service, assuming it
  • 17.   17 | P a g e     matches what was authorized. Many smaller, routine services do not require authorization.  Explanation of Benefits: A document sent by an insurer to a patient explaining what was covered for a medical service, and how they arrived at the payment amount and patient responsibility amount. Prescription drug plans are a form of insurance offered through some employer benefit plans in the U.S., where the patient pays a co-payment and the prescription drug insurance part or all of the balance for drugs covered in the formulary of the plan. Some, if not most, health care providers in the United States will agree to bill the insurance company if patients are willing to sign an agreement that they will be responsible for the amount that the insurance company doesn't pay. The insurance company pays out of network providers according to "reasonable and customary" charges, which may be less than the provider's usual fee. The provider may also have a separate contract with the insurer to accept what amounts to a discounted rate or capitation to the provider's standard charges. It generally costs the patient less to use an in-network provider. Health Care and The World The Commonwealth Fund, in its annual survey, "Mirror, Mirror on the Wall", compares the performance of the health care systems in Australia, New Zealand, the United Kingdom, Germany, Canada and the U.S. Its 2007 study found that, although the U.S. system is the most expensive, it consistently under-performs compared to the other countries. One difference between the U.S. and the other countries in the study is that the U.S. is the only country without universal health insurance coverage. Australia
  • 18.   18 | P a g e     The public health system is called Medicare. It ensures free universal access to hospital treatment and subsidized out-of-hospital medical treatment. It is funded by a 1.5% tax levy on all taxpayers, an extra 1% levy on high income earners, as well as general revenue. The private health system is funded by a number of private health insurance organizations. The largest of these is Medibank Private, which is government- owned, but operates as a government business enterprise under the same regulatory regime as all other registered private health funds. The Coalition Howard government had announced that Medibank would be privatized if it won the 2007 election, however they were defeated by the Australian Labour Party under Kevin Rudd which had already pledged that it would remain in government ownership. Some private health insurers are 'for profit' enterprises such as Australian Unity , and some are non-profit organizations such as HCF Health Insurance and GMHBA Health Insurance. Some have membership restricted to particular groups, but the majority has open membership. Membership to most health funds is now also available through comparison websites like money time, select or the decision assistance sites Help Me Choose and the latest entry You Compare. These comparison sites operate on a commission-basis by agreement with their participating health funds. Most aspects of private health insurance in Australia are regulated by the Private Health Insurance Act 2007. Complaints and reporting of the private health industry is carried out by an independent government agency, the Private Health Insurance Ombudsman . The ombudsman publishes an annual report that outlines the number and nature of complaints per health fund compared to their market share [ The private health system in Australia operates on a "community rating" basis, whereby premiums do not vary solely because of a person's previous
  • 19.   19 | P a g e     medical history, current state of health, or (generally speaking) their age (but see Lifetime Health Cover below). Balancing this are waiting periods, in particular for pre-existing conditions (usually referred to within the industry as PEA, which stands for "pre-existing ailment"). Funds are entitled to impose a waiting period of up to 12 months on benefits for any medical condition the signs and symptoms of which existed during the six months ending on the day the person first took out insurance. They are also entitled to impose a 12-month waiting period for benefits for treatment relating to an obstetric condition, and a 2-month waiting period for all other benefits when a person first takes out private insurance. Funds have the discretion to reduce or remove such waiting periods in individual cases. They are also free not to impose them to begin with, but this would place such a fund at risk of "adverse selection", attracting a disproportionate number of members from other funds, or from the pool of intending members who might otherwise have joined other funds. It would also attract people with existing medical conditions, who might not otherwise have taken out insurance at all because of the denial of benefits for 12 months due to the PEA Rule. The benefits paid out for these conditions would create pressure on premiums for all the fund's members, causing some to drop their membership, which would lead to further rises in premiums, and a vicious cycle of higher premiums-leaving members would ensue. There are a number of other matters about which funds are not permitted to discriminate between members in terms of premiums, benefits or membership - these include racial origin, religion, sex, sexual orientation, nature of employment, and leisure activities. Premiums for a fund's product that is sold in more than one state can vary from state to state, but not within the same state. The Australian government has introduced a number of incentives to encourage adults to take out private hospital insurance. These include:
  • 20.   20 | P a g e      Lifetime Health Cover: If a person has not taken out private hospital cover by the 1st July after their 31st birthday, then when (and if) they do so after this time, their premiums must include a loading of 2% per annum for each year they were without hospital cover.  Thus, a person taking out private cover for the first time at age 40 will pay a 20 per cent loading. The loading is removed after 10 years of continuous hospital cover. The loading applies only to premiums for hospital cover, not to ancillary (extras) cover.  Medicare Levy Surcharge: People whose taxable income is greater than a specified amount (currently $70,000 for singles and $140,000 for couples) and who do not have an adequate level of private hospital cover must pay a 1% surcharge on top of the standard 1.5% Medicare Levy. The rationale is that if the people in this income group are forced to pay more money one way or another, most would choose to purchase hospital insurance with it, with the possibility of a benefit in the event that they need private hospital treatment - rather than pay it in the form of extra tax as well as having to meet their own private hospital costs.  The Australian government announced in May 2008 that it proposes to increase the thresholds, to $100,000 for singles and $150,000 for families. These changes require legislative approval. A bill to change the law has been introduced but was not passed by the Senate. An amended version was passed on 16 October 2008. There have been criticisms that the changes will cause many people to drop their private health insurance, causing a further burden on the public hospital system, and a rise in premiums for those who stay with the private system. Other commentators believe the effect will be minimal.
  • 21.   21 | P a g e      Private Health Insurance Rebate: The government subsidises the premiums for all private health insurance cover, including hospital and ancillary (extras), by 30%, 35% or 40%, depending on age. The Rudd Government announced in May 2009 that as of July 2010, the Rebate would become means-tested, and offered on a sliding scale. Canada Health care is constitutionally mainly a provincial government responsibility in Canada (the main exceptions being federal government responsibility for services provided to aboriginal peoples covered by treaties, the Royal Canadian Mounted Police, the armed forces, and members of parliament). Consequently, each province administers its own health insurance program. The federal government influences health insurance by virtue of its fiscal powers - it transfers cash and tax points to the provinces to help cover the costs of the universal health insurance programs. Under the Canada Health Act, the federal government mandates and enforces the requirement that all people have free access to what are termed "medically necessary services," defined primarily as care delivered by physicians or in hospitals, and the nursing component of long-term residential care. If provinces allow doctors or institutions to charge patients for medically necessary services, the federal government reduces its payments to the provinces by the amount of the prohibited charges. Collectively, the public provincial health insurance systems in Canada are frequently referred to as Medicare. This public insurance is tax-funded out of general government revenues, although British Columbia and Ontario levy a mandatory premium with flat rates for individuals and families to generate additional revenues - in essence a surtax. Private health insurance is allowed, but in six provincial governments only for services that the public health plans do not cover, for example, semi-private or private rooms in hospitals and prescription drug plans. Four provinces allow
  • 22.   22 | P a g e     insurance for services also mandated by the Canada Health Act, but in practice there is no market for it. All Canadians are free to use private insurance for elective medical services such as laser vision correction surgery, cosmetic surgery, and other non-basic medical procedures. Some 65% of Canadians have some form of supplementary private health insurance; many of them receive it through their employers. Private-sector services not paid for by the government account for nearly 30 percent of total health care spending. In 2005, the Supreme Court of Canada ruled, in Chaoulli v. Quebec, that the province's prohibition on private insurance for health care already insured by the provincial plan violated the Quebec Charter of Rights and Freedoms, and in particular the sections dealing with the right to life and security, if there were unacceptably long wait times for treatment, as was alleged in this case. The ruling has not changed the overall pattern of health insurance across Canada but has spurred on attempts to tackle the core issues of supply and demand and the impact of wait times. France The national system of health insurance was instituted in 1945, just after the end of the Second World War. It was a compromise between Gaullist and Communist representatives in the French parliament. The Conservative Gaullists were opposed to a state-run healthcare system, while the Communists were supportive of a complete nationalization of health care along a British Beverage model. The resulting programme is profession-based: all people working are required to pay a portion of their income to a not-for-profit health insurance fund, which mutualisms the risk of illness, and which reimburses medical expenses at varying rates. Children and spouses of insured people are eligible for benefits, as well. Each fund is free to manage its own budget, and used to reimburse medical expenses at the rate it saw fit, however following a number of reforms in recent
  • 23.   23 | P a g e     years, the majority of funds provide the same level of reimbursement and benefits. The government has two responsibilities in this system.  The first government responsibility is the fixing of the rate at which medical expenses should be negotiated, and it does this in two ways: The Ministry of Health directly negotiates prices of medicine with the manufacturers, based on the average price of sale observed in neighbouring countries. A board of doctors and experts decides if the medicine provides a valuable enough medical benefit to be reimbursed (note that most medicine is reimbursed, including homeopathy).  In parallel, the government fixes the reimbursement rate for medical services: this means that a doctor is free to charge the fee that he wishes for a consultation or an examination, but the social security system will only reimburse it at a pre-set rate. These tariffs are set annually through negotiation with doctors' representative organisations.  The second government responsibility is oversight of the health-insurance funds, to ensure that they are correctly managing the sums they receive, and to ensure oversight of the public hospital network. Today, this system is more-or-less intact. All citizens and legal foreign residents of France are covered by one of these mandatory programs, which continue to be funded by worker participation. However, since 1945, a number of major changes have been introduced. Firstly, the different health-care funds (there are five: General, Independent, Agricultural, Student, Public Servants) now all reimburse at the same rate. Secondly, since 2000, the government now provides health care to those who are not covered by a mandatory regime (those who have never worked and who are not students, meaning the very rich or the very poor). This regime, unlike the worker-financed ones, is financed via general taxation and
  • 24.   24 | P a g e     reimburses at a higher rate than the profession-based system for those who cannot afford to make up the difference. Finally, to counter the rise in health-care costs, the government has installed two plans, (in 2004 and 2006), which require insured people to declare a referring doctor in order to be fully reimbursed for specialist visits, and which installed a mandatory co-pay of 1 € (about $1.45) for a doctor visit, 0,50 € (about 80 ¢) for each box of medicine prescribed, and a fee of 16-18 € (20-25 $) per day for hospital stays and for expensive procedures. An important element of the French insurance system is solidarity: the more ill a person becomes, the less the person pays. This means that for people with serious or chronic illnesses, the insurance system reimburses them 100 % of expenses, and waives their co-pay charges. Finally, for fees that the mandatory system does not cover, there is a large range of private complementary insurance plans available. The market for these programs is very competitive, and often subsidized by the employer, which means that premiums are usually modest. 85% of French people benefit from complementary private health insurance. Netherlands In 2006, a new system of health insurance came into force in the Netherlands. This new system avoids the two pitfalls of adverse selection and moral hazard associated with traditional forms of health insurance by using a combination of regulation and an insurance equalization pool. Moral hazard is avoided by mandating that insurance companies provide at least one policy which meets a government set minimum standard level of coverage, and all adult residents are obliged by law to purchase this coverage from an insurance company of their choice. All insurance companies receive funds from the equalization pool to help cover the cost of this government-mandated coverage.
  • 25.   25 | P a g e     This pool is run by a regulator which collects salary-based contributions from employers, which make up about 50% of all health care funding, and funding from the government to cover people who cannot afford health care, which makes up an additional 5%. The remaining 45% of health care funding comes from insurance premiums paid by the public, for which companies compete on price, though the variation between the various competing insurers is only about 5%. However, insurance companies are free to sell additional policies to provide coverage beyond the national minimum. These policies do not receive funding from the equalization pool, but cover additional treatments, such as dental procedures and physiotherapy, which are not paid for by the mandatory policy. Funding from the equalization pool is distributed to insurance companies for each person they insure under the required policy. However, high-risk individuals get more from the pool, and low-income persons and children under 18 have their insurance paid for entirely. Because of this, insurance companies no longer find insuring high-risk individuals an unappealing proposition, avoiding the potential problem of adverse selection. Insurance companies are not allowed to have co-payments, caps, or deductibles, or to deny coverage to any person applying for a policy, or to charge anything other than their nationally set and published standard premiums. Therefore, every person buying insurance will pay the same price as everyone else buying the same policy, and every person will get at least the minimum level of coverage. United Kingdom The UK's National Health Service (NHS) is a publicly funded healthcare system that provides coverage to everyone normally resident in the UK. It is not strictly an insurance system because (a) there are no premiums collected, (b) costs are not charged at the patient level and (c) costs are not pre-paid from a pool.
  • 26.   26 | P a g e     However, it does achieve the main aim of insurance which is to spread financial risk arising from ill-health. The costs of running the NHS (est. £104 billion in 2007-8) are met directly from general taxation. The NHS provides the majority of health care in the UK, including primary care, in-patient care, long-term health care, ophthalmology and dentistry. Private health care has continued parallel to the NHS, paid for largely by private insurance, but it is used by less than 8% of the population, and generally as a top- up to NHS services. There are many treatments that the private sector does not provide. For example, health insurance on pregnancy is generally not covered or covered with restricting clauses. Typical exclusions for Bupa schemes (and many other insurers) include: ageing, menopause and puberty; AIDS/HIV; allergies or allergic disorders; birth control, conception, sexual problems and sex changes; chronic conditions; complications from excluded or restricted conditions/ treatment; convalescence, rehabilitation and general nursing care ; cosmetic, reconstructive or weight loss treatment; deafness; dental/oral treatment (such as fillings, gum disease, jaw shrinkage, etc); dialysis; drugs and dressings for out- patient or take-home use† ; experimental drugs and treatment; eyesight; HRT and bone densitometry; learning difficulties, behavioural and developmental problems; overseas treatment and repatriation; physical aids and devices; pre-existing or special conditions; pregnancy and childbirth; screening and preventive treatment; sleep problems and disorders; speech disorders; temporary relief of symptoms (except in exceptional circumstances) There are a number of other companies in the United Kingdom which include, among others, AXA,Aviva, Groupama Healthcare, WPA and PruHealth. Similar exclusions apply, depending on the policy which is purchased.
  • 27.   27 | P a g e     Recently (2009) the main representative body of British Medical physicians, the British Medical Association, adopted a policy statement expressing concerns about developments in the health insurance market in the UK. In its Annual Representative Meeting which had been agreed earlier by the Consultants Policy Group (i.e. Senior physicians) stating that the BMA was "extremely concerned that the policies of some private healthcare insurance companies are preventing or restricting patients exercising choice about (i) the consultants who treat them; (ii) the hospital at which they are treated; (iii) making top up payments to cover any gap between the funding provided by their insurance company and the cost of their chosen private treatment." It went in to "call on the BMA to publicise these concerns so that patients are fully informed when making choices about private healthcare insurance." The NHS offers patients a choice of hospitals and consultants and does not charge for its services. The private sector has been used to increase NHS capacity despite a large proportion of the British public opposing such involvement. According to the World Health Organization, government funding covered 86% of overall health care expenditures in the UK as of 2004, with private expenditures covering the remaining 14%. United States The United States health care system relies heavily on private health insurance, which is the primary source of coverage for most Americans. According to the CDC, approximately 58% of Americans have private health insurance. Public programs provide the primary source of coverage for most senior citizens and for low-income children and families who meet certain eligibility requirements. The primary public programs are Medicare, a federal social insurance program for seniors and certain disabled individuals, Medicaid, funded jointly by the federal government and states but administered at the state level, which covers certain
  • 28.   28 | P a g e     very low income children and their families, and SCHIP, also a federal-state partnership that serves certain children and families who do not qualify for Medicaid but who cannot afford private coverage. Other public programs include military health benefits provided through TRICARE and the Veterans Health Administration and benefits provided through the Indian Health Service. Some states have additional programs for low-income individuals. A recent study found that 62 percent of all bankruptcies filed in 2007 were linked to medical expenses. Of those who filed for bankruptcy, nearly 80 percent had health insurance. In just three years, the Medicare and Medicaid programs will account for 50 percent of all national health spending. This has fueled an outcry for an overhaul of the health care system in the United States. The House of Representatives passed a health care reform bill by a vote of 220-215 on November 7, 2009. Currently the fate of the bill rests on the Senate. The legislation once included changes that would give the government the power to negotiate policy premiums and to provide a public option, but in an effort to acquire the necessary votes to prevent a Republican filibuster the public option was eliminated from the bill. This would have given citizens the option to buy into public programs like Medicare for which current members pay only $96.40 monthly. Instead the bill now requires that all Americans purchase private health insurance or be subject to fines. The insurance industry represents a significant lobbying group in the United States. The major health interests have spent an average of $1.4 million per day to lobby Congress so far this year and are on track to spend more than half a billion dollars by the end 2009. On March 21, 2010, the House of Representatives passed a bill proposed by President Obama, which will supposedly offer a wide range of coverage and extend it to roughly 32 million more Americans without coverage. California
  • 29.   29 | P a g e     In 2007, 87% of Californians had some form of health insurance. Services in California range from private offerings: HMOs, PPOs to public programs: Medi-Cal, Medicare, and Healthy Families (SCHIP).California developed a solution to assist people across the State and is one of the only States to have an Office devoted to giving people tips and resources to get the best care possible. California's Office of the Patient Advocate was established July 2000 to publish a yearly Health Care Quality Report Card on the Top HMOs, PPOs, and Medical Groups and to create and distribute helpful tips and resources to give Californians the tools needed to get the best care. Additionally, California has a Help Center that assists Californians when they have problems with their health insurance. The Help Center is run by the Department of Managed Health Care, the government department that oversees and regulates HMOs and some PPOs. Germany Germany has Europe's oldest universal health care system, with origins dating back to Otto von Bismarck's Social legislation, which included the Health Insurance Bill of 1883, Accident Insurance Bill of 1884, and Old Age and Disability Insurance Bill of 1889. As mandatory health insurance, these bills originally applied only to low-income workers and certain government employees; their coverage, and that of subsequent legislation gradually expanded to cover virtually the entire population. Currently 85% of the population is covered by a basic health insurance plan provided by statute, which provides a standard level of coverage. The remainder opt for private health insurance, which frequently offers additional benefits.
  • 30.   30 | P a g e     According to the World Health Organization, Germany's health care system was 77% government-funded and 23% privately funded as of 2004.The government partially reimburses the costs for low-wage workers, whose premiums are capped at a predetermined value. Higher wage workers pay a premium based on their salary. They may also opt for private insurance, which is generally more expensive, but whose price may vary based on the individual's health status. Reimbursement is on a fee-for-service basis, but the number of physicians allowed to accept Statutory Health Insurance in a given locale is regulated by the government and professional societies. Co-payments were introduced in the 1980s in an attempt to prevent over utilization. The average length of hospital stay in Germany has decreased in recent years from 14 days to 9 days, still considerably longer than average stays in the United States (5 to 6 days).Part of the difference is that the chief consideration for hospital reimbursement is the number of hospital days as opposed to procedures or diagnosis. Drug costs have increased substantially, rising nearly 60% from 1991 through 2005. Despite attempts to contain costs, overall health care expenditures rose to 10.7% of GDP in 2005, comparable to other western European nations, but substantially less than that spent in the U.S. (nearly 16% of GDP).
  • 31.   31 | P a g e     Development in India Social security for medical emergencies is not new to the Indian ethos. It is a common practice for villagers to take a ‘piruvu’ (a collection) to support a household with a sick patient. However, health insurance, as we know it today, was introduced only in 1912 when the first Insurance Act was passed (Devadasan 2004). The current version of the Insurance Act was introduced in 1938. Since then there was little change till 1972 when the insurance industry was nationalized and 107 private insurance companies were brought under the umbrella of the General Insurance Corporation (GIC). Private and foreign entrepreneurs were allowed to enter the market with the enactment of the Insurance Regulatory and Development Act (IRDA) in 1999.The penetration of health insurance in India has been low. It is estimated that only about 27% of Indians are covered under any form of health insurance. In terms of the market share, the size of the commercial insurance is barely 3.56% of the total health spending in the country. The Indian health insurance scenario is a mix of mandatory social health insurance (SHI), voluntary private health insurance and community-based health insurance (CBHI). Health insurance is thus really a minor player in the health ecosystem. The concept of insurance is intimately related to security. Insurance acts as a protective shield against risk and future uncertainties. Traditionally, a risk-averse .Behaviours been characteristic feature of Indians who preferred a “low & certain” disposable income to a “high& uncertain” one.
  • 32.   32 | P a g e     Hence insurance has become a close associate of Indians since 1818, when Oriental Life Insurance Company was started by Europeans in Kolkata to cater to the needs of their own community. The age was characterized by intense racial discrimination as Indian. Insurance policy holders were charged higher premiums than their foreign counterparts. The first Indian Insurance Company to cover Indian lives at normal rates was Bombay Mutual Life Assurance Society which was established in the year 1870.By the dawn of the 20. The century, new insurance companies started mushrooming up. In order to regulate the insurance business in India and to certify the premium rate tables and periodic valuations of the insurance companies, the Life Insurance Companies Act and the Provident Fund Act were passed to regulate the Insurance Business in India in 1912. Such statistical estimates made by actuaries revealed the disparity that existed between Indiana foreign companies. The Indian Insurance Sector went through a full circle of phases from being unregulated to completely regulate and then being partly deregulated which is the present situation. Brief on how the events folded up is discussed as follows: The Insurance Act of 1938 was the first legislation governing all forms of insurance to provide strict state controls over insurance business. In 19th January, 1956, the life insurance in India was completely nationalized through the Life Insurance Corporation Act of 1956.
  • 33.   33 | P a g e     At that time, there were 245 insurance companies of both Indian and foreign origin. Government accomplished its policy of nationalization by acquiring the management of the companies. Bearing this objective in mind, the Life Insurance Corporation (LIC) of India was created on 1st September, 1956 which has grown in leaps and bounds henceforth, to become the largest insurance company in India. The General Insurance Business (Nationalization) Act of 1972 was formulated with the objective of nationalizing nearly 100 general insurance companies and subsequently amalgamating them into four basic companies namely National Insurance, New India Assurance, Oriental Insurance and United India Insurance which have their headquarters in four metropolitan cities. The Insurance Regulatory and Development Authority (IRDA) Act of 1999 deregulated the insurance sector in India and allowed the entry of private companies into the insurance sector. Moreover, the flow of Foreign Direct Investment (FDI) was also restricted to 26 % of the total capital held by the Indian Insurance Companies. Some of the important milestones in the life insurance business in India 1912: The Indian insurance Companies Act enacted as the first statute to regulate the insurance business. 1928: The Indian Insurance Companies Act enacted to enable the government to collect statistical information about both life and non-life insurance businesses. 1938: Earlier legislation consolidated and amended to by the Insurance Act with the objective of protecting the interests of the insuring public.
  • 34.   34 | P a g e     1956: Indian and foreign insurers and provident societies taken over by the central government were nationalized. LIC formed by an Act of Parliament, viz. LIC Act, 1956, with a capital contribution of Rs. 5 crores from the Government of India. Insurance is an Rs.400 billion business in India, and together with banking services adds about 7% to India’s GDP. Gross premium collection is about 2% of GDP and has been growing by 15 - 20% per annum. India also has the highest number of life insurance policies in force in the world, and total investible funds with the LIC are almost 8% of GDP. Yet more than three-fourths of India's insurable population has no life insurance or pension cover. Health insurance of any kind is negligible and other forms of non-life insurance are much below international standards. To tap the vast insurance potential and to mobilize long - term savings we need reforms which include revitalizing and restructuring of the public sector companies, and opening up the sector to private players. A statutory body needs to be made to regulate the market and promote a healthy market structure. Insurance Regulatory Authority (IRA) is one such body, which checks on these tendencies. IRA role comprises of following three functions: a. Protection of consumer's interest. b. To ensure financial soundness and solvency of the insurance industry, and c. To ensure healthy growth of the insurance market. An insurance policy protects the buyer at some cost against the financial loss arising from specified risk. Different situations and different people require a different mix of risk cost combinations. Insurance companies provide these by offering schemes of different kinds. Unfortunately, the concept of insurance is not popular in our country. As per the latest estimates, the total premium income generated by life and general insurance in India is estimated at around a meager 3.56% of GDP. However, India’s share of world insurance market has shown an
  • 35.   35 | P a g e     increase of 10% from 0.31 in 1996-97 to 0.34% in 1997-98. India's market share in the life insurance business showed a real growth of 11% thereby outperforming the global average of 7.7%. Non-life business grew by 3.1against global average of 0.20%. In India insurance spending per capita was among the lowest in the world at $7.6 compared to $7 in the previous year. Amongst the emerging economies, India is one of the least insured countries but the potential for further growth is phenomenal, as a significant portion of its population is in services and the life expectancy has also increased over the years. The nationalized insurance industry has not offered consumers a variety of products. Opening of the sector to private firms will foster competition, innovation, and variety of products. It would also generate greater awareness on the need for buying insurance as a service and not merely for tax exemption, which is currently done. On the demand side, a strong correlation between demand for insurance and per capita income level suggests that high economic growth can spur growth in demand.
  • 36.   36 | P a g e     Top Health Insurance Companies in India
  • 37.   37 | P a g e     Religare health insurance is one of the best health insurances in India which offers coverage for health insurance, critical illness, personal accident, top-up coverage, international travel insurance, and maternity along with group health insurance. The claim settlement ratio of Religare is 93% and a high ICR of 51.97%. Religare has over 5420 hospitals in its network. Type: Private Industry: Health Insurance Founded: 2012 Headquarter: New Delhi, India Area served: India Key people: Mr. Anuj Gulati Owner: Mr. Anuj Gulati
  • 38.   38 | P a g e     Tata AIG Insurance is a trusted 20-year-old joint venture between Tata & AIG Group that carries an iAAA rating by ICRA for the highest claims-paying ability. The individual death claim ratio for 2018-19 was 96.12%. The company has access to 4000+ network hospitals. Type: Joint venture   Industry: Insurance   Founded: 2001   Headquarter: Mumbai, India   Area served: India   Key people: Neelesh Garg   Owner: Tata Sons 
  • 39.   39 | P a g e     Max Bupa insurance offers coverage for a number of illnesses, access to hospital networks and cashless claims. Claim settlement ratio of Max Bupa is 91.2% and a high ICR of 51.96%. Max has over 3000 hospitals in its network. Type: Joint Venture   Industry: Health Insurance   Founded: 2008   Headquarter: New Delhi, India   Area served: India   Key people: Krishnan Ramachandran {MD}   Owner: Bupa, Fettle Tone LLP  
  • 40.   40 | P a g e     ICICI Lombard has a network of 4500+ hospitals to avail cashless facilities. According to IRDA, it is supposed to have settled 98.32% of the claims received. It has a very high ICR of 80.38% which indicates that people are renewing the policy and also making claims. Type: Public   Industry: Insurance   Founded: 2001   Headquarter: Mumbai, India   Area served: Worldwide   Key people: Bhargav Dasgupta   Owner: ICICI Bank 
  • 41.   41 | P a g e     Star Health Insurance company provides a wide range of health insurance policies for individuals, families, senior citizens and for those who need specialized care like heart patients and cancer patients. Star has a high claims settlement percentage of 98.72% and ICR of 60.51% with a whopping 8200+ hospitals are on its network. Type: Private   Industry: Insurance   Founded: 2006   Headquarter: Chennai, India   Area served: India   Key people: V Jagannathan, Anand Roy   Owner: Dr. S Prakash  
  • 42.   42 | P a g e     Iffco Tokio General Insurance Company was founded in the year 2000. It is an effective health insurance company and a joint venture between Indian Farmers F (IFFCO) and its associates with Nichido Fire Group (biggest listed insurer of Japan) & Tokio Marine. You will get a wide range of general insurance products which c tough times. Type: Private   Industry: Insurance   Founded: 2000   Headquarter: Gurugram   Area served: Worldwide   Key people: Anamika Roy Rashtrawar   Owner: B.S Nakai  
  • 43.   43 | P a g e     CHAPTER 4: OBJECTIVES & METHODOLOGY
  • 44.   44 | P a g e     Objective of study: 1.To analyse the investors perception on investing in private insurance company. 2.To analyse the various investment options of the investors. 3. To analyse preference of investors between public and private insurance company. 4. To analysing, the investing habits of the investors and the factors influencing the investor in investing in insurance. 5. To study the important parameters that investors think about before investing in insurance products. 6. To know about the factors contributing to satisfaction and dissatisfaction of customers. 7.To analyse investors attitude towards insurance products on selected factors.
  • 45.   45 | P a g e     Methodology: TITLE OF THE STUDY: The title of the study is “Consumer Perception towards Health insurance in this Covid Era.” RESEARCH DESIGN: A research design is simply a plan for study in collection and analysis the data. The report is exploratory and descriptive in nature. It is a descriptive in nature but it suggests some important points to improve the services, so it is exploratory in nature also. DATA COLLECTION: For the purpose of project data is very much required which works as a food for process which will ultimately give output in the form of information. So before mentioning the source of data for the project I would like to mention that what type of data I have collected for the purpose of project and what it is exactly. During preparation of the project report many different kinds of data were required which includes both primary and secondary sources. SOURCES OF DATA COLLECTION: PRIMARY DATA: -
  • 46.   46 | P a g e     Primary data is basically the live data which I collected -Questionnaire SECONDARY DATA: Secondary data is already published data. It is the data which is funded or collected by someone else before and presently used by further research work. Secondary data for the base of the project, I collect the data from: - -internet -journals - Referring different books & previous project report. SAMPLE SIZE: The sample size selected from universe to constitute my study is 80. SAMPLE UNIT: Study is conducted by the survey of self-employed persons and business men.
  • 47.   47 | P a g e     CHAPTER 5: - DATA ANALYSIS & INTEREPREATION
  • 48.   48 | P a g e     DATA ANALYSIS & INTEREPREATION TABLE 1 Table 1: showing the occupation of respondents OCCUPATION NO. OF RESPONDENTS % OF RESPONDENTS GOVERNMENT EMPLOYEE 9 11.3% PRIVATE EMPLOYEE 12 15% BUSINESSMAN 23 28.8% PROFESSIONAL 10 12.5% OTHERS 46 32.4% TOTAL 80 100% Analysis From the above table, it can be analysed that out of 80 respondents 26.3% of the respondents are employed, 28.8% of the respondents are belonging to business, 12.5% of the respondents are professional and 32.4% are belongs to others.
  • 49.   49 | P a g e     GRAPH 1 Graph 1: showing the occupation of respondents Interpretation It can be inferred from the data that a greater number of others people take insurance. So, the companies should emphasize and formulate products appropriate to employed customers. 0 5 10 15 20 25 30 35 40 45 50 Govt. Employee Private Employee Businessman Professional Others No. of Respondents No. of Respondents
  • 50.   50 | P a g e     TABLE 2 Table 2: showing the age group of respondents Analysis From the above table we can infer that, highest percentages of respondents belong to the age group of 21-30 years. AGE GROUPS NO. OF RESPONDENTS % OF RESPONDENTS Below 20 years 10 12.5% 21 - 30 years 31 38.7% 31 - 40 years 24 30% 41 - 60 years 08 08% Above 60 years 07 8.8% Total 80 100%
  • 51.   51 | P a g e     GRAPH 2 Graph 2: showing the age group of the respondents. Interpretation From the analysis we can infer that people in the age group of 21-30 take insurance services. They have sufficient funds to invest. Therefore, the companies should target the potential customer in this age group. 0.00% 5.00% 10.00% 15.00% 20.00% 25.00% 30.00% 35.00% 40.00% 45.00% Below 20 years 21‐30 years 31‐40 years 41‐60 years Above 60 years % of Respondents % of Respondents
  • 52.   52 | P a g e     TABLE 3 Table 3: showing the gender of the respondents Analysis From the above table we can infer that, highest percentages of respondents belong to the Female category 61.3% Gender NO. OF RESPONDENTS % OF RESPONDENTS Male 31 38.7% Female 49 61.3% Total 80 100%
  • 53.   53 | P a g e     GRAPH 3 Graph 3: showing the gender of the respondents Interpretation From the analysis we can infer that Female category take insurance services. They have sufficient funds to invest. Therefore, the companies should target the potential customer. % of Respondents 0.00% 20.00% 40.00% 60.00% 80.00% Male Female % of Respondents % of Respondents
  • 54.   54 | P a g e     TABLE 4 Table 4: showing the kind of investment consumer prefer in this pandemic Analysis From the above table we found which type of investment prefer. So out of 100% candidates prefer medium-term investment which is 41.3%. Investment NO. OF RESPONDENTS % OF RESPONDENTS Long-term 31 38.8% Medium-term 33 41.3% Short-term 16 20% Total 80 100%
  • 55.   55 | P a g e     GRAPH 4 Graph 4: showing the kind of investment consumer prefer in this pandemic Interpretation It can be inferred from the data that a greater number of people take insurance in medium term. So, the companies should emphasize and focus on medium term investment. 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Long‐term medium‐term Short‐term No. of Respondents No. of Respondents
  • 56.   56 | P a g e     TABLE 5 Table 5: showing the awareness about Health insurance Analysis From the above table we can infer that, 62.5% of consumer are aware/ exposed and subscribed to health insurance out of 100% Awareness about Health insurance NO. OF RESPONDENTS % OF RESPONDENTS Not Aware / not exposed 06 07.5% Aware/ exposed and subscribed 50 62.5% Aware/ exposed and unsubscribed 24 30% Total 80 100%
  • 57.   57 | P a g e     GRAPH 5 Graph 5: showing the awareness about Health insurance Interpretation It can be inferred from the data that a greater number of people are aware/ exposed and subscribed which shown in graph orange colour. So, companies should create more awareness by giving benefits like cashless treatment to consumers. No. of Respondents Not Aware / not exposed Aware/ exposed and subscribed Aware/ exposed and unsubscribed
  • 58.   58 | P a g e     TABLE 6 Table 6: showing the Source of Awareness Analysis From the above table we can infer that, most of the consumer awareness source are family & friends 28.7%. Sources of Awareness NO. OF RESPONDENTS % OF RESPONDENTS Self-decision 14 17.5% Advertisement in TV 11 13.8% Newspaper or Magazines 04 05% Internet 09 11.2% Insurance Agents 07 8.8% Family/ Friends suggestion 23 28.7% Employee of insurance company 08 10% Tax consultants & Doctors 04 05% Total 80 100%
  • 59.   59 | P a g e     GRAPH 6 Graph 6: showing the Source of Awareness Interpretation It can be inferred from the data that a greater number of people are created awareness by taking the suggestions from family & friends. So, companies should focus on creating awareness by showing the importance of health insurance. % of Respondents 0.00% 5.00% 10.00% 15.00% 20.00% 25.00% 30.00% % of Respondents % of Respondents
  • 60.   60 | P a g e     TABLE 7 Table 7: showing the which Health Insurance policy prefer most Analysis From the above table we can infer that, most of the consumer prefer private health insurance 56.3% as comparison to public sector insurance which is 43.8%. Sector NO. OF RESPONDENTS % OF RESPONDENTS Private Sector 45 56.3% Public Sector 35 43.8% Total 80 100%
  • 61.   61 | P a g e     GRAPH 7 Graph 7: showing the which Health Insurance policy prefer most Interpretation It can be inferred from the data that a greater number of people are taking the health insurance services of private companies instead of public health insurance. So, private sector should create more customers by giving importance of insurance by private sector. % of Respondents  Private Sector Public Sector
  • 62.   62 | P a g e     TABLE 8 Table 8: showing how many people have health insurance policy, if yes then in which health insurance company Analysis From the above table we can infer that, most of the consumer doesn’t taken the health insurance policy which is 27.5% Insurance Company NO. Of RESPONDENTS % OF RESPONDENTS Don't have health Insurance policy 22 27.5% Apollo Munich Health Insurance Company Limited. 7 8.7% IFFCO Tokio 7 8.8% Star Health & Allied Insurance Company Limited. 10 12.5% ICICI Lombard General Insurance Company Limited. 18 12.5% National Insurance Company Limited. 12 15% Others 4 15% Total 80 100%
  • 63.   63 | P a g e     GRAPH 8 Graph 8: showing how many people have health insurance policy, if yes then in which health insurance company Interpretation It can be inferred from the data that out of 80 consumers 22 consumer doesn’t have any insurance policy out of which 18 consumers taken the policy of ICICI Lombard General Insurance Company Limited. So, companies should create more availability of services through which people can create interest and buy health insurance. No. of Respondents 0 5 10 15 20 25 Don't have health Insurance policy Apollo Munich Health Insurance Company Limited IFFCO Tokio Star Health & Allied Insurance Company Limited. ICICI Lombard General Insurance Company Limited. National Insurance Company Limited. Others No. of Respondents No. of Respondents
  • 64.   64 | P a g e     TABLE 9 Table 9: showing how many people has got a health insurance plan for himself/herself and his/her family? Analysis From the table above we can say that 62.5% of the respondents has taken the insurance for ourself and families. Plans taken NO. OF RESPONDENTS % OF RESPONDENTS Yes 50 62.5% No 30 37.5% Total 80 100%
  • 65.   65 | P a g e     GRAPH 9 Graph 9: showing how many people has got a health insurance plan for himself/herself and his/her family? Interpretation From the analysis we can infer that out of 80 respondents 50 has taken insurance. So, companies should more focus on creating more customer by organizing a campaign. 0 5 10 15 20 25 30 35 40 45 50 Yes No No. of Respondents No. of Respondents
  • 66.   66 | P a g e     TABLE 10 Table 10: showing Company provides cashless treatment or not. Analysis From the table above we can say that 61.3% of the companies provides cashless treatment to their consumers. Cashless treatment NO. OF RESPONDENTS % OF RESPONDENTS Yes 49 61.3% No 31 38.7% Total 80 100%
  • 67.   67 | P a g e     GRAPH 10 Graph 10: showing Company provides cashless treatment or not. Interpretation From the analysis we can infer that out of 80 respondents 49 get a cashless treatment from their companies. So, these companies can create more trust with their customers by provides a need while they need it. NO. OF RESPONDENTS Yes No
  • 68.   68 | P a g e     TABLE 11 Table 11: showing health insurance is important in today world or not. Analysis From the table above we can say that 62.5% yes health insurance is important in today’s world. Importance of Health Insurance NO. OF RESPONDENTS % OF RESPONDENTS Yes 50 62.5% No 15 18.8% Maybe 15 18.8% Total 80 100%
  • 69.   69 | P a g e     GRAPH 11 Graph 11: showing health insurance is important in today world or not. Interpretation From the analysis we can infer that out of 80 respondents 50 respondents says that health insurance is important in today’s world, because of this Corona pandemic more and more consumers buy health insurance and most of the consumers claims their existing health insurance. 0 10 20 30 40 50 60 yes No Maybe NO. OF RESPONDENTS NO. OF RESPONDENTS
  • 70.   70 | P a g e     TABLE 12 Table 12: showing that what should be minimum sum insured. Analysis From the table above we can say that 52.5% of respondents prefer 5 lacs insurance policy. Rest 28.5% prefer 10 lacs policy. Minimum Sum Insured NO. OF RESPONDENTS % OF RESPONDENTS 3 lacs 10 12.5% 5 lacs 42 52.5% 10 lacs 23 28.7% 15 lacs 4 5% Don't know 1 1.2% Total 80 100%
  • 71.   71 | P a g e     GRAPH 12 Graph 12: showing that what should be minimum sum insured. Interpretation From the analysis we can infer that out of 80 respondents 42 respondents thinks that 5 lacs policy is enough for claiming. But 23 respondents think that 10 lacs will be enough for getting the claim. 0 5 10 15 20 25 30 35 40 45 3 lacs 5 lacs 10 lacs 15 lacs Don’t Know No. of Respondents No. of Respondents
  • 72.   72 | P a g e     TABLE 13 Table 13: showing Term of Health Insurance Policy. Analysis From the table above we can say that 51.2% respondents think the terms of health insurance policy should be 2-5 years. Term of Policy NO. OF RESPONDENTS % OF RESPONDENTS Less than – 2 years 07 8.8% Between 2-5 years 41 51.2% Between 5-7 years 18 22.5% Between 7-10 years 10 12.5% More than 10 years 04 05% Total 80 100%
  • 73.   73 | P a g e     GRAPH 13 Graph 13: showing Term of Health Insurance Policy. Interpretation From the analysis we can infer that out of 80 respondents 41 respondents tick the option of between 2-5 years. So, with this term of policy companies can avail more health insurance products. No. of Respondents 0 10 20 30 40 50 Less than – 2  years Between 2‐5 years Between 5‐7 years Between 7‐10 years More than 10 years No. of Respondents No. of Respondents
  • 74.   74 | P a g e     TABLE 14 Table 14: showing which time period prefer most to pay health- insurance premium amount. Analysis From the table above we can say that 35% of respondents thinks that Half yearly payment of premium is best then quarterly or annual/ yearly. Time-period NO. OF RESPONDENTS % OF RESPONDENTS Monthly 09 11.3% Quarterly 17 21.3% Half Yearly 28 35% Annual / Yearly 26 32.5% Total 80 100%
  • 75.   75 | P a g e     GRAPH 14 Graph 14: showing which time period prefer most to pay health- insurance premium amount. Interpretation From the analysis we can infer that out of 80 respondents 28 respondents pays their premium amount half yearly rest 26 respondents pays annually. So, it shows that consumer prefer half yearly payment. NO. OF RESPONDENTS 0 10 20 30 Monthly Quarterly Half yearly Annual/ Yearly NO. OF RESPONDENTS NO. OF RESPONDENTS
  • 76.   76 | P a g e     TABLE 15 Table 15: showing the Objective of taking Health Insurance Policy. Analysis From the table above we can say that 41.3% of respondents buys health insurance for Medical emergencies. Objectives NO. OF RESPONDENTS % OF RESPONDENTS Risk Coverage 10 12.5% To Protect against high and unexpected 27 33.8% Medical Emergencies 33 41.3% Tax Benefits 10 12.5% Total 80 100%
  • 77.   77 | P a g e     GRAPH 15 Graph 15: showing the Objective of taking Health Insurance Policy. Interpretation From the analysis we can infer that out of 80 respondents 33 of them buys health policy for medical emergencies rest 27 buys for to protect against high and unexpected difficulties. So, it is clear that COVID change the mindset of the consumer to buy policy for medical emergencies. NO. OF RESPONDENTS 0 10 20 30 40 Risk Coverage To Protect against high and unexpected Medical Emergencies Tax Benefits NO. OF RESPONDENTS NO. OF RESPONDENTS
  • 78.   78 | P a g e     CHAPTER 6: - SUMMARY OF FINDINGS
  • 79.   79 | P a g e     SUMMARY OF FINDINGS  The majority of the respondents 15% are Private employees, 11.3% are Government employees 12.5% are Professional, 28.8% are Businessman and 61.2% are Farmers and students and old age people.  30% percentage of respondents belongs to the age group between 31-40 years.  Majority of respondents 13.8% feel that TV is the best media for insurance companies to reach customers.  Other than TV, people feel that newspaper 05% is the next best media to reach customers.  Majority 28.7% People share interesting ads with family and friends.  Majority of the respondents 62.5% are aware of health insurance.  Majority of the respondents 13.8% have watched insurance advertisement on news channels.  ICICI is the most popular in terms of advertisement 22.5% followed by National Insurance Company Limited 15%.  Almost 62.5% of People have got a health insurance plan for himself/herself and his/her family.
  • 80.   80 | P a g e      Nearly 28.7% of the respondents believe that the Family/ Friends suggestion clearly convey their message.  Majority of 38.8% People prefer long-term investment in this pandemic.  Nearly 56.3% people believe that Private sector Insurance is quite good then Public sector insurance.  Majority of 51.2% people believe Term of Health Insurance Policy should be between 2-5 years.
  • 81.   81 | P a g e     CHAPTER 7: - SUGGESTION AND RECOMMENDATIONS
  • 82.   82 | P a g e     SUGGESTIONS  Taking health policy at very young age and covering all members of the family.  Customers should be fully aware of the various health coverages available.  Customers should know about the various health insurance schemes and companies providing these schemes.  The attitude of customers should be always towards the preventive health care.  Customers should take decisions relating to the features of the policy, sum assured, premium paid, persons covered, after careful analysis.  They must be aware of the conditions and exclusions in the policy.  They have to pay the premium in time and file the claims if any strictly as per rules and regulations.  Take at most care towards ethics in reveling the preexisting disease.  Make use of the grievances cell in the case of any dissatisfaction relating to health insurance.
  • 83.   83 | P a g e     CHAPTER 8: - CONCLUSION
  • 84.   84 | P a g e     CONCLUSION “Health coverage to all” should be the motto of the health insurance sector. There should be easy access to healthcare facilities and cost control measures should be in place. Health insurance is going to develop more in the current liberal economic scenario. But, a completely unregulated or very less regulated health insurance sector may concentrate only on those who have the ability to pay for the insurance cover. So, the challenge is in helping the benefits percolate to the economically weaker sections of the population. Transparent and accountable government and non-government participation should be encouraged. Developing and marketing social health insurance schemes through cooperatives and rural association would go a long way in benefiting the vast unorganized employment sectors currently neglected under the existing schemes. Also, a thorough revamp of schemes like ESIS and CGHS is necessary for them to be more purposeful and efficient. If the government, service provider, health care industry and the health insurance customers can incorporate all these suggestions given in the study, then the concept of health insurance will reach new heights in the near future and Mother India will be definitely, the healthiest nation in the world.
  • 85.   85 | P a g e     CHAPTER 10: - BIBLIOGRAPHY
  • 86.   86 | P a g e     BIBLIOGRAPHY WEBSITES: 1. Scribd.com. 2. irdai.gov.in 3. www.google.com. 4. www.ibef.org 5. www.facebook.com 6. www.hdfcergo.com
  • 87.   87 | P a g e     CHAPTER 11: - ANNEXURE
  • 88.   88 | P a g e     Annexure Hello Sir/Madam, I, ___________, student of 3th semester MBA am conducting a research on the "A Study on Consumer Perception towards Health Insurance Products in COVID era". The purpose of this study is to understand, capture, assesses and evaluate the effectiveness of the Health Insurance Product. I would appreciate if you could spend about 15 Min. and communicate your feelings, expression, comments. Please give your honest opinion and be sure that this information collected will be purely confidential and not be shared with any other entity in term of commercialization. Q1. Occupation: A. Government Employee B. Private Employee C. Professional D. Businessman E. Others
  • 89.   89 | P a g e     Q2. Age: A. Below 20 years B. 21-30 years C. 31-40 years D. 41-60 years E. Above 60 years Q3. What kind of investment do you prefer in this pandemic? A. Long-term B. Medium-term C. Short-term Q4. Are you aware about Health insurance? A. Not Aware / not exposed B. Aware/ exposed and subscribed C. Aware/ exposed and unsubscribed Q5. Source of Awareness? A. Self-decision B. Advertisement in TV C. Newspaper or Magazines D. Internet E. Insurance Agents F. Family/ Friends suggestion G. Employee of insurance company H. Tax consultants & Doctors I. Others
  • 90.   90 | P a g e     Q6. Which Health Insurance policy you prefer most? A. Private Sector B. Public Sector Q7. Do you have health insurance policy, if yes then? A. No, I don't have health Insurance policy B. IFFCO Tokio C. Apollo Munich Health Insurance Company Limited. D. Star Health & Allied Insurance Company Limited. E. ICICI Lombard General Insurance Company Limited. F. National Insurance Company Limited. G. Other Q8. Have you got a health insurance plan for you and your family? A. Yes B. No Q9. If yes, whether your Company provides cashless treatment? A. Yes B. No
  • 91.   91 | P a g e     Q10. Do you think health insurance is important in today world? A. Yes B. No C. Maybe Q11. If yes, what according to you should be minimum sum insured? A. 3 lacs B. 5 lacs C. 10 lacs D. 15 lacs E. Other Q12. Do you consult insurance agent while taking a health insurance policy? A. Every Time B. Often C. Sometime D. Never
  • 92.   92 | P a g e     Q13. Term of Health Insurance Policy? A. Less than – 2 years B. Between 2-5 years C. Between 5-7 years D. Between 7-10 years E. More than 10 years Q14. How you would prefer most to pay health-insurance premium amount? A. Monthly B. Quarterly C. Half Yearly D. Annual / Yearly Q15. Objective of taking Health Insurance Policy? A. Risk Coverage B. To Protect against high and unexpected Medical cost C. Tax Benefits D. Medical Emergencies E. Other
  • 93.   93 | P a g e     Q16. Barriers in the Subscription of Health Insurance.
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