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2012

MAX BUPA HEALTH


INSURANCE COMPANY LTD.

SUMAN BHATTACHERJEE

[ A comparative study between services provided


by Max Bupa and other health insurance
company in Kolkata for employee group health
insurance.]
A STUDY ON MAXBUPA HEALTH INSURANCE COMPANY LTd. By
SUMAN BHATTACHERJEE,INSTITUTE OF ENGINEERING AND
MANAGEMENT.
2

A comparative study between services provided by Max Bupa and


other health insurance company in Kolkata for employee group
health insurance

Summer Internship Project Report Submitted Towards Partial Fulfillment Of


MASTERS IN BUSINESS ADMINISTRATION
(Approved By AICTE, Affiliated by WBUT)
Academic Session 2011 - 13

SUBMITTED BY
Student Name: SUMAN BHATTACHERJEE
Roll No. : 10400911083
REGISTRATION NO: 111040710083

COMPANY GUIDE FACULTY GUIDE


Name: MRS.ARADHANA GUHA BISWAS Name: Prof. S.N.SANYAL
Designation: BUSINESS DEVELOPMENT MANAGER
Organization: MAX BUPA HEALTH INSURANCE CO. LTD.

INSTITUTE OF ENGINEERING AND


MANAGEMENT D1, Sector V, Salt Lake Electronics
Complex Kolkata 700091
3

DECLARATION

I hereby declare that the project work entitled A comparative study between services
provided by Max Bupa and other health insurance company in Kolkata for employee
group health insurance. submitted to WEST BENGAL UNIVERSITY OF TECHNOLOGY as
a part of the MBA curriculum, is a record of an original work done by me under the guidance of
Prof. Shamindra Nath Sanyal(Faculty Guide, Institute Of Engineering and Management) and
Mrs.Aradhana Guha Biswas(Company Guide, Max Bupa Health Insurance co. LTD.) and this
project work is submitted in the partial fulfillment of requirement for the award of the degree of
Masters of Business Administration. The result embodied in this project has not been submitted
to any other university or company for the award of any degree or diploma.

_________________________

SUMAN BHATTACHERJEE

DATE:-
4

INSTITUTE OF ENGINEERING AND MANAGEMENT


D1,SECTOR V,SALTLAKE ELECTRONICS COMPLEX

KOLKATA-700091
__________________________________________________________________

DECLARATION

I hereby declare that the project work entitled A comparative study between services
provided by Max Bupa and other health insurance company in Kolkata for employee
group health insurance. Submitted by Mr. Suman Bhattacherjee student of institute of
engineering and management (Roll no.- 10400911083 and Reg No.- 111040710083) to WEST
BENGAL UNIVERSITY OF TECHNOLOGY as a part of the MBA curriculum, is a record of an
original work done by under the guidance of me (Prof. Shamindra Nath Sanyal,Faculty of
Institute Of Engineering and Management) and this project work is a original project and this
project has not been submitted to any other university or company for the award of any degree or
diploma.

_______________________
SHAMINDRA NATH SANYAL
DATE :-
5

Acknowledgement

I have taken efforts in this project. However, it would not have been possible
without the kind support and help of many individuals and organizations. I
would like to extend my sincere thanks to all of them.
I am highly indebted to Mrs. Aradhana Guha Biswas for her guidance and constant
Supervision as well as for providing necessary information regarding the project &
also for his support in completing the project.
I would like to express my gratitude towards my parents & member of Max Bupa Health
Insurance Company Ltd. for their kind co-operation and encouragement which help me in
Completion of this project.
I would like to express my special gratitude and thanks to my college Institute of
Engineering & Management, our principal sir Mr.P.K.Mishra and my guide prof. Mr.
S.N.Sanyal and all the faculties for helping me.
My thanks and appreciations also go to my colleague in developing the
project and people who have willingly helped me out with their abilities.

_________________________

SUMAN BHATTACHERJEE

DATE:-
6

Index of Contents:

Particulars Page no.


1. EXECUTIVE SUMMARY. 7
2. SENARIO BUILDING. 8
3. OBJECTIVE OF STUDY. 30
4. RESEARCH METHODOLOGY. 31
5. DATA ANALYSIS. 33
6. RECCOMENDATION AND SCOPE 39
OF STUDY.
7. LIMITATION OF THE PROJECT. 40
8. CONCLUSION. 41
9. BIBLIOGRAPHY. 42
10. ANNEXURE. 43
7

CHAPTER 1

1. EXECUTIVE SUMMARY

There are different types of services which are generally provided by various health insurance
companies. So in this project I am mainly trying to make a comparative study and make an
analysis the difference between services provided by the companies to the employees of other
companies mainly SME sector. This analysis made on the basis of different bar chart, pie chart,
and bar chart because this is a just a introductory project and no one before make this project.

This project also presents the core diffences between services of different company. This project
also concentrates on the different services which are required by the customers. In this project
the customers are mainly are the Business customers form SME sectors which are mainly from
KOLKATA. This project also establishers the core difference of various services provided by the
different health insurance company.

The data which use in this project are mainly the primary data. But there are also some data
provided here which are secondary data which I had collect from the company. The questionnaire
is mainly based on the sale of services which are business customers preference. This project is
a qualitative project. At the end of this project there is different recommendation and future
scope of study on this project is written. There are different findings from this project like cash
less benefit, different services are there where this company can prosper .but there is one another
thing is that if Max Bupa try to cut down the age limit of employee health insurance coverage it
can be very helpful for them in the future. We can also see that different companies who
currently use other companies as their current health insurance provider interested to use Max
Bupa health insurance services.

This project also consist of a brief introduction of Max Bupa health insurance co. ltd( A joint
venture of Max India and Bupa financial plc.). As well as Max India co. ltd. And Bupa financial
plc.
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CHAPTER 2

2. SENARIO BUILDING

2.1. HEALTH INSURANCE

A health insurance policy is:

1) a contract between an insurance provider (e.g. an insurance company or a government) and an


individual or his/her sponsor (e.g. an employer or a community organization). The contract can
be renewable (e.g. annually, monthly) or lifelong in the case of private insurance, or be
mandatory for all citizens in the case of national plans. The type and amount of health care costs
that will be covered by the health insurance provider are specified in writing, in a member
contract or "Evidence of Coverage" booklet for private insurance, or in a national health policy
for public insurance.

2) Insurance coverage is provided by an employer-sponsored self-funded ERISA plan. The


company generally advertises that they have one of the big insurance companies. However, in an
ERISA case, that insurance company "doesn't engage in the act of insurance", they just
administer it. Therefore ERISA plans are not subject to state laws. ERISA plans are governed by
federal law under the jurisdiction of the US Department of Labor (USDOL). The specific
benefits or coverage details are found in the Summary Plan Description (SPD). An appeal must
go through the insurance company, then to the Employer's Plan Fiduciary. If still required, the
Fiduciarys decision can be brought to the USDOL to review for ERISA compliance, and then
file a lawsuit in federal court.

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 to purchase health coverage.
Deductible: The amount that the insured must pay out-of-pocket before the health insurer
pays its share. For example, policy-holders 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
9

doctor's visits or prescription refills before the insured person reaches the deductible and
the insurance company starts to pay for care however, most policies do not apply co-pays
for doctor's visits or prescriptions against your deductible.
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 are generally expected to pay the
full cost of non-covered services out of their own pockets.
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
health insurance 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
10

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 matches what was authorized. Many smaller, routine
services do not require authorization.
Explanation of Benefits: A document that may be sent by an insurer to a patient
explaining what was covered for a medical service, and how payment amount and patient
responsibility amount were determined.

Prescription drug plans are a form of insurance offered through some health insurance plans. In
the U.S., the patient usually pays a copayment and the prescription drug insurance part or all of
the balance for drugs covered in the formulary of the plan. Such plans are routinely part of
national health insurance programs. For example in the province of Quebec, Canada, prescription
drug insurance is universally required as part of the public health insurance plan, but may be
purchased and administered either through private or group plans, or through the public 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.
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2.2. INTRODUCTION ABOUT COMPANIES

2.2.1. MAX INDIA CO. LTD:-

Max India Limited is a multi-business corporate, driven by the spirit of enterprise and focused
on people and service-oriented businesses. The Companys vision is to be one of Indias most
admired corporate for Service Excellence.

We 'Protect Life' through our Life Insurance subsidiary. Max Life Insurance, a Joint Venture
between Max India and Mutsui Sumitomo, Japan;

We 'Care for Life' through our Healthcare company, Max Healthcare, a subsidiary of Max India
Limited;

We 'Enhance Life' through our Health Insurance company, Max Bupa Health Insurance, a Joint
Venture between Max India and Bupa Finance Plc, UK;

We 'Improve Life' through our Clinical Research business, Max Neeman Medical International, a
fully owned subsidiary of Max India.

Max India recently entered the Senior Living business with Antara, a fully owned subsidiary of
Max India. From its past, Max India continues its interest in the manufacture of Specialty
Products for the packaging industry.

Max India Groups consolidated turnover for FY12 was Rs. 85,623 million and the consolidated
operating revenue was Rs. 76,958 million, a growth of 15% above the same period last year. The
Group is on a high growth path, with a customer base of 5.1 million, over 500 offices across 400
locations in the country and people strength of 57,000 persons as on March 31, 2012.
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2.2.2. BUPA FINANCIAL PLF.:-

Bupa is a British healthcare organization in the United Kingdom, with bases on three continents
and more than ten million customers in over 190 countries. It is a private healthcare company, an
alternative to the UK's National Health Service (NHS), which is a tax-funded healthcare system.

BACKGROUND

Bupa (originally, the British United Provident Association) was established in 1947 when 17
British provident associations joined together to provide healthcare for the general public. The
original services offered by Bupa included private medical insurance, and eventually expanded to
include privately-run Bupa hospitals. Bupa had an initial registration of 38,000 when founded,
but currently has over 11 million members worldwide, and is the largest private health insurance
provider in the UK.

It was founded before the advent of the National Health Service (NHS) in 1947 as a provident
organization. Initially, it was purely a UK health insurance provider, offering policies to
individuals, companies and other organizations. This continues to be a large part of the company
and around 80 percent of the UK's FTSE 100 are customers.

Over the years, it has diversified away from its core health insurance business and is now an
international healthcare company with services that include travel insurance, health insurance,
care homes, health assessments, occupational health services and hospitals. The firm is a private
company limited by guarantee; it has no shareholders, and any profits (after tax) are reinvested in
the business.

Operations

The company has its head office in central London, with main UK contact centers in Staines and
Salford Quays. There are also offices in Brighton (Bupa International), Leeds (Bupa Care
Services), and Harlow (Bupa Home Healthcare) in the UK, Adelaide, Brisbane, Sydney and
13

Melbourne in Australia (Bupa Australia and Bupa Aged Care Australia), New Delhi (Max Bupa),
Madrid (Sanitas), Boston (Health Dialog), Beijing (Bupa China), Hong Kong (Bupa Asia), Jedda
(Bupa Arabia), Bangkok (Bupa Thailand), and Miami (Bupa Latin America).

The firm also owns several healthcare companies overseas including Spain's largest healthcare
company, Sanitas, and acquired ihi Danmark and Amedex (Miami, US) in September 2005. In
November 2006, it acquired Clinovia, now known as Bupa Home Healthcare, in a move that
gave Bupa new opportunities in out of hospital care. In December 2007, it purchased DCA
Agedcare Group in Australia and New Zealand, making it a leading player in these markets. Also
in December 2007, it announced the purchase of Health Dialog, a provider of chronic condition
management and "shared decision making" services.

In 2007, the company announced plans to sell its UK hospitals to Spire Healthcare.

During 2008, the firm acquired the London-based Cromwell Hospital flagship hospital to
provide healthcare to its members and other private patients including medical tourists from
outside the UK. Approval was given for the merger between Bupa's Australian arm (which, prior
to the merger, comprised HBA and Mutual Community) and insurance group MBF. The merger
created Australia's second largest private health insurance group. On 1 December 2008,
Clinovia's name was changed to Bupa Home Healthcare.

The firm has entered the Indian health insurance market through a joint venture with the local
conglomerate, Max India, called Max Bupa Health Insurance Limited.

2.2.3. SHORT INTRODUCTION OF MAX INDIA INSURANCE LTD.:-

Max Bupa Health Insurance Company Limited is a joint venture between Max India Limited
and Bupa Finance plc UK established for the purpose of carrying on health insurance business in
India. The company has been incorporated under the Companies Act, 1956 with its registered
office at Max House, 1 Dr. Jha Marg, Okhla, New Delhi 110020.

Max India Limited is a multi-business corporate. It Protects Life through its Life Insurance
subsidiary Max New York Life Insurance, a joint venture between Max India and New York
14

Life, a fortune 100 company; Cares for Life through its Healthcare company, Max Healthcare,
a subsidiary of Max India Limited; and Improves Life through its Clinical Research business,
Max Neeman, a fully owned subsidiary of Max India. From its past, Max India continues its
interest in manufacture of Specialty Products for the packaging industry. Max India endeavors to
Enhance Life through the company.

The British United Provident Association Limited (Bupa) is the parent company of the Bupa
Group. As such it has no shareholders and all of its surpluses are re-invested back into the
various businesses.

Bupa Group offers health insurance to customers around the world and specializes in health
insurance and aged care. Bupa Group has more than 10 million customers in over 190 countries.
Bupa Group provides health insurance cover for individuals, families and companies. It is the
largest private medical insurer in the UK. Here is the board of directors of MAX BUPA.

Analjit Singh, Chairman

Anuroop (Tony) Singh, Director

Rahul Khosla, Director

William Stephen Ward, Director

Dean Allan Holden, Director

Anthony Maxwell Coleman, Director

Damien Marmion, Director

James Gordon Wheaton, Director

K. Narasimha Murthy, Director


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2.3. INTRODUCTION OF COMPETITIVE COMPANIES:-

2.3.1. ICICI LOMBARD:-

ICICI Lombard GIC Ltd. is a joint venture between ICICI Bank Limited, India's second largest
bank with consolidated total assets of over USD 91 billion at March 31, 2012 and Fairfax
Financial Holdings Limited, a Canada based USD 30 billion diversified financial services
company engaged in general insurance, reinsurance, insurance claims management and
investment management.

ICICI Lombard GIC Ltd. is the largest private sector general insurance company in India with a
Gross Written Premium (GWP) of Rs. 5,358 crore for the year ended March 31, 2012. The
company issued over 76 lakh policies and settled over 44 lakh claims and has a claim disposal
ratio of 99% (percentage of claims settled against claims reported) as on March 31, 2012.

The company has been conferred the "Golden Peacock Award 2012" for Corporate Social
Responsibility, "Golden Peacock Innovation Award-2010" for Rashtriya Swasthya Bima Yojana.
It also received the "Skoch Financial Inclusion Award-2011" in the micro finance category. The
company has been conferred with 'NASSCOM - CNBC TV18 IT User Award 2010' for Best
Technology Implementation in the Insurance Sector. It has been awarded CNBC Awaaz
Consumer Award 2010 for being the 'most preferred brand' in the General Insurance category.
ICICI Lombard Auto Insurance has been rated highest in customer satisfaction by J.D. Power
Asia Pacific in India among 11 auto insurance providers. It was awarded Customer and Brand
Loyalty award in the 'Insurance Sector - Non-Life' at the 3rd Loyalty awards, 2010 and the
'General Insurance Company of the Year' at the 11th Asia Insurance Industry Awards. The
company also won the NDTV Profit Business Leadership Award 2007 and was adjudged as the
most Customer Responsive Company in the Insurance category at the Economic Times Avaya
Global Connect Customer Responsiveness Award 2006. It has the Gold Shield for 'Excellence in
Financial Reporting' by the ICAI (Institute of Chartered Accountants of India) for the year ended
March 31, 2006.
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2.3.2. RELINCE INSURANCE:-

Reliance General Insurance is one of the leading private general insurance companies of India.
We offer an exhaustive and customized basket of insurance products that include motor, health,
travel, student travel insurance etc with over 94 customized insurance products catering to the
corporate, SME and individual customers. In our endeavor to delight our customers, we strive to
come up with innovative products like India's first Over-The-Counter health & home insurance
policies.

To pursue our belief in providing easy access to our customers and distributors, we have 152
offices spread across 119 cities in 24 states. Apart from this, we also provide easy access to our
customers with our dedicated 24x7 call center, a transactional website, tie-ups through banks,
channel partners and brokers.

2.3.3. UNITED INDIA INSURANCE:-

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

United India has been in the forefront of designing and implementing complex covers to large
customers, as in cases of ONGC Ltd , GMR- Hyderabad International Airport Ltd, Mumbai
International Airport Ltd Tirumala-Tirupati Devasthanam etc. We have been also the pioneer in
taking Insurance to rural masses with large level implementation of Universal Health Insurance
Programme of Government of India & Vijaya Raji Janani Kalyan Yojana ( covering 45 lakhs
17

women in the state of Madhya Pradesh) , Tsunami Jan Bima Yojana (in 4 states covering 4.59
lakhs of families) , National Livestock Insurance and many such schemes.

2.3.4. APOLLO MUNICH:-

Apollo Munich Health Insurance Co. Ltd. is the new name for Apollo DKV Insurance Co. Ltd.
The new name was officially announced today as the company embarks on the new re-branding
exercise after receiving the required shareholder and regulatory approvals to change its name.
The announcement of the 'Apollo Munich' name is a significant milestone as the company is set
to scale its business to garner a sizable share of the growing market for health insurance.
Headquartered in Gurgaon with an expanding national presence, Apollo Munich is a joint
venture between Asias largest integrated healthcare provider, The Apollo Hospitals Group, and
Germany based Munich Res newest business segment, Munich Health.

Munich Health is in fact the new brand under which Munich Re is now offering its healthcare
sector services to clients and partners throughout the world. Munich Re is thus bringing together
under one banner its global insurance and reinsurance know-how in health. The new brand will
come to stand for partnership, excellence and clarity from a company that is the expert in both
health and insurance.

Apollo Munich has robust plans to expand its branch network, double the number of policy
selling agents and increase the company headcount in its aim to achieve a market penetration of
5% of the retail health insurance market by 2013-14.

The companys name change comes at a time when the health industry sector in the country is
growing at an aggressive pace and Apollo Munich has set out to provide innovative health
insurance products to address "preventive" needs and not merely focus on "curative" needs.
Apollo Munich is 74:26 joint-venture between Apollo Hospitals Group and Germany-based
Munich Re's newest business segment Munich Health, which came into being following the re-
organization of business. DKV is also part of Munich Re of Germany.
18

2.3.5. BAJAJ ALLIANZ:-

The financial services and wind energy businesses were transferred to Bajaj FinServ Limited
(BFS) as part of the recently concluded demerger of Bajaj Auto Limited, approved by the Hon.
High Court of Judicature at Bombay by its order dated December 18, 2007. The demerger is
effective from the Appointed Date i.e. closing hours of business on March 31, 2007.

Bajaj FinServ will strive to be one of the top financial services businesses in India focused on
delivering superior customer experience through competitive products and class leading services
while providing consistent and superior returns to our shareholders and maintaining the high
levels of integrity of Bajaj.

The company is currently engaged in life insurance; general insurance and consumer finance
businesses and has plans to expand its business by offering a wide array of financial products and
services in India. Apart from financial services, BFS is also active in wind-energy generation.

2.3.6. Life Insurance Corporation of India (LIC):-

Life Insurance Corporation of India (LIC) is the largest insurance group and investment
company in India. Its a state-owned where Government of India has 100% stake. LIC also funds
close to 24.6% of the Indian Government's expenses. It has assets estimated of 13.25 trillion
(US$239.83 billion). It was founded in 1956 with the merger of 243 insurance companies and
provident societies.

Headquartered in Mumbai, financial and commercial capital of India, the Life Insurance
Corporation of India currently has 8 zonal Offices and 113 divisional offices located in different
parts of India, around 3500 servicing offices including 2048 branches, 54 Customer Zones, 25
Metro Area Service Hubs and a number of Satellite Offices located in different cities and towns
of India and has a network of 13,37,064 individual agents, 242 Corporate Agents, 79 Referral
Agents, 98 Brokers and 42 Banks (as on 31.3.2011) for soliciting life insurance business from
the public.
19

2.3.7. NATIONAL INSURANCE:-

National Insurance Company Limited was incorporated in 1906 with its Registered office in
Kolkata. Consequent to passing of the General Insurance Business Nationalisation Act in 1972,
21 Foreign and 11 Indian Companies were amalgamated with it and National became a
subsidiary of General Insurance Corporation of India (GIC) which is fully owned by the
Government of India. After the notification of the General Insurance Business (Nationalisation)
th
Amendment Act, on 7 August 2002, National has been de-linked from its holding company
GIC and presently operating as a Government of India undertaking.

National Insurance Company Ltd (NIC) is one of the leading public sector insurance companies
of India, carrying out non life insurance business. Headquartered in Kolkata, NIC's network of
about 1000 offices, manned by more than 16,000 skilled personnel, is spread over the length and
breadth of the country covering remote rural areas, townships and metropolitan cities. NIC's
foreign operations are carried out from its branch offices in Nepal.

Befittingly, the product ranges, of more than 200 policies offered by NIC cater to the diverse
insurance requirements of its 14 million policyholders. Innovative and customized policies
ensure that even specialized insurance requirements are fully taken care of.

The paid-up share capital of National is Rs.100 crores. Starting off with a premium base of 500
million rupees (50 crores rupees) in 1974, NIC's gross direct premium income has steadily
grown to 4021.97 million rupees (4021.97 crores rupees ) in the financial year 2007-2008.

National transacts general insurance business of Fire, Marine and Miscellaneous insurance. The
Company offers protection against a wide range of risks to its customers. The Company is
privileged to cater its services to almost every sector or industry in the Indian Economy viz.

Banking, Telecom, Aviation, Shipping, Information Technology, Power, Oil & Energy,
Agronomy, Plantations, Foreign Trade, Healthcare, Tea, Automobile, Education,
Environment, Space Research etc.
20

National Insurance is the second largest non life insurer in India having a large market presence
in Northern and Eastern India.

The steady growth in premium income has been commensurately matched by profits over the
years. As of March 2008, NIC's general reserve stood at 1457.25 million rupees (1457.25 crores
rupees) with an asset value of 8867.99 million rupees (8867.99 crores rupees) signaling strong
financial fundamentals. No wonder than that NIC has been accorded AAA/STABLE financial
strength rating by CRISIL rating agency, which reflects the highest financial
strength to meet policyholders obligations.

2.3.8. MICROSEC CAPITAL INSURANCE(MICROSEC GROUP):-

(Our Company was incorporated as Satyam Fiscal Services Private Limited on June 6, 1989.
The name of our Company was subsequently changed to Microsec Financial Services
Private Limited pursuant to a fresh certificate of incorporation issued by the Registrar of
Companies, West Bengal at Kolkata, dated October 17, 2005. Our status was subsequently
changed to a public limited company and the word private was deleted from the name of our
Company by a special resolution of the members of our Company passed at the Extra
Ordinary General Meeting held on October 19, 2005. The fresh certificate of incorporation
consequent to change of name was granted to our Company on October 20, 2005.

2.3.9. ORIENTAL INSURANCE:-

The Oriental Insurance Company Ltd was incorporated at Bombay on 12th September 1947.
The Company was a wholly owned subsidiary of the Oriental Government Security Life
Assurance Company Ltd and was formed to carry out General Insurance business. The Company
was a subsidiary of Life Insurance Corporation of India from 1956 to 1973 ( till the General
Insurance Business was nationalized in the country). In 2003 all shares of our company held by
the General Insurance Corporation of India has been transferred to Central Government.
21

The Company is a pioneer in laying down systems for smooth and orderly conduct of the
business. The strength of the company lies in its highly trained and motivated work force that
covers various disciplines and has vast expertise. Oriental specializes in devising special covers
for large projects like power plants, petrochemical, steel and chemical plants. The company has
developed various types of insurance covers to cater to the needs of both the urban and rural
population of India. The Company has a highly technically qualified and competent team of
professionals to render the best customer service.

Oriental Insurance made a modest beginning with a first year premium of Rs.99,946 in 1950.
The goal of the Company was Service to clients and achievement thereof was helped by the
strong traditions built up overtime.

ORIENTAL with its head Office at New Delhi has 30 Regional Offices and nearly 900+
operating Offices in various cities of the country. The Company has overseas operations in
Nepal, Kuwait and Dubai. The Company has a total strength of around 15,000+ employees.
From less than a lakh at inception, the Gross Premium went up to Rs.58 crores in 1973 and
during 2010-11 the figure stood at a mammoth Rs. 5569.88 crores.

2.4. HISTORY OF INSURANCE SECTOR IN INDIA

In India, insurance has a deep-rooted history. Insurance in various forms has been mentioned in
the writings of Manu (Manusmrithi), Yagnavalkya (Dharmashastra) and Kautilya (Arthashastra).
The fundamental basis of the historical reference to insurance in these ancient Indian texts is the
same i.e. pooling of resources that could be re-distributed in times of calamities such as fire,
floods, epidemics and famine. The early references to Insurance in these texts have reference to
marine trade loans and carriers' contracts.

Insurance in its current form has its history dating back until 1818, when Oriental Life Insurance
Company was started by Anita Bhavsar in Kolkata to cater to the needs of European community.
The pre-independence era in India saw discrimination between the lives of foreigners (English)
22

and Indians with higher premiums being charged for the latter. In 1870, Bombay Mutual Life
Assurance Society became the first Indian insurer.

At the dawn of the twentieth century, many insurance companies were founded. In the year 1912,
the Life Insurance Companies Act and the Provident Fund Act were passed to regulate the
insurance business. The Life Insurance Companies Act, 1912 made it necessary that the
premium-rate tables and periodical valuations of companies should be certified by an actuary.
However, the disparity still existed as discrimination between Indian and foreign companies. The
oldest existing insurance company in India is the National Insurance Company Ltd., which was
founded in 1906. It is in business.

The Government of India issued an Ordinance on 19th January, 1956 nationalizing the Life
Insurance sector and Life Insurance Corporation came into existence in the same year. The Life
Insurance Corporation (LIC) absorbed 154 Indian, 16 non-Indian insurers as also 75 provident
societies245 Indian and foreign insurers in all. In 1972 with the General Insurance Business
(Nationalization) Act was passed by the Indian Parliament, and consequently, General Insurance
business was nationalized with effect from 1st January, 1973. 107 insurers were amalgamated
and grouped into four companies, namely National Insurance Company Ltd., the New India
Assurance Company Ltd., the Oriental Insurance Company Ltd and the United India Insurance
Company Ltd. The General Insurance Corporation of India was incorporated as a company in
1971 and it commence business on January 1st 1973.

The LIC had monopoly till the late 90s when the Insurance sector was reopened to the private
sector. Before that, the industry consisted of only two state insurers: Life Insurers (Life Insurance
Corporation of India, LIC) and General Insurers (General Insurance Corporation of India, GIC).
GIC had four subsidiary companies.

With effect from December 2000, these subsidiaries have been de-linked from the parent
company and were set up as independent insurance companies: Oriental Insurance Company
Limited, New India Assurance Company Limited, National Insurance Company Limited and
United India Insurance Company Limited.
23

2.5. DIFFERENT PSU AND PRIVET SECTOR HEALTH INSURANCE COMPANY IN


INDIA

2.5.1. Public Sector

Government of India Fully owned 4 companies:

National Insurance Co Ltd (public sector)


New India Assurance Co Ltd (public sector)
Oriental Insurance Co Ltd (public sector)
United India Insurance Co Ltd (public sector)

2.5.2. Private Sector

Bajaj Allianz General Insurance


Bharti AXA General Insurance
Cholamandalam MS
Future Generali India Insurance
HDFC ERGO General Insurance
ICICI Lombard
IFFCO Tokio
Liberty Videocon General Insurance Co Ltd
L & T General Insurance
Magma HDI General Insurance Co Ltd
Raheja QBE General Insurance
Reliance General Insurance
Royal Sundaram
SBI General Insurance
Shriram General Insurance
Tata AIG General
Universal Sompo General Insurance
24

2.5.3. Standalone health insurance companies - List

.Private Sector

Apollo Munich Health Insurance


Max Bupa Health Insurance
Religare Health Insurance Company Ltd
Star Health Insurance

2.6. HISTORY OF HEALTH INSURANCE SECTOR IN INDIA:-

The Insurance sector in India governed by Insurance Act, 1938, the Life Insurance Corporation
Act, 1956 and General Insurance Business (Nationalisation) Act, 1972, Insurance Regulatory and
Development Authority (IRDA) Act, 1999 and other related Acts. With such a large population
and the untapped market area of this population Insurance happens to be a very big opportunity
in India. Today it stands as a business growing at the rate of 15-20 per cent annually. Together
with banking services, it adds about 7 per cent to the countrys GDP .In spite of all this growth
the statistics of the penetration of the insurance in the country is very poor. Nearly 80% of Indian
populations are without Life insurance cover and the Health insurance. This is an indicator that
growth potential for the insurance sector is immense in India. It was due to this immense growth
that the regulations were introduced in the insurance sector and in continuation Malhotra
Committee was constituted by the government in 1993 to examine the various aspects of the
industry. The key element of the reform process was Participation of overseas insurance
companies with 26% capital. Creating a more efficient and competitive financial system suitable
for the requirements of the economy was the main idea behind this reform.

Since then the insurance industry has gone through many sea changes .The competition LIC
started facing from these companies were threatening to the existence of LIC .since the
liberalization of the industry the insurance industry has never looked back and today stand as the
25

one of the most competitive and exploring industry in India. The entry of the private players and
the increased use of the new distribution are in the limelight today. The use of new distribution
techniques and the IT tools has increased the scope of the industry in the longer run

HISTORY OF INSURANCE SECTOR

The business of life insurance in India in its existing form started in India in the year 1818 with
the establishment of the Oriental Life Insurance Company in Calcutta. Some of the important
milestones in the life insurance business in India are given in the table 1.

Table 1: milestones in the life insurance business in India

Year Milestones in the life insurance business in India

1912 The Indian Life Assurance Companies Act enacted as the first statute to regulate
the life 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.

1956 245 Indian and foreign insurers and provident societies taken over by the central
government and nationalized. LIC formed by an Act of Parliament, viz. LIC
Act, 1956, with a capital contribution of Rs. 5 crore from the Government of
India.
26

The General insurance business in India, on the other hand, can trace its roots to the Triton
Insurance Company Ltd., the first general insurance company established in the year 1850 in
Calcutta by the British. Some of the important milestones in the general insurance business in
India are given in the table 2.

Table 2: milestones in the general insurance business in India

Year Milestones in the general insurance business in India

1907 The Indian Mercantile Insurance Ltd. set up, the first company to transact all
classes of general insurance business

1957 General Insurance Council, a wing of the Insurance Association of India, frames
a code of conduct for ensuring fair conduct and sound business practices

1968 The Insurance Act amended to regulate investments and set minimum solvency
margins and the Tariff Advisory Committee set up.

1972 The General Insurance Business (Nationalization) Act, 1972 nationalized the
general insurance business in India with effect from 1st January 1973.
107 insurers amalgamated and grouped into four companys viz. the National

Insurance Company Ltd., the New India Assurance Company Ltd., the Oriental
Insurance Company Ltd. and the United India Insurance Company Ltd. GIC
incorporated as a company.

Indian Insurance Market History:-

Insurance has a long history in India. Life Insurance in its current form was introduced in 1818
when Oriental Life Insurance Company began its operations in India. General Insurance was
however a comparatively late entrant in 1850 when Triton Insurance company set up its base in
27

Kolkata. History of Insurance in India can be broadly bifurcated into three eras: a) Pre
Nationalization b) Nationalizations and c) Post Nationalizations. Life Insurance was the first to
be nationalized in 1956. Life Insurance Corporation of India was formed by consolidating the
operations of various insurance companies. General Insurance followed suit and was nationalized
in 1973. General Insurance Corporation of India was set up as the controlling body with New
India, United India, National and Oriental as its subsidiaries. The process of opening up the
insurance sector was initiated against the background of Economic Reform process which
commenced from 1991. For this purpose Malhotra Committee was formed during this year who
submitted their report in 1994 and Insurance Regulatory Development Act (IRDA) was passed in
1999. Resultantly Indian Insurance was opened for private companies and Private Insurance
Company effectively started operations from 2001.

Insurance Market- Present:-

The insurance sector was opened up for private participation four years ago. For years now, the
private players are active in the liberalized environment. The insurance market have witnessed
dynamic changes which includes presence of a fairly large number of insurers both life and non-
life segment. Most of the private insurance companies have formed joint venture partnering well
recognized foreign players across the globe.

There are now 29 insurance companies operating in the Indian market 14 private life insurers,
nine private non-life insurers and six public sector companies. With many more joint ventures in
the offing, the insurance industry in India today stands at a crossroads as competition intensifies
and companies prepare survival strategies in a detariffed scenario.

There is pressure from both within the country and outside on the Government to increase the
foreign direct investment (FDI) limit from the current 26% to 49%, which would help JV
partners to bring in funds for expansion.

There are opportunities in the pensions sector where regulations are being framed. Less than 10
% of Indians above the age of 60 receive pensions. The IRDA has issued the first license for a
standalone health company in the country as many more players wait to enter. The health
insurance sector has tremendous growth potential, and as it matures and new players enter,
28

product innovation and enhancement will increase. The deepening of the health database over
time will also allow players to develop and price products for larger segments of society.

State Insurers Continue To Dominate There may be room for many more players in a large
underinsured market like India with a population of over one billion. But the reality is that the
intense competition in the last five years has made it difficult for new entrants to keep pace with
the leaders and thereby failing to make any impact in the market.

Also as the private sector controls over 26.18% of the life insurance market and over 26.53% of
the non-life market, the public sector companies still call the shots.

The countrys largest life insurer, Life Insurance Corporation of India (LIC), had a share of
74.82% in new business premium income in November 2005.

Similarly, the four public-sector non-life insurers New India Assurance, National Insurance,
Oriental Insurance and United India Insurance had a combined market share of 73.47% as of
October 2005. ICICI Prudential Life Insurance Company continues to lead the private sector
with a 7.26% market share in terms of fresh premium, whereas ICICI Lombard General
Insurance Company is the leader among the private non-life players with a 8.11% market share.
ICICI Lombard has focused on growing the market for general insurance products and increasing
penetration within existing customers through product innovation and distribution.

2.7.Introduction of the project

Insurance service is a intangible service which is mainly given by the insurance companies like
LIC, ICICI Lombard etc. in the sector of health insurance the main service provide them is the
medical claims by the companies. There are many other services provided by the any insurance
company like child vaccination plan, cashless benefit at the time of claims, etc.

Service.The condition or occupation of a servant or of any person who serves; work; the
act or mode of serving; providing service rather than manufacturing goods. In the area of
29

marketing service plays a very important role . service is a intangible, perishable, non
durable product. It can only feel at the time of delivering the product.

2.7.1UPS of study

The uniqueness of my project is stated below:-

Max Bupa is very new in the Kolkata market so its very interesting so find out the
difference between its services and services of another health insurance companies.
This company provides a very new range of services so its pretty interesting to analyze
those services.
This project analyzes the core services that a Business customer need from any health
insurance company.
The share for any private health insurance company is very low in the Kolkata sector so
its very interesting to find out the chances that Max Bupa have in Kolkata.
It analyze the core differences between max Bupa and Other health insurance company.
30

CHAPTER 3

3. OBJECTIVE

The main objectives of the current study are to


1. Compare the services of different health insurance companies and Max Bupa Health
Insurance services in Kolkata on employee group health insurance.
2. Find out the key service areas where Max Bupa can prosper and give a quality services to
corporate and prosper.
3. Know about the unique services provided by Max Bupa.
31

CHAPTER 4

4. RESEARCH METHODOLOGY

Research Approach:

The research includes meetings with the HR managers of different SME companies and
preparation of the questionnaire to be answered by above people for knowing their respective
point of view in the providing health insurance to their respective employees, and examine their
satisfactory level with existing health insurance company for their employee with comparison the
employer who use Max Bupa as their insurance provider.

Research Instrument:

Structured open and very few closed end questionnaire. In the questionnaire the HR managers
were directly asked to give the reply about satisfaction level with companies existing health
insurance provider.

Data Collection Methods:

Secondary Data: Books, Internet, Departmental Records.

Primary Data: Interview, Analysis of Departmental Records & Surveys, Direct interaction and
survey different contractors.

Target Sample Size for proposed Survey: 40.

Method of Survey:

Direct interview of the HR managers by personally visiting them and having face to face
communication and taking the respective feedbacks based on the questionnaire. Refusal rate is
Very high. Companies are moderately cooperative. Much information other than the
questionnaire set was also gained from these interviews which will be later related within the
project as per requirement.
32

Analysis:

Sampling : sampling is not so essential as only 100 surveys are done which is itself a
sample
Data Interpretation: Different statistical methods and graphical approach will be applied
to get to the final objective and conclusion based on the data collected through survey
and interview.
33

CHAPTER 5

DATA ANALYSIS

5. MAJOR DIFFERENCES OF DIFFERENT HEALTH INSURANCE


COMPANIES IN KOLKATA:-

5.1. THIRD PARTY ASSOCIATION ( TPA ) IN THE SERVICE OF MAX


BUPA AND OTRHER COMPANIES:-

TPA ANALYSIS

17%

MAX BUPA HEALTH


INSURANCE HAS NOT TPA
OTHER HEALTH
INSURANCE HAS TPA

83%

Here we can see that Max Bupa health insurance company give service to the 17% of
the total market without any TPA service. But other 83% market accrues by other
companies who have TPA as their service. Generally the clients of health insurance
companies want services without TPA service because this service delays the
emergency service and other claims. So this can be a area where Max Bupa can
prosper if they make a proper strategy to promote this unique fiture among the
prospectice clients. This is a key service area where is quality service can provides
sells can be increase
34

5.2. MAXBUPA AND OTHER COMPANIES RATING IN TERM OF


CASHLESS BANEFIT

TOTAL RATING FOR SERVICES


14
12
10
8
6
4
2

0 TOTAL RATING FOR SERVICES

Here we can see that the different corporate clients who use Max Bupa health
insurance services give highest rating but other companies who do not use Max Bupa
as their health insurance service provider give their service provider less rating . so
here one thing is clear that they very unsatisfied by their service . so this can be a
good opportunity for Max Bupa to increase their market share by accrue new
prospecting customer who is currently unhappy and unsatisfied by the opponent
health insurance companies of Max Bupa in the insurance market.
35

5.3. DIFFERNET COMPANY PROFILE IN TERMS OF CHILD BENEFIT

COMPANY PROFILE IN TERMS OF CHILD


BENEFIT

12%
MAX BUPA HEALTH
INSURANCE HAS CHILD
BANEFIT
OTHER HEALTH
INSURANCE HAS NOT
CHILD BANEFIT
88%

In this analysis we can see that the companies to whom Max Bupa give services only 12% of the
total market has the child benefit as the service but other companies never give the child benefit.
So this can be a good area where Max Bupa can prosper in the future. This is one of the unique
service that provided by Max Bupa Health Insurance company. This is one of the key service
areas where is quality service can be provided this company really prosper in the future.
36

5.4.FAMILY MEMBERS INSURED:-

NATIONAL ORIENTAL UNITED INDIA


INSURANCE, 1 INSURANCE, 1 INSURANCE, 2

ICICI
LOMBARAD, 3
MAX BUPA, 4

RELINCE INDIA BAJAJ


ALLIANZ, 2
INSURANCE, 1
LIC, 1 APOLLO

MUNICH, 1

In this analysis in the chart I give company name and beside that the numerical numbers are the
number of family member insured by each of the health insurance company. In this analysis we can
see that Max Bupa has the highest provision for family member insured. Here Max Bupa insure 4
person in a family( employee , spouse , children , parents ) with the employee but others companies
has the provision for family member insured some time only employee or some time spouse and
children . so if Max Bupa can emphasize in this service and this type of specialty of services to the
prospective customers them they can really prosper in this health insurance market. This is also a
unique service provided by Max Bupa as before this company none of the company try to cover 4
person (employee, spouse, children, parents) in a single insurance plan.
37

5.5. AGE LIMIT OF EMPLOYEES WHO COME UNDER THE HEALTH INSURANCE

120
100
80
AGE 60
40
20
0
Series1

COMPANY NAME

In this analysis we see that the different companies who use Max Bupa as their health insurance
provider age limit for their employees under health insurance get insurance coverage over 80
years of age but other health insurance companies has the age limit under 65 years or 65 years .
In India a employee can serve any company up to 65 years. So is Max Bupa gives a no age limits
health insurance then it has no use in the corporate sector. So this can be a limitation for them. So
if they analyze the current market situation and change this service then it can be helpful for then
in the future.
38

5.6. PERCENTAGE OF COMPANIES WHO WANT TO USE MAX BUPA AS THEIR


SERVICE PROVIDER:-

PERCENTAGE OF COMPANIES WHO WANT TO USE MAX BUPA


AS THEIR HEALTH INSURANCE PROVIDER
2% 2%
2%
10% LIC YES
12% 10% ICICI LOMBARD YES
UNITED INDIA INSURANCE NO
BAZAZ ALLIANZ NO
12% RELINCE INDIA YES
MAX BUPA YES
NATIONAL INSURANCVE YES
36% 12% MICROSEC YES
ORIENTAL YES

APPOLLO MUNICH YES


2%

In this analysis we can see that different companies who use other health insurance company
instead of Max Bupa health insurance are clearly interested. But only the companies(12%
companies of total market) who use Bajaj Alianz do not want to use Max Bupa as their health
insurance service provider. But other companies(88% of companies in the total market) want to
use Max Bupa as their service provider . this can be a big opportunity for Max Bupa to prosper in
the market .
39

CHAPTER 6

6. RECCOMENDATION AND SCOPE OF STUDY:-

1. The very first recommendation is that if Max Bupa Health Insurance Company try to
lower down the employee health insurance age coverage limit then it can be helpful to
them to prosper in another way. So here is the scope of future study that is they cut down
the age limit then how it can be helpful for them. And they can find in the future that this
age cut down how much help then for making bigger profit.
2. As this company is very much new to the Kolkata market they have to research that what
are the new type of interesting services they can provide to their customer. This can be a
scope of study for the future.
3. In the Kolkata market there are very few companies are there who actually know the
name of the Max Bupa because lack of promotional strategies. So my third
recommendation will be that if Max Bupa make various promotional activity then it will
be good for them. So here is the another scope of study that how can they make and creat
an effective promotional strategies for them to sustain in the market.
4. At the time of research I find out that this company dont have a sound customer care
base in Kolkata . their every customer care base is in Delhi . so if they make a new
customer care base in Kolkata then it can be very help ful for them to give a smooth and
fast service.
5. Max Bupa health insurance company has only one office in the Kolkata as their eastern
zonal office by this they miss out different potential customer outside the West Bengal .
so my recommendation will be if they try to establish a new office out side WB but in
side of the Eastern zone then it can be helpful for them to take new prospecting customer.
This can be a scope of study for the future that if they establish a new office then which
area they would choose basis on different element.
40

CHAPTER 7

7. LIMITATION OF STUDY:-

1. A Max Bupa health insurance company is not so familiar name in the health insurance
market so whenever I tried to take an appointment from the HR manager or respective
person who handles health insurance for their employee denied filling up the
questionnaire for research.
2. As this for this research project I had to make the cold calls so there always a high
percentage of denial is there. This makes a limitation of my project.
3. As the sample size of this project is small so there always a high error is preset in getting
right answers.
4. As this research project is based on the small and medium enterprises, many of these
enterprises do not has any provision for health insurance for their employees. This makes
a limitation for my project.
41

CHAPTER 8

8.1 CONCLUSION:-

1. From the above study we see that there are few area where Max Bupa can prosper is that
child benefit area, cash less benefit and total person coverage in one single insurance etc.
but there are some other cause of worry like the age limit for employee which is
unnecessary very high.
2. Max Bupa is very new in the business but they give some of the unique services to their
customer like child benefit, and persons covered in one single coverage so if they
introduce some of this feature in near future then they can really prosper in the insurance
market.
3. There are some limitation in this insurance plan like Max Bupa has only capability to
cover a client who has less than 1000 employee, so if they want to prosper in the market
they must take the bigger clients if this market.
4. From my findings I can say that if Max Bupa try to find out what type of future services
they can provide then there is a scope of future study that in which of the area they can
increase their services and what will be the area where service is not so important.
42

CHAPTER 9

9. BIBLIOGRAPHY

9.1. http://wikipedia.org

9.2. www.maxbupa.in/Health-Insurance
43

CHAPTER 10

10. ANNEXURE

10.1. QUESTIONNAIR
NAME:-

ORGANIZATION:-

PHO. NO./ MOB. NO.:-

E- MAIL:-

A. Who is your current service provider?

Ans:- _____________________________________________________________

B. Is TPA there in service? ( please put a tick in correct answer)

Ans: - (a) Yes (b) No

C. Is cashless benefit there in employee health insurance? ( please put a tick in correct
answer)

Ans: - (a) yes (b) No

D. Is child vaccination there in service? ( please put a tick in correct answer)

Ans: - (a) yes (b) No

E. How many family members is presently insured with employee?

Ans: - (a) Only Employee (b) Employee, spouse, children.


44

(c)Employee, spouse, children, parents of employee

F. How will you like to rate your current health insurance service provider in terms of claim
settlement?

Ans:- (a)1 (b) 2 (c)3 (d) 4 (e) 5

G. Age limit for employee health insurance :-

Ans:- (a) <75 years (b) < 70years (c) 70 years (d) 75 years (e) no age limit.

H. Any specific cause of worry :-

Ans: - (a) Claims are not getting on time.

(b) Cash less benefit not approved.

(c) No response from current health insurance company.

(d) Conflict between TPA and company at the time of claims.

(e) Pre authorization approval not come in time .

(e) Any other specific reason:- _________________________________________

I. When is your renewal date?

Ans:-

J. Would like take a view from Max Bupa before renewal of current years policy?

(a) Yes (b) No

Name:-

Signature:-

Date:-
45