Summer Internship Project Report

On

The strategies to Improve the Conversion Ratio of Prospective

Retail Investors at Karvy Stock Broking Ltd

Submitted towards the partial fulfillment of the requirement for the

award of the degree of

Post Graduate Diploma in Management

Submitted To- Submitted By-

Dr. Anand Kumar Rai Vikrant
Associate Professor kaushik
Finance
GM18264
(2018-20)

GL BAJAJ INSTITUTE OF MANAGEMENT AND RESEARCH

GREATER NOIDA

2019

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 ACKNOWLEDGEMENT

It is my proud privilege to release the feelings of my gratitude to several persons who

helped me directly or indirectly to conduct this project work. I express my heart full in

debt and owe a deep sense of gratitude to my Industry Mentor Sir Shiv Kumar biradar

(Manager) for their sincere guidance and inspiration in completing this project.

I am extremely thankful to my Director General Dr. Urvashi Makker ,faculty members

and Dr Arvind Bhatt CRC head of the GLBIMR for their coordination and cooperation

and thankful to Mrs Daitri Chatterjee for his kind guidance and encouragement.

I am also extremely thankful to all those persons who have positively helped me and

Karvy stock broking Ltd. employees who responded my questionnaire, around whom the

whole project cycle revolves.

Thanking you

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 GL BAJAJ INSTITUTE OF MANAGEMENT AND RESEARCH

GREATER NOIDA

Faculty Guide Certificate

This is to certify that the work embodied in this summer training report entitled “Factors
affecting customers interest towards Health Insurance Policies in India” being submitted
by VIKRANT KAUSHIK towards the partial fulfillment of the requirement for the
award of “Post Graduate Diploma in Management” during 2018-20 is a record of
original piece of work, carried out by her under my supervision and guidance in GL Bajaj
Institute of Management and Research, Greater Noida (U.P).

Faculty Guide

Mrs Daitri Chatterjee

Associate Professor

GL Bajaj Institute of Management and Research, Greater Noida (U.P)

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 ABSTRACT
This descriptive research is conducted in order to find out various objectives of the
research study, i.e to assess the individual awareness about coverages and benefits of
Health Insurance Policies, to understand the buying pattern of Mediclaim policies, to
assess the effectiveness of services of insurance companies and broking companies, to
examine the customer satisfaction and perception towards policies and insurance claims.
This study contributes a clear view through the symbolic interaction theory and several
past relevant empirical studies. The findings of the research is that the major source of
meeting the requirements of funds for medical bills and expenses are the own savings of
the person but not the health insurance. SPA is a customer-centric which offers a
comprehensive range of insurance products / services like risk mapping & evaluation,
risk control, risk transfer, insurance broking and claim handling to our customers as per
their requirements. SPA is a broker who earns brokerage by providing services to final
consumers/ insurers like individuals, corporates, and high-net-worthindividuals.

TABLE OF CONTENTS
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S.NO TOPICS PAGE NO.

1. CHAPTER – I

1.1 Introduction of Health Insurance 8-9

1.2 Background of Health Insurance 10-12

1.3 Features & Benefits of Health Insurance 13-14

1.4 Types of Health Insurance Policies 14-19

1.5 Importance of Buying Health Insurance 20

2. CHAPTER – II
2.1 Profile of SPA 21

2.2 Vision of SPA 21

2.3 Milestones of SPA 22

2.4 SPA Group of Companies 22

2.5 Company Profile 23

2.6 Why SPA ? 24

3. CHAPTER - III

3.1 LiteratureReview 25-31

4. CHAPTER - IV
4.1 Overview of Research Objectives 32

4.2 Research Objectives 32

4.3 Hypothesis of the study 32

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5. CHAPTER - V
5.1 Research Design 33

5.2 Research Methodology 34-36

6. CHAPTER - VI
6.1 Data Analysis & Interpretation- Introduction 37

6.2 Demographic Profile of the Respondents 37-40

6.3 Medical expenses & sources of meeting expenses 41-42

6.4 Consumer buying pattern of Mediclaim policy 43-52

6.5 Attitude towards Settlement of Insurance Claims 53-58

6.6 Interpretation throughSPSS 59-63

7. CHAPTER - VII
7.1 Conclusion 64

7.2 Findings from the study 65

7.3 Limitations of the study 66

7.4 Scope of future research 67

8. CHAPTER - VIII

8.1 Suggestions & Recommendations 68

9. APPENDIX

9.1 References 69

9.2 Bibliography 69

9.3 Questionnaire 70-72

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 LIST OF TABLES

S.NO TITLE PAGE NO.

1. Socio-economic indicators 11

2. Achievements (1951-2000) 11

3. Company Profile 23

4. Interpretation through SPSS 59-63

LIST OF FIGURES

S.NO TITLE PAGE NO.

1. Demographic Profile of the Respondents 37-40

2. Medical expenses & sources of meeting expenses 41-42

3. Consumer buying pattern of Mediclaim policy 43-52

4. Attitude towards Settlement of Insurance Claims 53-58

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 why you should buy an insurance plan are:

 Buying a comprehensive health insurance plan is very important because your employer
cover might not be sufficient. Most of us think that the insurance policy provided by our
employer is sufficient and an additional plan will not be required but that may not be the
case. Most employers in India offer basic health insurance plan to their employees which
are not tailor made to suit your needs. For example, a basic health insurance plan will not
cover criticalillnesses.
 Also, you should buy a health insurance plan as it covers more than just your
hospitalisation expenses. Most of the insurance plans that are available in our country
cover day care procedure, OPD charges, consultations, and other such expenses. Even if
you are not terminally ill or hospitalised, you can make use of your insurance plan for
your regular doctorvisits.
 A health insurance becomes essential as day by day the cost of medical treatments in
India is increasing. An individual's savings will not be sufficient when an illnessstrikes.
 If you are looking for ways to reduce the tax you pay to the government every financial
year, buying a health insurance plan will help you to do that. Most health insurance plans
in India comes with taxbenefits.
 The number of illnesses that a human being can get in contact with is increasing day by
day.
 Post-hospitalisation expenses like consultation fees, tests, and doctor visits have
increasedtoo.
 One of the very important benefits of having a health insurance plan is the cashlessbenefit
offered by the insurer. Without a health insurance plan, a person will be forced to pay the
hospital bills from his/her own pocket. Whereas, when you have a health insurance plan,
you can walk into a network hospital, avail the treatment, and the insurer will settle the
bill directly with thehospital.
 A comprehensive health insurance plan also covers your spouse, children, and any other
dependents likeparents.

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 CHAPTER – II

2.1 PROFILE OFSPA

SPA Group was promoted by a team of finance professionals in 1995 with an objective
to provide value added financial services. Initially, the Group focused as a niche financial
solutions provider in corporate finance and wealth management to Indian companies and
high net worth individuals. In January 2000, the Group expanded its operations and the
range of services. Today, SPA provides services for securities broking, merchant
banking, wealth management, financial advisory, corporate finance, risk management and
insurancebroking.
SPA is being managed by its promoters along with a young and dynamic team of over
500+ professionals with rich experience, in their respective fields. The Group has
established itself as one of India’s leading financial advisory house, offering various
financial solutions to its Institutional, corporate and individual clients.
Customer centric approach of SPA’s dedicated professional team has helped carve a
niche for itself in financial services arena and won confidence of its clients. Clients of
SPAarefromawidespectrumandcompriseofBanksandotherfinancialinstitutions,
Mutual funds, Insurance companies, foreign institutional investors, public sector
undertakings and government departments, private corporates, trusts and individuals.

2.2 VISION OFSPA

SPA believes in attaining customer satisfaction, on continuing basis, by providing highest

standard of financial services in India. The philosophy at SPA is to provide services to
clients after assessment of their profile, needs and risk-appetite. The basic work theme at
SPA is:
 Dedicated, competent and honest team of professionals
 Customer centric work environment
 Insight of customers’perspectives
 Strong researchbase
 Clear understanding of applicablelaws
 Consistency and passion toexcel
 Technologysavvy.

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 2.3 MILESTONES OFSPA
Since 1994, with the coming into existence of the SPA Group, we have diversified into
acomplete financial solution providing house, catering varied needs of our clients
rangingfrom investment advisory services to investment banking, corporate re-
structuring,distribution and broking services, risk management and insurance advisory.
Within ashort span of time, the Group has made a place for itself in the midst of the top
financialsolutions provider in thecountry.

2.4 SPA GROUP OFCOMPANIES

SPA Group of companies is the flagship Company of the Group and is engaged in
providing Wealth Management and Financial Advisory services to institutions, corporate,
and individuals since 1995. The Company is a leading distributor of Mutual Funds in the
country and presently has assets around 12000 crores under its management. The
Company has successfully positioned itself as a strategic advisor to its customers for
wealth management with its customer centric approach and innovative solutions.

The Company is registered with Reserve Bank of India as a Non Banking Financial
Company. Presently the shares of the Company are listed on the Delhi Stock Exchange.

There are 5 Group of companies in SPA:-

1. SPA Capital ServicesLtd.

2. SPA Securities Ltd.

3. SPA Insurance Broking Services Ltd.

4. SPA Com Trade Ltd.

5. SPA Capital AdvisorsLtd.

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 2.5 COMPANYPROFILE

Company Name SPA Insurance Broking Services Ltd.

Founded in 1995

Promoters Mr. Sandeep Parwal

(B.Com Hons, FCA)

Principal Officer Mr. V K Khattar (G.I)

Senior Vice President Mr. M M Lohia (G.I)

Head Office Janakpuri, New Delhi

Website www.spacapital.com

SPA Sandeep Parwal Associates

Head Office 25, C-Block Community Centre, Janak Puri

New Delhi - 110058

TABLE 3

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 2.6 WHYSPA?

 Experience & Clientele: SPA prides itself on its professional experience and expertise in
the field of corporate valuations. SPA has done more than 2000 valuations across
industries. The clientele consist of domestic and multinational companies including
various Fortune 500companies.

 Team: Quality valuations are performed by experienced, capable appraisers. The team
consists of Chartered Accountants, CFAs, Company Secretaries and ICAI Certified
Valuationexperts.

 Quality output: As a result of clear understanding of applicable laws and passion to

excel and deliver, the valuation passes two tests. First, it reaches an accurate value
conclusion. Second, it clearly and convincingly establishes how the conclusion was
reached. SPA valuation can be successfully defended and supported under critical
scrutiny.

 Touch of advisory: We understand that, clients require more than just the report. SPA is
more than willing to provide advisory and support before and after the rendering of
services.

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 CHAPTER- III

3.1 LITERATURE REVIEW

A literature review is an account of what has been published on a topic by accredited
scholars and researchers. The research dimension of the related literature and the relevant
information begins from an explanatory perspective, approaching towards specific studies
which do relate to judge the limitations and informational gaps in data from the
secondary sources.This analysis may reveal conclusions from past studies to realize the
reliability of the secondary source and their credibility. This in turn enables one to rely on
a comprehensive review for thestudy.

Health insurance or medical expense insurance schemes have been in existence for a
number of years prior to nationalization of insurance business. These policies were
granted on a group basis, only to large corporate clients purely on an accommodation
basis as claim experience was unsatisfactory. There was no scheme for individual and
families.
In 1981, a limited cover was devised for individuals and families. This was replaced by a
Mediclaim Policy in 1986 under a market agreement. The scheme was modified in 1996
in the light of experience and suggestions from the insuring public and the medical
fraternity. This scheme is available both on an individual and group basis.
A number of studies both conceptual and empirical have been conducted regarding
various aspect of health insurance in India and abroad. The review of these studies has
been done to explore the concept, framework and state of health insurance.

Hence for the purpose of present study, the review of literature has been divided broadly
in four sections.

 Section I deals with the review of studies in relation to performanceevaluation.

 Section II covers the review of studies in relation to Community Health insurance
(CHI).
 Section III includes the review of studies in relation to Third Party
Administrators(TPAs).
 Section IV covers the review of studies in relation to customersPerception.

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Section I: Review of Studies in Relation to Performance Evaluation

Houston and Simon (1970) conducted a cross sectional study of relation between the
average costs and premium receipts of general insurance companies, as a means of
investigating economies of scale. Further, average cost functions for the general
insurance industry, all of which show increasing and then constant returns, are estimated
from cross section data for 237 companies of U.S. The special problems of measuring
output, controlling for product mix, and accounting for the effect of rate of growth in
output are
examined and dealt with. The study concluded that average costs are constant beyond
$100 million of premiums.

Praetz (1980) examined the average cost relationship between health insurers and each
of ten main insurer characteristics. The data used was mainly drawn from 90 insurers.The
study revealed that the following independent variables were significant in producing
economies of scale in general insurance business: premium income; new business ratio;
proportion of whole life business; and size of insurer (i.e., giant mutualinsurers).

Doherty (1981) analyzed the conceptual and econometric problems arising from the use
of premium income as a proxy for output, while making estimation of various
efficiencies. The study suggested that output measure is not independent of the firm's
pricing policy and its use implies potentially serious problems of simultaneous equation
bias and errors in variables. Moreover, the study concluded that a delivery-based output
measure is theoretically more superior and will encounter less severe econometric
problems.

Fukuyama (1997) investigated the productive efficiency and productive changes of

Japanese general insurance companies with primarily focus upon the ownership structure
and economic conditions. The results of the study revealed that mutual and stock
companies possess identical technologies, but the productive efficiency and productive
performance changes from time to time across the stock and mutual under different
economicconditions.

Brockett et al. (1998) examined the efficiency effects of different forms of ownership
(stock versus mutual) and types of marketing system (agency versus direct) for the
property-liability insurance industry of US. Data envelopment analysis (DEA) results are
obtained from the recently developed RAM (Range Adjusted Measure) model and then
extended for comparison with studies by others. Using agency theory (and like
approaches) the study assumed that the operations all occur only on the efficient frontier.
The need for that assumption is obviated by using operations provided by DEA to project
all observations on their efficient frontiers. A use of (non-parametric) rank-order statistics
then produced and provided with results which differ from these other studies. Therefore
the results provided that application of different measures provided with the different
estimate ofefficiency.

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Ansah et al. (2010) evaluated the performance or efficiency of Ghanaian general
insurance companies from the year 2002 to 2007 and also tested the hypotheses relating
to the roles played by dimension and market share in the efficiency of the Ghanaian
general insurance companies. The study provided with the result that Ghanaian general
insurers operated at an average overall efficiency of 68%, technical efficiency of 87%
and scale efficiency of 78%. Besides this, result also provided with the fact that Ghanaian
general insurers with higher dimension and market shares tend to have higher
efficiencies; implying that general insurers could increase their efficiencies by trying to
increase among other things their dimension and marketshares.

Section II: Review of Studies in Relation to Community Health Insurance (CHI)

Rama and Baru (1994) examined the structure of health care in provision existed public;
private; and voluntary sectors and utilization patterns for both inpatient and outpatients
care across states. For this data obtain from the World Bank’s Country Report on India,
“India: health sector financing-coping with adjustment; opportunities for reforms” and
World Development Report 1993. The study showed the presence of much variation in
the availability of non-government health services across states. In most of the states,
public sector was the main source of provider of curative services and private and
voluntary sector marked by uneven spread and regional variations. However, therewere
some states in which private and voluntary sector was achieving the significant growth
and supplementing the public services. However, the suggested that the privateand
voluntary sector should move only into those areas, where they can show better results
and get profit. Moreover, majority of socio economic groups depend on public
provisions. Therefore the cut back of public services will results in disparities of access
between rural-urban, advanced-backward areas and acrossclasses.

Sodani P.R (2001) investigated the community’s preference on the various aspect of
health insurance.The study revealed a low level of awareness about health insurance.
Quality of care and cost are two important factors affecting the community’s decision to
subscribe any new health insurance plan. An integrated provider and insurer system is
preferred as compared to public or private-based management. Hospitalization and
Maternity services are preferred among the given choices for benefits to be included
under the plan. The study also suggested that there is high level of willingness to join a
health insurance plan in future, if designed carefully for the informal sector i.e. an
innovative and feasible health insurance scheme at low cost for providing quality services
to the informal sector of thecommunity.

Ahuja (2004) examined the more suited arrangement for providing health insurance to
poor people in India and also explored how the reforms in insurance sector alter health
insurance prospects facing the poor in developing countries and what changes have
happened or likely to happen as a result of insurance sector reforms. In developing
countries, community based arrangement is more suited for providing health insuranceto

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low income people. Insurance sector reforms lead to development of private health
insurance, at the same time reforms can affect the low income people through its effect
on the provision and financing of health care services. The study concluded in India,
CBHI will play an important role, but there is need to be encouraged by government’s
interventions in order to guide and direct health insurance market, so as to minimize the
cost escalation of health careprovision.

Bennett (2004) conducted a study with a view to set out preliminary conceptual
framework for examining interaction between Community-Based Health Insurance
(CBHI) schemes and other aspects of health care financing system. In order to explore
implication of interaction, this paper;
 set out a series of conceptual maps that illustrate how CBHI schemes may relate
to the broader health care financingsystem.
 Uses the maps to explore how CBHI schemes may (or may not) contribute to
national policy objectives, and how different feature of CBHI schemes and
government policy may interact to affect achievement of policyobjectives.
The utility of broader approach to analyze CBHI schemes is illustrated through
examination of two policy issues, namely
 coordination of CBHI risk pools and government risk pools,and
 equity implications of CBHI schemes and the role of government
subsidies in such schemes. The study concluded that there is a strong need
for empirical work to explore how CBHI schemes and broader health care
financing system interact, and that even if individual schemes achieve
their own objectives (in terms of equity, efficiency etc), this does not
necessarily imply that such objectives will be achieved at the systemlevel.

Section III: Review of Studies in Relation to Third Party Administrators (TPAs)

Mahal (2002) analyzed whether the regulatory steps in the IRDA bill will influence the
progress towards achieving health policy goals of India or not; and also described the
regulatory structure currently existing in India in relation to health care provisions,
private health insurance and its ability to promote national health policy goals. The study
concluded that private health insurance is likely to have an impact on equity in the
financing of health care, cost and quality of health care. The private health insurance may
turn out to be more inequitable than social insurance of comparable coverage. However
an informed and well defined, regulated and implemented insurance regime will
ameliorate the bad outcomes of private health insurance. Not only the insurance
regulations, but the regulation relating to benefit packages, restriction on risk selection
and consumer’s protection would be equally useful. At the same time there is need for
improved enforcement of regulatory regimes and better coordination between the IRDA
and other Regulatory Bodies. New legislation may also be required in improving
standards in health careprovision.

Parekh (2003) examined the training aspects of the Third Party Administrators (TPAs)
and concluded that there is a dearth of knowledge and training in the TPA community

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and training for the leadership team alone is inadequate. The lack of training at most
insurance companies is also woefully insufficient and alarming. So the study suggested
that IRDA should arrange for adequate training facilities for TPAs which will enhance
their knowledge and the ultimate benefit will be reap by the community.

Sureka (2003) conducted a study on the TPAs and its regulator and concluded that TPAs
are forced to provide service to the policyholder for an obsolete product – the Mediclaim
policy which was introduced at least almost two decades ago. Beside this, if the
policyholder is made to pay for the services he is availing, then why is the insurer
imposing a TPA on the policyholder? The policyholder should have the right to accept or
refuse the services of a TPA for such absolute products.

Gupta, Roy and Trivedi (2004) examined the role of TPAs and the issues that required
to be taken into consideration while evaluating their usefulness and functioning in India.
The study based on a series of meetings, discussions and interviews with various TPAs,
insurance companies and providers. No doubt, the TPAs face different barriers in terms
of capital, capacity and connections but still they are providing cashless transaction at the
time of service delivery to the customers. The IRDA and Health Ministry should come
together so as to ensure TPAs which in turn will ensure active role of the TPAs in
Community and Universal Health Insurance Schemes. Moreover, the study concluded
that TPAs can play an important role in making insured health care availability smoother,
but neither can it be seen as a panacea for all the problems, nor it can be blamed for these
problems of health sector. The TPAs system should be regulated and checked in order to
take care off consumers’interest.

Bhat and Babu (2004) discussed the role, importance, functioning of TPAs in health
insurance market; analyzed the existing TPA system; IRDA regulation on TPAs and its
implications; examined the issues and challenges TPAs face in an unregulated health
sector; and analyzed the prospects of intermediaries in insurance sector. The study
concluded that introduction of IRDA has paved the way for (TPAs) Third Party
Administrators who are playing the role of insurance intermediaries in setting up of
managed health care systems. The objective behind setting up of TPAs was to ensure
better services to policy holders and to mitigate the negative consequences of private
health insurance. However the TPAs face immense challenges in the health sector
because of demand and supply side complexities of private health insurance and health
care market. IRDA has defined the role of TPAs as insurance intermediary in the
management of claims and reimbursement, but at the same time their role is not well
defined in controlling the cost of health care and ensuring appropriate quality ofcare.

Bhat, Maheshwari and Saha (2005) ascertained the experiences and challenges faced
by hospitals and policyholders in availing the services of TPA in Ahmadabad, Gujarat.
For this 110 hospitals and policyholders were selected by random sampling method, out
of which 72 hospitals and 85 policyholders were found suitable for analysis. The study
shown that only a small percentages of respondents have knowledge about existence of
TPA, there was substantial delay in settlement of claims between TPAs and health care
providers, administrators of hospital perceive burden in terms of efforts and expenditure
aftertheintroductionofTPA.Thestudyconcludedtherewasnomechanismtoappraise

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the performance of TPAs and regulatory body need to focus attention on developing
mechanism, in order to strengthen the TPAs so as to ensure smooth delivery of TPAs
services in the emerging health insurance market.

Jaswal (2010) examined the cashless hospitalization which was evolved during the last
decade, as an integral part of health insurance claim offering, making claim under health
insurance policy indeed a customer friendly process. The practice to pay claims through
physical cheques is quite outdated and inefficient; it would benefit all, if newer methods
of payment like electronic fund transfer were to be implemented. Indian medical industry
being unregulated, there are no standard treatment guidelines or uniform Medical
protocols which are followed by medical professionals all over the country, in all
hospitals.

Section IV: Review of Studies in Relation to Customers’ Perception

Purohit and Siddiqui (1994) examined the utilization of health services in India by
making the comparison of Indian states in terms of low, medium and high household
expenditure on the health care, public and private facilities across the state. For this, data
obtained from NSSO 1992 (extends over 8346 villages in rural areas and 4568 blocks in
urban areas) and NCAER1992 (extends over 1061 villages in rural areas and 1873 blocks
in urban areas). The study concluded that there is growing popularity of indigenous non
allopathic system, increasing involvement of private sector in expensive tertiary care,
existence of regional disparities in health service utilization among different expenditure
groups of states and these disparities in urban and rural areas tends to continue.
Moreover, there is no serious government initiative to encourage utilization of health
services by means of devising health insurance and other cost recovery mechanism.
Therefore, the study suggested the dire need to consider carefully in to some of aspects
most important of which is that policy guideline should be implemented in a satisfactory
manner.

Sodani P.R (2001) investigated the community’s preference on the various aspect of
health insurance. For this data has been collected from a sample of 300 households of
Jaipur, Rajasthan. The study provided with the fact that low level of awareness exist
about health insurance. Beside this, quality of care and cost are two important factors
affecting the community’s decision to subscribe any new health insurance plan. An
integrated provider and insurer system is much preferred as compared to public or
private-based management. Alternatively, hospitalization and maternity services are
preferred among the given choices for benefits to be included under the plan. The study
concluded that there is high level of willingness to join a health insurance plan in future,
if designed carefully for the informal sector i.e. an innovative and feasible health
insurance scheme at low cost for providing quality services to the informal sector of the
community.

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Fronstin (2002) examined the state of employment based health benefits among workers
in U.S and how it has changed since 1993. For this purpose, the data was obtained from
Current Population Survey (CPS) and workers were asked questions about health benefits
in the work place. The study findings provided that the percentage of workers offered
health benefits has been rising, percentage of workers with health benefits through their
own employer has also increased, but the fewer workers were taking health benefits when
they were offered because they were getting health insurance through other sources. This
expansion in employer coverage (health benefits) began in Mid-1990 and continued into
early 2001.

Gupta (2002) conducted a study in Delhi, which is different from other because it has
looked at a kind of formal insurance that is likely to come to India with privatization. The
main objective was to analyze whether individuals and households would be willing to
participate in private health insurance schemes. For this purpose, a survey of 504
households of Delhi was conducted.
The study showed high level of willingness to participate in insurance programme was
mainly from low income individuals because the middle and high income households
have already some form of insurance. The biggest deterrent would be prior coverage and
most of the households willing to opt for standalone health insurance schemes. The study
concluded that majority of population is either uninsured or underinsured and the
introduction of private health insurance would definitely be a welcome change, if it could
bring the uninsured and underinsured under its fold.

Matthies and Cahill (2004) observed how India can break barriers to expand health
insurance, as several developed and developing nation have already done. It state health
insurance involving a mix of health insurance company management and risk taking,
state government, industrial contributions and local NGOs administration, would
gradually encompasses most of the rural poor. The study shown a level playing field with
adequate consumer protection created through the legal regulatory framework is
necessary, but not sufficient to promote the development of health insurance market.
Alternatively, health insurance claim tends to be more frequent, smoother and
predictable, so that the insurance companies could reflect this. Moreover, the absences of
a substantial and accurate data base addressing morbidity, mortality, beneficiary and
claim related information is especially handicapping the development of health insurance.
But the India can develop and expand its health insurance market through the right
policies and stringent regulations and this would bring quality care for teeming millions
of people at a reasonable cost.

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 CHAPTER- IV

4. RESEARCH OBJECTIVES

4.1 A BRIEFOVERVIEW
This chapter basically describes the objectives of study. It also focuses on how study has
been conducted, the research design used for the study, methods of selecting and
approaching the samples, sources used for the collection of data. It also describes
hypothesis used to identify the relationship between variables and tests applied with the
help of statistical tools. Four research objectives were identified from the research gap
obtained from literature review. They are asfollows:

4.2 OBJECTIVES OF THESTUDY

 To assess the individual awareness about coverages, types & benefits of Health
Insurancepolicies.
 To evaluate the buying pattern of Health Insurancepolicies.
 To access the effectiveness of services of insurance companies and broking
companies for Healthcover.
 To examine the customer satisfaction and perception towards policies and
insurance claims.
 To know about the preference of individual regarding HealthInsurance.

4.3 HYPOTHESIS OF THESTUDY

1. H0- There is no association between gender of the individual and owning of
Health Insurance Policy.
2. H0- There is no association between age of the individual and owning of Health
InsurancePolicy.
3. H1- There is an association between annual income of the individual and owning
of Health InsurancePolicy.
4. H0- There is no association between monthly medical expenses of family and
owning of Health InsurancePolicy.

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 CHAPTER - V

5. RESEARCHMETHODOLOGY
5.1 RESEARCHDESIGN

This chapter describes a research design as ―a plan that describes how, when and where
data are to be collected and analyzed. It basically shows how study will be conducted to
fulfill the defined objectives.

There are major two ways in which research design is identified, Exploratory Research
and Descriptive Research.

Exploratory research is useful when researcher doesn‘t have enough idea about how to
proceed with the research problem. If any formal research methods or protocol are not
employed in particular area then researcher may use Exploratory Research Design.

Descriptive Research helps to identify characteristics of groups or individuals. The

major purpose of descriptive research is description of the state of affairs as it exists at
present. Descriptive research is gathering of information about prevailing conditions or
situations for the purpose of description and interpretation. This type of research method
is not simply amasing and tabulating facts but includes proper analyses, interpretation,
comparisons, identification of trends andrelationships.

A good and well-planned research design consists of the following components, or tasks:

 Identification of specific information needed based problem in hand and the

selecteddesign.
 Selection of appropriate type of design: Exploratory, descriptive and/or causal
design.
 Specification of measurement and scaling procedures for measuring the selected
information.
 Mode of collection of information and specification of appropriate form for data
collection.
 Designing of appropriate sampling process and samplesize
 Specification of appropriate data analysismethod.

Research Design Selected

For purpose of fulfilling the objectives defined earlier Descriptive Research Design was
most suitable. Hence it has been adopted for conducting study.

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5.2 RESEARCHMETHODOLOGY

Research methodology of the project is the way and the methods in which project is
conducted. The methodology broadly consists of primary survey and secondary survey
for collection of relevant information. It involves identification of necessary steps in two
phase of primary & secondarysurvey.

SAMPLE DESIGN

A sample design is the roadmap or framework which serves as the basis for selecting
sample for survey. It will include Sampling Unit, Sampling Technique and Sample Size.

5.2.1 SAMPLINGUNIT

Main objective of the research is to assess the individual awareness about the health
insurance coverages and benefits, to evaluate the buying pattern and examine the
customer satisfaction regarding insurance claims. Sampling unit of the research is
different age group people with the age bracket of 18-30, 31-40, 41-50, 51-60and income
and occupation of therespondent.

5.2.2 SAMPLINGTECHNIQUES

Sampling technique can be broadly classified in two parts as Non Probability and
Probability Sampling.

Non Probability technique of selecting sample has been used for the study. Samples
were divided in quota according to their demographics variables: Age Group, Income
level, occupations. Hence, Quota sampling technique has been used under non
probabilitymethod.

5.2.3 SAMPLESIZE

Sample size determination in empirical research is very important. Sample size should be
carefully selected so inference for entire population can be done from it. Aim of the study
is to find the awareness of health insurance benefits and coverages and examine the
customer satisfaction of health insurance claims of the respondents in New Delhi & Delhi
NCR. Therefore, for the purpose of study, samples were selected from New Delhi &
Delhi NCR region: Delhi, New Delhi, Noida, Greater Noida, Lucknow etc. So Sample
size for the present study is 100 individuals.

The sample population consists of salaried employee, professionals, businessmen and

others. This sample population comes under the age group of minimum 18 years and
maximum 60 years.

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5.2.4 DATASOURCES

There are generally two ways from where data can be generated and they are as follows:-

Primary Data: Primary data are information collected by a researcher specifically for a
research assignment. In other words, primary data are information that a company must
gather because no one has compiled and published the information in a forum accessible
to the public

Secondary Data: Secondary data is a type of data that has already been published in
books, newspapers, magazines, journals, online portals etc. There is an abundance of
data available in these sources about your research area in business studies, almost
regardless of the nature of the researcharea.

This study specifically consists of both the sources of Data Collection.

5.2.5 DATA COLLECTIONINSTRUMENTS

For the purpose of Primary Data collection, survey technique has been adopted, in which
close ended questions are asked with the help of structured questionnaire. In this study,
data were collected from 100 individuals of Lucknow, New Delhi & Delhi NCR by using
Survey Method. Any salaried employee, Businessman, and Professional can be a
sampling unit for the survey.

Planning was done to select employees from diversified industries, so that the result may
not get skewed. For the purpose of collecting data, employees of different Organization
were contacted with convenience sampling and with referrals methods.

The instrument which used for collecting responses from respondent is Structured
Questionnaire.

A questionnaire is a written list of questions, the answers to which are recorded by

respondents. The respondents read the questions from the questionnaire interpret what is
expected and then write down the answers.

Questionnaire may have questions which are classified as Open ended and Close ended
questions.

An open ended question gives respondents ‘liberty to think and narrate answers in their
own language of understanding. It may get difficult to code and analyze the response
given in open ended questionnaire. Closed ended questions, because they provide ready-
made categories within which respondents reply to the questions asked by researcher,
help to ensure that the information needed by the researcher iscollected.

In this study, close ended questions were used to record the responses from the
respondents. Data collected through closed ended questions include Nominal Data,
Categorical Data and data on multiple choice grids.

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5.2.6 TOOLS & TECHNIQUES FOR ANALYSIS OFDATA

The tools and techniques which will be use for the analysis of data MS Excel and SPSS.

Microsoft – Excel has been used for data entry stage. Later that data was exported to
SPSS. Microsoft Excel was also used to find some descriptive analysis.

SPSS 20 has been used to perform various tests like Chi- Square, Mann Whitney U Test,
Krushkal Wallis Test, Factor Analysis, correlation, regression, T-Test, One way
ANOVA.

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 CHAPTER - VI

6. DATA ANALYSIS &INTERPRETATION

6.1 INTRODUCTION

This Chapter deals with the Descriptive and inferential statistical analysis of data
collected from the respondents of Lucknow, New Delhi & Delhi NCR.

Analysis of the data has been divided in four major sections:

Section I- Demographic profile of the respondents

Section II- Medical expenses & sources of meeting expenses

Section III- Consumer Buying pattern of Mediclaim Policy

Section IV- Attitude towards Settlement of Insurance Claims

6.2 DEMOGRAPHIC PROFILE OF THERESPONDENTS

6.2.1 AGEGROUP

Age Group No. of Respondents

18-30 84
31-40 13
41-50 2
51-60 1

AGEGROUP
2% 1%

13% 18-30

31-40

41-50

84%
50-60

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INTERPRETATION :-

This above mentioned table and figure shows the age of the respondents. Age of the
respondents are classified as: 18-30, 31-40, 41-50, and 51-60. Where, 84 respondents are
belong to age group of 18-30, 13 respondents are of 31-40 age group, 2 respondents are
belong to 41-50, 1 respondent belong to 51-60 years of age.

6.2.2 GENDER

Gender No. of Respondents

Male 61
Female 39

GENDER

39%

MALE

61%
FEMALE

INTERPRETATION :-

This above mentioned table and figure shows the gender of the respondents, where 61
respondents are male and 39 respondents are female.

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6.2.3 OCCUPATION

Occupation No. of Respondent

Salaried Employee 28
Professionals 8
Business 4
Student 55
Others 5

OCCUPATION

5%
28% Salaried Employee

Professionals

Business
55% 8%
Student
4%
Others

INTERPRETATION :-

The above mentioned table and figure shows occupation of the respondents, where 4%
respondents are businessman, 5% respondents are comes in other category, 8%
respondents are in professionals and 28% respondents comes in salaried employee and
55% are the students.

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6.2.4 ANNUALINCOME

Annual Income Number of Respondents

Below 250000 57
Between 250000-500000 20
Between 500001- 1500000 15
Between 1500001- 2500000 2
Above 2500001 2

ANNUAL INCOME

Below 250000
2%2%

16% Between 250000-500000

Between 500001- 1500000

21% 59%

Between 1500001-
2500000

Above 2500001

INTERPRETATION :-

The above mentioned table and figure shows Annual Income of the respondents, where
59% respondents comes under 2.5 lakhs, 21% respondents are comes between 2.51
lakhs-5 lakhs, 16% respondents comes between 5 lakhs-15 lakhs, 2% respondents comes
between 15 lakhs-25 lakhs, and 2% respondents comes under the category of above 25
lakhs annual income group.

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 6.3 MEDICAL EXPENSES & SOURCES OF MEETINGEXPENSES

6.3.1 AVERAGE MONTHLY MEDICAL EXPENSES OF THEFAMILY

Average Monthly Expenses Number of Respondents

Upto 500 17
Between 500-1000 34
Between 1000- 2000 26
Between 2000- 5000 14
Above 5000 8

AVERAGEMONTHLYMEDICALEXPENSES

8% 17% Upto 500

14%
Between 500-1000

Between1000-2000

26% 35% Between2000-5000

Above 5000

INTERPRETATION :-

The above mentioned table and figure shows the average monthly medical expenses
incurred in a family where 17% respondents feels that they expend below Rs. 500 on an
average as their monthly medical expenditure, 35% respondents expend between Rs. 500-
1000, 26% respondents expend between Rs. 1000- 2000, 14% respondents feels that they
expend between Rs. 2000- 5000 and 8% respondents feels that they expend above
Rs.5000.

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 6.3.2 MOST USED SOURCE OF FUNDS FOR MEETING MEDICAL
EXPENSES

Sourceoffundsformeetingmedicalexpenses Number ofRespondents

Own savings 72
Health Insurance 21
Paid by employer/ company 3
Others 4

SOURCESOFFUNDSFORMEETINGMEDICALEXPENSES

3%
4% Ownsavings
21%
Health Insurance

Paid byemployer/
72% company
Others

INTERPRETATION:-

The above mentioned table and figure shows the sources of funds for meeting out the
expenses of medical bills by the families where 72% respondents have answered that they
expend from their own savings, 21% respondents have answered that they have taken
Health Insurance policy so they make reimbursements or do Cashless Treatment from the
respective hospital, whereas 3% respondents have answered that they have taken Group
Mediclaim policy in their respective working companies and their employer or the
company reimburse the same or they directly pays the medical bills of their employees
and 4% respondents have answered that they meet their medical expenses from other
(non- defined) sources.

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 6.4 CONSUMER BUYING PATTERN OF MEDICLAIMPOLICY

6.4.1 PURCHASE OF HEALTH INSURANCEPOLICY

Purchase of Health Insurance policy Number ofRespondents

Yes 51
No 43
May be 6

PURCHASE OF HEALTH INSURANCE POLICY

6%

YES

51%
43% NO

MAYBE

INTERPRETATION :-

The above mentioned table and figure shows that 51% of the population of the sample
size of 100 have purchased the Mediclaim Policy from their respective preferable Health
Insurance Company , 43% respondents out of 100 have answered that they have not
purchased any kind of Mediclaim Policy as yet, whereas 6% respondents have no idea
about the purchases of Health Insurance Policy in their family.

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 6.4.2 PREFERENCE OF INSURANCE CO. FOR
PURCHASINGMEDICLAIM

Preference of Insurance Co. for purchasing Mediclaim Number of Respondents

National Insurance Co. 38
New India Assurance Co. 15
United India Insurance Co. 9
Oriental Insurance Co. 13
Star Health & Allied Insurance Co. 10
Religare Health Insurance Co. 6
Apollo Munich Health Insurance Co. 24
Any Other 23

PREFERENCE OF INSURANCE CO. FORPURCHASING

MEDICLAIM

AnyOther 23
Apollo MunichHealth
24
Insurance Co.

Religare Health InsuranceCo. 6

StarHealth&AlliedInsurance
10
Co. Number of
Oriental Insurance Co. 13 Respondents

UnitedIndiaInsuranceCo. 9

New India AssuranceCo. 15

National Insurance Co. 38

0 10 20 30 40

INTERPRETATION :-

The above mentioned table and figure shows that 38 respondents have opted National
Insurance Co. for purchasing Mediclaim Policy which is a Public Sector Undertaking
(PSU) Insurance Co. where most of the population preferred the most for purchasing
Mediclaim Policy which shows it is the most reliable insurance companies amongst
others, whereas 24 respondents prefer to purchase Mediclaim from Apollo Munich
Health Insurance Co. Ltd., 15 respondents have preferred New India Insurance Co.
Ltd.(PSU), 13 respondents have preferred Oriental Insurance Co. Ltd.(PSU).

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 6.4.3 TYPE OF POLICYOPTED

Type of policy opted or purchased Number of Respondents

Individual Mediclaim 29
Floater Mediclaim Family 51
Group Mediclaim 3
Personal Accident 7
Overseas Mediclaim (Travel) 0
Any Other 24

TYPEOFPOLICYOPTED

IndividualMediclaim 29

FloaterMediclaimFamily 51
Number
of
GroupMediclaim 3 Responde
nts

Personal Accident 7

Overseas Mediclaim
0
(Travel)

AnyOther 24

0 10 20 30 40 50 60

INTERPRETATION:-

The above mentioned table & figure shows that 51 respondents out of 100 have opted for
Family Floater because they wanted to cover the risk of their families as it covers all
family members against diseases under a single cover. 29 respondents have opted for
individual mediclaim, whereas maximium population is not aware of Group mediclaim &
personal accidentpolicy.

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 6.4.4 BENEFITS OF PURCHASING HEALTH INSURANCEPOLICY

Benefits of purchasing Health Insurance Policy Number of Respondents

Attractive schemes available 14
Better Healthcare of family 62
Tax benefits u/s 80 D 22
Covers Heavy expenses 45
Life long renewal 14
More coverages of diseases 20
Any other 13

BENEFITS OF PURCHASING HEALTH INSURANCE POLICY

Any other 13

More coverages of diseases 20

Lifelongrenewal 14
Number of
Respondents
CoversHeavyexpenses 45

Taxbenefitsu/s80D 22

BetterHealthcareoffamily 62

Attractive schemes available 14

0 10 20 30 40 50 60 70

INTERPRETATION :-

The above mentioned table & figure shows that 62 respondents purchases mediclaim
because it provides better health care of their families and 45 respondents believes that it
also covers heavy expenditure in medical bills or hospitalisation. 22 respondents says that
it provides tax benefits u/s 80 D under Income Tax Act, 1961, whereas 20 respondents
feel that they purchase mediclaim because it covers many number of diseases.

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 6.4.5 ANY OTHER INSURANCE POLICY PURCHASED?

Other Insurance Policy purchased Number of Respondents

Life Insurance 71
Motor Insurance 56
Fire Insurance 4

OTHER INSURANCE POLICY PURCHASED

Life Insurance 71

Motor Insurance 56

FireInsurance 4

0 10 20 30 40 50 60 70 80

NumberofRespondents

INTERPRETATION :-

The above mentioned table & figure shows that maximum population in a sample i.e 71
respondents have already purchased Life Insurance Policy to meet out their retirement
goals or to achieve their long term goals to secure their future & their coming
generations, moreover 56 respondents have purchased Motor Insurance & 4 respondents
have purchased fire insurance policy to save from the threat of propertydamage.

60| P a g e
 6.4.6 RATING WHICH CAN FORM THE BASIS FOR SELECTING THE
HEALTH INSURANCEPOLICY
A. AUTHENTIC INFORMATION PROVIDED BY THE AGENT/BROKER-

Authentic information provided by the agent/ broker Number of Respondents

Excellent 9
Good 25
Satisfactory 5
Average 1

AUTHENTICINFORMATIONPROVIDEDBYTHEAGENT/
BROKER
30

25

20
Number of
Respondents
15
25
10

5 9
5 1
0
Excellent Good Satisfactory Average

INTERPRETATION :-

The above mentioned table & figure shows that 25 respondents feel good about that the
information provided by the agents or brokers are authentic and reliable. 9 respondents
feels that information provided by them are highly authentic.

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 B. WIDE POLICYOPTIONS-

Wide policy options Number ofRespondents

Excellent 7
Good 25
Satisfactory 7
Average 1

WIDEPOLICYOPTIONS

30

25

20

15 Number of
Respondent
25 s
10

5
7 7
1
0
Excellent Good Satisfactory Average

INTERPRETATION :-

The above mentioned table & figure shows that 25 respondents feel good about that there
are wide policy options in health insurance policy. 7 respondents feels that there are
excellent coverages & wide policy options are available to them.

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 C. EASY AND HASSLE FREE CLAIMSSETTLEMENT-

Easy & Hassle free claims settlement Number of Respondents

Excellent 8
Good 22
Satisfactory 11
Average 1

EASYANDHASSLEFREECLAIMSSETTLEMENT

25

20

15 Number of
Respondents

22
10

5 11
8

1
0
Excellent Good Satisfactory Average

INTERPRETATION :-

The above mentioned table & figure shows that 22 respondents feel good about that the
process of settlement of insurance claims are easy and hassle-free. 8 respondents feel that
there are excellent services provided to them at the time of settlement of claims and they
find easy and hassle free for reimbursement.

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 D. LOW PREMIUMCHARGED-

Low premium charged Number of Respondents

Excellent 4
Good 20
Satisfactory 15
Average 1

LOW PREMIUM CHARGED

25

20

15

Number of
10 20 Respondents

15
5

4
1
0
Excellent Good Satisfactory Average

INTERPRETATION :-

The above mentioned table & figure shows that 20 respondents feel good about that low
premium is charged from them at the time of Mediclaim Insurance. 15 respondents feel
satisfactory about the premium charged by them at the time of Mediclaim Insurance.

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 E. CASHLESS FACILITY IN HOSPITALS-
Cashless Facility in Hospitals Number of Respondents
Excellent 7
Good 24
Satisfactory 9
Average 0

CASHLESSFACILITYINHOSPITALS
30

25

20
Number of
Respondent
15
s
24
10

5 9
7
0
0
Excellent Good Satisfactory Average

INTERPRETATION :-

The above mentioned table & figure shows that 24 respondents feel good about that there
is a cashless process of settlement of insurance claims in hospitals and are easy and
hassle-free. 7 respondents feel that there are excellent services provided to them by
insurance co.s or TPAs in opting for claiming cashless hospitalisation benefit where the
insured person does not pay the hospital bills at the time of admission to the hospital for
certain treatment but they opt for cashless process where the insurance co and the hospital
directly comes into the contact and insurance co. pays all the bills & hospital charges. 7
respondents feel excellent about the cashless facility provided by the insurance co.s to the
insured.

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 6.5 ATTITUDE TOWARDS SETTLEMENT OF INSURANCECLAIMS

6.5.1 DO YOU HAVE LOGGED ANY CLAIMS YET?

Do you have logged any claims yet Number of Respondents

Yes 24
No 71
May be 3

NO.SOFPERSONLOGGEDCLAIMS

3%
25% Yes

No

Maybe
72%

INTERPRETATION :-

The above mentioned table & figure shows that 72% respondents have not logged any
claims yet during their health insurance policy period whereas 25% respondents who
have already taken the health insurance policy have already logged the claims with the
insurance co. 3% respondents have no idea about any claims processloggin.

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 6.5.2 RATING OF THE FOLLOWING FACTORS-

A. HASSLE FREE CASHLESS CLAIMS PROCESS-

Hassle free cashless claims process Number of Respondents

Strongly Agree 11
Agree 50
Indifferent 4
Disagree 2
Strongly Disagree 0

HASSLEFREECASHLESSCLAIMSPROCESS
60

50

40
Number of
Respondent
30 s
50
20

10
11
4 2 0
0
Strongly Agree Indifferent Disagree Strongly
Agree Disagree

INTERPRETATION :-

The above mentioned table & figure shows that 50 respondents are agreeing with the
hassle free cashless claims process which is Rank 2, whereas 11 respondents are strongly
agreeing with the hassle free cashless claims process.

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 B. HASSLE FREE REIMBURSEMENT CLAIMS PROCESS–

Hassle free reimbursement claims process Number of Respondents

Strongly Agree 12
Agree 39
Indifferent 11
Disagree 0
Strongly Disagree 0

HASSLEFREEREIMBURSEMENTCLAIMSPROCESS
45

40

35

30

25 Number of
Respondent
20 39 s
15

10

5 12 11
0 0
0
Strongly Agree Agree Indifferent Disagree Strongly
Disagree

INTERPRETATION :-

The above mentioned table & figure shows that 39 respondents are agreeing with the
hassle free reimbursement claims process which is Rank 2, whereas 12 respondents are
strongly agreeing with the hassle free reimbursement claims process.

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 C. COOPERATION AND ATTITUDE OF INSURANCE CO-

Cooperation and attitude of insurance co. Number of Respondents

Strongly Agree 10
Agree 42
Indifferent 8
Disagree 3
Strongly Disagree 0

COOPERATIONANDATTITUDEOFINSURANCECO.
45

40

35

30

25
Number of
20 42 Respondents

15

10

5 10 8
3 0
0
Strongly Agree Agree Indifferent Disagree Strongly
Disagree

INTERPRETATION :-

The above mentioned table & figure shows that 42 respondents are agreeing with the
good cooperation and attitude of Insurance companies which is Rank 2, whereas 10
respondents are strongly agreeing with the cooperation and attitude of insurance
companies.

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 D. COOPERATION AND ATTITUDE OF TPA’S AND BROKERS–

Cooperation and attitude of TPA’S & brokers Number of Respondents

Strongly Agree 13
Agree 37
Indifferent 11
Disagree 3
Strongly Disagree 0

COOPERATIONANDATTITUDEOFTPA’SANDBROKERS
40

35

30

25

20
37 Number of
15 respondents

10
13
5 11
3 0
0
Strongly Agree Indifferent Disagree Strongly
Agree Disagree

INTERPRETATION :-

The above mentioned table & figure shows that 37 respondents are agreeing with the
good cooperation and attitude of TPA’S and brokers which is Rank 2, whereas 13
respondents are strongly agreeing with the cooperation and attitude of TPA’S and
brokers.

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 E. CLAIMS SETTLEMENT WITHIN A LIMITED PERIOD-

Claims settlement within a limited period Number of Respondents

Strongly Agree 15
Agree 38
Indifferent 9
Disagree 2
Strongly Disagree 0

CLAIMSSETTLEMENTWITHINALIMITEDPERIOD
40

35

30

25

20 Number of
38 Respondents
15

10
15
5 9
2 0
0
Strongly Agree Agree Indifferent Disagree Strongly
Disagree

INTERPRETATION :-

The above mentioned table & figure shows that 38 respondents are agreeing that claims
are easily settled within a limited time period from the insurance company which is Rank
2, whereas 15 respondents are strongly agreeing that claims are being settled with ease
process and in a limited time period.

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6.6 INTERPRETATION THROUGHSPSS

1. RELATIONSHIP BETWEEN GENDER AND PURCHASE OF HEALTH

INSURANCEPOLICY-
Case Processing Summary
Cases

Valid Missing Total

N Percent N Percent N Percent

Gender * 101 100.0% 0 0.0% 101 100.0%

purchaseofmediclaim

Gender * purchase of mediclaim Crosstabulation

purchaseofmediclaim Total
1.00 2.00 3.00

Count 34 23 4 61
1.00
Expected Count 30.8 26.6 3.6 61.0
Gender
Count 17 21 2 40
2.00
Expected Count 20.2 17.4 2.4 40.0
Count 51 44 6 101
Total
Expected Count 51.0 44.0 6.0 101.0

Chi-Square Tests

Value df Asymp. Sig. (2-sided)

Pearson Chi-Square 2.151a 2 .341

Likelihood Ratio 2.149 2 .342
Linear-by-Linear Association .892 1 .345
N of Valid Cases 101

a. 2 cells (33.3%) have expected count less than 5. The minimum expected count is 2.38.

RESULT:- As the significant value denotes 0.05 but the result is 0.341 , so the
interpretation is Null Hypothesis in which there is no association between the gender and

owning of a Health Insurance Policy.

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 2. RELATIONSHIP BETWEEN AGE AND PURCHASE OF HEALTH
INSURANCEPOLICY-

Case Processing Summary

Cases

Valid Missing Total

N Percent N Percent N Percent

Age * purchaseofmediclaim 101 100.0% 0 0.0% 101 100.0%

Age * purchaseofmediclaim Crosstabulation

purchaseofmediclaim Total
1.00 2.00 3.00

Count 37 42 6 85
1.00
Expected Count 42.9 37.0 5.0 85.0
Count 11 2 0 13
2.00
Expected Count 6.6 5.7 .8 13.0
Age
Count 2 0 0 2
3.00
Expected Count 1.0 .9 .1 2.0
Count 1 0 0 1
4.00
Expected Count .5 .4 .1 1.0
Count 51 44 6 101
Total
Expected Count 51.0 44.0 6.0 101.0

Chi-Square Tests

Value df Asymp. Sig. (2-sided)

Pearson Chi-Square 10.743a 6 .097

Likelihood Ratio 12.959 6 .044
Linear-by-Linear Association 8.586 1 .003
N of Valid Cases 101

a. 7 cells (58.3%) have expected count less than 5. The minimum expected count is .06.

RESULT:- As the significant value denotes 0.05 but the result is 0.097 , so the
interpretation is Null Hypothesis in which there is no association between the age and
owning of a Health Insurance Policy.
60| P a g e
 3. RELATIONSHIP BETWEEN ANNUAL INCOME AND PURCHASE OF
HEALTH INSURANCEPOLICY-

Case Processing Summary

Cases

Valid Missing Total

N Percent N Percent N Percent

AnnualIncome * 97 96.0% 4 4.0% 101 100.0%

purchaseofmediclaim

AnnualIncome * purchaseofmediclaim Crosstabulation

Purchaseofmediclaim Total
1.00 2.00 3.00
Count 23 31 4 58
1.00
Expected Count 30.5 23.9 3.6 58.0
Count 13 6 1 20
2.00
Expected Count 10.5 8.2 1.2 20.0
Count 12 3 0 15
AnnualIncome 3.00
Expected Count 7.9 6.2 .9 15.0
Count 2 0 0 2
4.00
Expected Count 1.1 .8 .1 2.0
Count 1 0 1 2
5.00
Expected Count 1.1 .8 .1 2.0
Count 51 40 6 97
Total
Expected Count 51.0 40.0 6.0 97.0

Chi-Square Tests

Value df Asymp. Sig. (2-sided)

Pearson Chi-Square 18.784a 8 .016

Likelihood Ratio 17.631 8 .024
Linear-by-Linear Association 4.588 1 .032
N of Valid Cases 97

a. 9 cells (60.0%) have expected count less than 5. The minimum expected count is .12.

61| P a g e
RESULT:- As the significant value denotes 0.05 but the result is 0.016 , so the
interpretation is Alternative Hypothesis in which there is an association between the
Annual Income and owning of a Health Insurance Policy.

4. RELATIONSHIP BETWEEN MONTHLY MEDICAL EXPENSESOF

FAMILY AND PURCHASE OF HEALTH INSURANCEPOLICY-

Case Processing Summary

Cases

Valid Missing Total

N Percent N Percent N Percent

Monthlyexpenses * 100 99.0% 1 1.0% 101 100.0%

purchaseofmediclaim

Monthlyexpenses * purchaseofmediclaim Crosstabulation

purchaseofmediclaim Total
1.00 2.00 3.00

Count 8 7 2 17
1.00
Expected Count 8.7 7.3 1.0 17.0
Count 17 18 0 35
2.00
Expected Count 17.9 15.1 2.1 35.0
Count 14 10 2 26
Monthlyexpenses 3.00
Expected Count 13.3 11.2 1.6 26.0
Count 8 6 0 14
4.00
Expected Count 7.1 6.0 .8 14.0
Count 4 2 2 8
5.00
Expected Count 4.1 3.4 .5 8.0
Count 51 43 6 100
Total
Expected Count 51.0 43.0 6.0 100.0

62| P a g e
 Chi-Square Tests
Value df Asymp. Sig. (2-sided)

Pearson Chi-Square 10.376a 8 .240

Likelihood Ratio 11.029 8 .200
Linear-by-Linear Association .006 1 .938
N of Valid Cases 100

a. 7 cells (46.7%) have expected count less than 5. The minimum expected count is .48.

RESULT:- As the significant value denotes 0.05 but the result is 0.240 , so the
interpretation is Null Hypothesis in which there is no association between the Monthly
Expenses and owning of a Health Insurance Policy.

63| P a g e
 CHAPTER-

VIICONCLUSI
7.1 CONCLUSION- ON

The result of this study shows that the annual premium is the most important factor that
influences the decision or choice of health Insurance plan. This means that households
having higher income have higher probability of buying healthcare plan. Thus, less
income groups may not opt for health insurance plan. Thus there is a need to develop
more products that cater to need of larger and all levels of income groups. Apart from
annual premium, hospital network and disease coverage or coverage of services hold
importance in making choice of healthcare plan. Thus, insurance company should
provide larger network of hospitals and services in their plans in order to satisfy their
customer fully. Accessibility of service provider and company reputation also moderately
influence the decisions. The decision made for choosing the plan is mainly influenced by
self perceptions. Family and relatives and past experience hold second position for
assisting in the choice of plan. Most people would prefer to buy healthcare plan from
private insurance companies for they provide better services and innovative products.
Thus, there is large scope for private insurance companies togrow.

The legal and regulatory framework of private health insurance, particularly because it
operates in the voluntary market, should continually balance competing goals of access,
affordability and quality of healthcare and provide health coverage to a larger fraction of
the population with varying risk characteristics and ability to pay.

The analysis clearly shows that there is demand for the plans need to include pregnancy
related expenses, inclusion of chronic and debilitating diseases, HIV and AIDS, TPAs
need to be more efficient in claims processing and providing better networking for the
policyholders. To create the awareness of health insurance is very important, the
Government and all the associated bodies should all offer their support in spreading
health insurance awareness so that Indian citizens are aware of the right to seek quality
healthcare without any financial thought and it will help to increase the awareness of
health insurance among thepeople.

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7.2 FINDINGS OF THESTUDY-

Findings of the analysis of consumer profile are as following:-

The average monthly medical expenditures for a family was found to be about Rs.
10000/-.
There is found to be relationship between income group and medical expenditure,
with higher income groups reporting relatively higher medical expenditure which
may be explained by the type of hospitals visited by the different income groups
for medicalcare.
The main reasons for consumers to opt for health insurance are to protect from
rising cost of health care, to provide better health care to family and to meet
unexpected major expenditures. Therefore, the cost of medical care is a major
drivingfactor.
Trustworthiness of the company emerges as the most important factor in selection
of a service provider. Ease of claim settlement comes as the secondreason.
Premium cost and schemes are the other majorfactors.
Awareness of health insurance, a pre-requisite for market growth, was good but
the depth of knowledge about schemes; exclusions, claim process etc were not
adequate. Further, the less educated group has lower levels of awareness about
health insurance. News paper advertisements, news items etc are the most widely
reported sources of information, followed by TV ads and insuranceagents.
Most of the respondents have taken Life Insurance Policy , hereby taking as a
substitute of MediclaimPolicy.
It is found out that the major source of meeting the requirements of funds for
medical bills and expenses are the own savings of the person but not the health
insurance.
More than 70% respondents in a sample size of 100 have not logged any claims
yet so they have no idea about the claims settlement process through Cashless
hospitalization and Reimbursement claimssettlement.

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7.3 LIMITATIONS OF THE STUDY–

Following are limitations and constraints of the present research:-

 The present study was confined to Lucknow, New Delhi and Delhi NCR region.
Sample Size was 100 and only salaried employees, business professionals and
students were considered for the research purpose. So, Findings of the present
study can‘t be generalized for the entireNation.
The study was all about the awareness, perception and customer satisfaction of
health insurance policies of the respondents, there may be the possibility of
biasness in the responses given bythem.
There were abundant literatures available in the area of buying pattern of
Mediclaim and Awareness of Health insurance, but there was absence of studies
specifically in the area of Customer satisfaction of Health Insurance Claims
through Cashless & reimbursement process to some extent. There was absence of
some model or developed scale in the particular area. If some published research
study had been available, it would have helped the current study to gauge still
betterresults.
Some of the findings of the study suggest that there may be chance of lack of
understanding of some of the concepts byrespondents.

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7.4 SCOPE OF FUTURE RESEARCH –Following areas can be considered for further
researchprocess:

Study of fraudulent claims & surrenders received by insurers such as fake

documentation, mis-selling, collusion between partiesetc.
Study of effectiveness of TPAcompanies
OPD coverages and eye treatments like Lasik.
Better coverages for patients suffering from pre-existing diseases like Cancer,
AIDS, Intentional self harm diseases, Digestive diseases, Malignant and other
tumors and also better coverages for seniorcitizens.
Comparison of PSU and private companies to find out the better health coverages
and services provided to theinsured.

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 CHAPTER- VIII

SUGGESTIONS AND RECOMMENDATIONS

8.1 SUGGESTIONS ANDRECOMMENDATIONS-

The Research recommends thefollowing:-

 Multiple health insurance products should be offered at various price points to

customers.
 IRDA should engage the services of the Ministry of Health and Family Welfare,
Indian Medical Council, Indian Medical Association, healthcare associations and
otherbodies.
 Large efforts should be laid towards developing health insurance as an alternative
and acceptable method of personal finance risk management tool. The whole aim
should be to divert towards popularizing health insurance as a concept in rural
areas under the guidance of the Ministry of finance and theIRDA.
 Life insurance companies to develop underwriting guidelines and sell health
insurance policies because of their wide distributionnetwork.

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 APPENDIX

9.1 REFERENCES

 IIMA 1999. Indian Institute of Management, Ahmedabad. Report of Health

Insurance in India.
 Insurance Regulatory and development Authority(IRDA).
 Jyotsna Sethi and Nishwan Bhatia (Dec.2008): To study the Type of Health
Insurance and Health Insurance scheme in India, PHI learning pvt.ltdpublication.
 Ellis RP, Alam M, Gupta 1.1996 Health Insurance in India: Prognosis and
prospectus Boston University: Boston and Institute of Economic Growth: Delhi
December18.
 Dholkia R. Economic reforms: Implications for HealthInsurance.
 Directorate General of HealthServices.

9.2 BIBLIOGRAPHY

 www.irdai.gov.in
 www.icicilombard.com
 www.coverfox.com
 www.apollomunichinsurance.com
 www.policybazaar.com

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 9.3 QUESTIONNAIRE

1. Email Address:
2. Age Group:
o18-30
o31-40
o41-50
o51-60
o 60 &Above
3. Gender:
o Female
o Male
o Prefer not to say
4. Occupation:
o SalariedEmployee
o Professional
o Business
o Student
o Others
5. AnnualIncome:
o Below250000
o Between 250000 to 500000
o Between 500001 to 1500000
o Between 1500001 to 2500000
o Above2500001
6. Average monthly medical expense of yourfamily?
o Up to500
o500 – 1000
o1000 – 2000
o2000 – 5000
o Above5000
7. Which is the most used source of fund for meeting your medicalexpenses?
o OwnSavings
o Paid by employer/company
o HealthInsurance
o Others

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 8. Do you have taken any Health InsurancePolicy?
o Yes
o No
o Maybe
9. Which insurance company do you prefer the most for purchasing Mediclaim
InsurancePolicy?
o National Insurance Co.Ltd.
o New India Assurance Co.Ltd.
o United India Insurance Co.Ltd.
o Oriental Insurance Co.Ltd.
o Star Health & Allied Insurance Co. Ltd.
o Religare Health Insurance Co.Ltd.
o Apollo Munich Health Insurance Co.Ltd.
o AnyOther
10. What type of policies you havetaken?
o IndividualMediclaim
o Family FloaterMediclaim
o GroupMediclaim
o PersonalAccident
o Overseas Mediclaim Policy ( TravelInsurance)
o AnyOther
11.Why do you think you should have Health Insurance Policy in yourhome?
o Attractive schemesavailable
o Better Healthcare ofFamily
o Tax Benefits u/s 80D
o Covers heavyexpenses
o Lifelongrenewal
12. Do you have any other InsurancePolicy?
o Life Insurance
o Motor Insurance
o FireInsurance
o Other

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 13.Rate the following which can form the basis for selecting a health insurance
policy:

14. Do you have logged any claimsyet?

o Yes
o No
o Maybe
15. If yes, how would you rate the followingfactors?

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