CHAPTER 1: INTRODUCTION OF THE PROJECT

1.1 Concept of the study:

Health insurance is insurance that covers the whole or a part of the risk of a person
incurring medical expenses, spreading the risk over a large number of persons. By
estimating the overall risk of health care and health system expenses over the risk pool,
an insurer can develop a routine finance structure, such as a monthly premium or payroll
tax, to provide the money to pay for the health care benefits specified in the insurance
agreement. The benefit is administered by a central organization such as a government
agency, private business, or not-for-profit entity. According to the Health Insurance
Association of America, health insurance is defined as "coverage that provides for the
payments of benefits as a result of sickness or injury. It includes insurance for losses from
accident, medical expense, disability, or accidental death and dismemberment" Health
Insurance Health Insurance is an insurance policy that ensures that you get cashless
treatment or expense reimbursement, in case you fall ill. A health insurance policy
reimburses the insured for medical and surgical expenses arising from an illness or injury
that leads to hospitalization. The insurance company provides the insured with the facility
of cashless hospitalization at a network hospital or provides a reimbursement for the
incurred expenses. Furthermore, health insurance cost is subsidized to the insured in the
form of tax exemption under section 80D of Income Tax Act, 1961. Individual Plans
Cashless Hospitalization: Medical expenses are sky-rocketing! Get health insurance
policies for your medical outlay. With cashless facility, stay tension-free. Approved by
IRDAI, Policy Bazaar helps you compare and find the best health plan. Individual Health
Insurance Plan from Top Insurers Lowest Premium On Medical Insurance Compare
Policies Instantly Importance of Health Insurance in India Health insurance in India is
one of the fastest growing industries. However, this wide scope for growth indicates the
limited penetration of health insurance among the Indian populace. As per the latest
report released by National Sample Survey Organization (NSSO) titled “Key Indicators
of Social Consumption in India: Health”, only 20 percent of the Indian population had
health insurance coverage. Additionally, only 18 percent of the total population residing
in urban areas and 14 percent of the total population residing in rural areas had any form

1
 of health insurance coverage. Thus, there is no debating the importance of having
insurance in a country like India where medical expenses are sky-rocketing. Everyone
must buy a good health insurance policy that includes medical costs, hospitalization
costs, medication and laboratory test costs, including critical illness. Don’t get confused
with questions like – Which health policy to buy? Does it cover every eventuality? What
illnesses are excluded from this cover? Policy Bazaar is here to resolve all such
confusions. Compare Health Insurance Quotes & Save Big It is vital that you compare
health insurance online before purchasing any plan in order to choose the best plan for
your healthcare needs.

1.2 Need for the study

 The need for this study is to understand both the company’s performance also which
factors are responsible for the performance of the companies and which company
provides more benefits and facilities to the customers and investors.
 To analyze the best offers and plan provided by each company. It is also assumed
that the observations, evaluations and conclusion made from the study will be useful
for comparison.

1.3 Objective of the study.

1. To study the factors affecting the customer buying decision and awareness of health
insurance.
2. To study the customer satisfaction for health insurance.
3. To compare health insurance policies of two companies in different aspects such as
premium, benefits and facilities provided by both the companies.
4. To study profit and loss a/c and balance sheet through ratio.

2
1.4 Scope of study.

Rising healthcare costs and increasing longevity has created awareness about the
importance of health insurance. At a very rudimentary level, health insurance is an
insurance, which covers for the medical expenses incurred by you. Similar to other forms
of insurance, you can take a policy under which a fixed sum is covered to protect yourself
against stated healthcare risks as mentioned in the policy. There is a cost by way of
premiums that you pay for such a policy, which depends on your age, current health
condition and the amount of insurance that you take, which is the sum assured by the
policy.

Like every other insurance policy, health plans too come with conditions. Usually, to
avail of any benefits under the health insurance policy, the policyholder needs to be
hospitalized for at least 24 hours. The policy typically covers for room or boarding
expenses, nursing expenses, surgeon fee, physician, operation theatre charges, medicines,
medical tests and a lot many other necessary expenses. Depending on the kind of policy
purchased it might also cover pre and post hospitalization expenses and further help you
with certain amount of daily cash allowance during hospitalization under ‘Hospital Cash’
benefit.

1.5 Introduction of the topic.

(a) Meaning:

Health insurance in a narrow sense would be an individual or group purchasing health

care coverage in advance by paying a fee called premium. In its broader sense, it would
be any arrangement that helps to defer, delay, reduce or altogether avoid payment for
health care incurred by individuals and households. Given the appropriateness of this
definition in the Indian context, this is the definition, we would adopt. The health
insurance market in India is very limited covering about 10% of the total population
Health insurance guarantees payments to a person in the event of sickness or injury and
works as protection scheme. Health insurance is protection, scheme to take care of health
of a person and works it works by buying a policy from a company or an insurance agent.
Depending on the premium paid the health insurance policy will pay specified amounts
for the medical expenses incurred to overcome the health problem. Currently the trend of
some of the reputable companies seems to be to build in a health insurance policy as a
benefit to an employee. Some countries offer free health insurance to their citizen. In
India certain sectors like railways, army and the employees working with the central

3
government are covered in a health scheme provided cover to almost 20million people in
different part of country. Health like education should be essential and should be freely
available to all the citizens of a country. Some developed countries realizing the
importance of the health of the nation spend as much as 6% to 8% of their GDP on it and
32 have advanced facilities in their government run hospitals. Some examples include the
United Kingdom where the National Health Services hospitals provide all the health
requirements to majority of their citizens. Sweden and Norway follow similar
government run health schemes. As per the census of USA in the year 2004, it was noted
that 245.3 million people had health insurance coverage; however 45.8 million lived
without an insurance cover. In response to some of these stats Senator John Kerry said.
"Great physicians and nurses, skilled, caring and unparalleled in their training, intervened
in my life and probably saved it. I was lucky but other Americans are not. It is time to
speak again and stand again for the ideal that in the richest nation ever on this planet, it is
wrong for 41 million Americans, most of them in working families, to worry at night and
wake up in the morning without the basic protection of health insurance." Developing
countries like India have priority of spending in other sectors like the army and the
infrastructure development and barely 2% of the GDP is spent on the health and results in
the government hospitals lack in facilities especially for any advanced procedure such as
heart surgery or hip placement.Health insurance schemes are particularly important for
individuals from the lower income group to provide them and their family members with
adequate cover in event of any mishap or illness. The escalating medical costs are due to
the advanced diagnostic and therapeutic procedures that have become the hallmark of
modern medical care. An insurance scheme will guarantee that no compromises are made
in your treatment for wants of funds.

“Health insurance aims that one can access to the best health care without fearing
the financial strain, it help people to have peace in mind rather than to have fear”.

Why do you need health insurance?

As medical care advances and treatments increase, health care costs also increase. The
purpose of health insurance is to help you pay for care. It protects you and your family

4
financially in the event of an unexpected serious illness or injury that could be very
expensive. In addition, you are more likely to get routine and preventive care if you have
health insurance.

You need health insurance because you cannot predict what your medical bills will be. In
some years, your costs may be low. In other years, you may have very high medical
expenses. If you have health insurance, you will have peace of mind in knowing that you
are protected from most of these costs. You should not wait until you or a family member
becomes seriously ill to try to purchase health insurance.

We also know that there is a link between having health insurance and getting better
health care. Research shows that people with health insurance are more likely to have a
regular doctor and to get care when they need it.

How Does Health Insurance Work?

When you become a member of a health plan, you’re joining a group of people who have
also chosen that plan. Insurers call it a risk pool because they measure the amount of risk
associated with those people.

Some people are high risk because they are not in good health and likely to use a lot of
medical services. Others are lower risk because they are healthy. And let’s not forget
unexpected illnesses or injuries that can happen to anyone.

The health insurer does lots of calculations to estimate how much money it will cost to
cover the collective medical expenses for everyone in your plan. Each member of the
plan pays a monthly rate, or premium.

When you need health care, you and your health insurer share the covered medical costs.
Your plan outlines your out-of-pocket costs for each service whether it’s
a company, deductible, or coinsurance.

Some years you may require lots of medical services, other years you may need less, but
the whole point of having it is so you can avoid paying the full cost of medical services

5
on your own. If medical costs are exceptionally high, your health insurer may have to
adjust rates from time to time.

(b)Types:

Health Management Organizations (HMOs):

HMOs can be the most affordable health plans, but that affordability comes at the price of
choice. HMOs are comprised of a group of doctors, specialists, and facilities that all work
together, so going outside of the HMO for care is not possible. Additionally, a referral is
often required from your primary care physician before seeing a specialist. Still, it can be
preferable. Generally, wait times and paperwork is much reduced and members can often
see multiple doctors in a single day.

Preferred Provider Organization (PPO):

PPOs are some of the most common employer-sponsored health insurance plans in the
country. PPOs give you freedom over the specific doctors you see and you don’t need a
referral from your primary care physician to go see a specialist. However, they tend to be
more expensive, particularly if you go see a doctor that does not participate in your health
insurer's network. Be sure to check if the doctor is in your network before you see them.

As you can see, PPO plans tend to offer a bit more freedom, but you’ll have to pay for it.
There are also three other plans that are less common.

Exclusive Provider Organization (EPO):

An EPO is similar to a PPO, in that you can see any doctor but do not pay for any out of
network doctors visits or procedures. They tend to be less expensive than the PPO but
more expensive than an HMO and are good options for first-time professionals.

6
Point-of-Service Plan (POS):

A blend of the HMO and PPO, POS insurance plans give you some choice but are
generally less expensive because your primary care refers you to any other physician.

(c) Advantages:

1. Tax benefits

Apart from providing you with the health security and safety in future, a medical
insurance plan can help you to save your taxes under Section 80D of the Income Tax Act.
According to the Income Tax Laws of 2015-2016, the premiums paid for the health
policies of your parents are also admissible to reduce your tax liability. However, the
amount of deduction depends on the age of the member who is medically insured and his
policy premium being taken into account. The range of tax deduction that can be availed
ranges from Rs. 25,000 to Rs. 60,000 per annum depending on the age of the person
whose policy premium is being taken into account. The deduction in case of senior
citizen above 60 years is certainly on the higher side of this range.

2. Health Check Benefit

Your individual health plan provides for a free health check once every four years the
process of application may vary from one insurer to another, but one thing remains the
same, and that it, the test results do not impact your current policy premiums. The new
results will only be considered if you want to increase your sum assured or purchase a
new health plan.

3. No-claims Bonus

It is not every year that you need to avail the benefits of your health cover, until and
unless you suffer from certain major diseases like cancer. In such a case, a no-claims
bonus can be availed leading to annual advantages. No-claims bonus refers to the benefits

7
you can avail while the renewal of the policy if you have not made a claim in the
previous year. Based on this, most insurers will assure to increase the total sum assured
of your health plan or offer discount in the Renewal premium costs.

4. Top-ups and Super Top-ups

Top Up Insurance works alongside your current health policies policy and enhances it to
provide you a larger coverage at a much lower premium. For example, if you have an
individual health insurance plan of Rs 10 lakhs and a top-up policy of Rs 20 lakhs with a
deductible of Rs 10 lakhs. If you run up a medical bill of Rs 15 lakhs; you can use your
individual health insurance policy to pay Rs 10 lakhs and then your top-up policy to pay
the remaining Rs5 lakhs. Many insurance companies provide this benefit to people who
live in the metro cities, thus increasing the cost of health facilities automatically for them.

5. Restore or Regain Benefit

Restore Benefit is offered in case you end up exhausting the whole of the sum insured. In
such a case, your sum insured will be restored in case the claim is made for a different
illness during the same policy year. It is similar to a super top-up plan, but it can only be
availed for a separate disease and within the same policy year. For example, if you end up
having a stomach tumor problem due to which you end up exhausting all the sum insured,
say Rs. 15,00,000 and then after a couple of months in the same policy year, if
unfortunately, you are diagnosed with some heart illness, the insurance company will
refill the sum insured of Rs. 15,00,000.

1.6 Literature review on company .

Koradala Venkateshwarlu in his research paper- Health Care Insurance in India: The New
Paradigm pointed out that people require health insurance to decrease the out of pocket
expenses for unforeseen medical emergencies. He also pointed out the barriers of health
insurance industry is the income, unsuitable policy, no much priority of government and

8
awareness. Income is the major constraint which cannot be avoided in India. Therefore
koradala in his paper suggested to adopt triangular model of universal health insurance.

Him Gupta in the research paperpointed out that health insurance in India has
little development but competition between the health insurance providers will cause the
market to grow and offer the customer with new plans and policies along with different
price. Also the infrastructure of hospitals in rural area is poor than urban areas. Hima
Gupta suggested that healthcare sector needs to be regulated and reformed to reduce
health care risk.

Pooja Kansra in her paper pointed out, in the past two decades the health care
cost has drastically increased, this has made many families to control their spending and
invest in health care. Health insurance is still at the preliminary stage even after
awareness and penetration ofhealth insurance in Indian Market. The health insurance
awareness should be increased in India. Once the penetration increases in Indian market,
the catastrophic out of pocket health expenditure will decrease immensely which is
necessary for quality life.

Indrani Gupta and Mayur Trivedi in their paper pointed out that it is unjust for
not including HIV positive patients in health insurance and suggested health insurance
company to include them also in the policies so that there is growth in health insurance
sector in India.

Tina Murarka in her paper point out that now insurance industry is in nascent stage. In
a very short time private companies have acquired 13 percent market share. She said that
the insurance products will grow in the coming years because of increasing working class
people and saving pattern. Some of the drivers are growth of financial industry,
promoting innovations and removing inefficiencies and the role of IT sector. Till now
insurance sold by agents were as an investment and tax benefit product. However
penetration still remains low in insurance.

9
Chitra Rachel in her article in Economics times point out that some health insurance
companies like Bajaj Allianz General Insurance, Cigna TTK and Star health insurance
covers the critical illness like diabetes, cancer, hypertension etc in their pro health policy.
They also provide health coach for individuals with pre-existing diseases. They have tied
up with gymnasiums, doctors, dietitians and fitness consultants for their insurance
holders to maintain their fitness. They have tied up with these gyms, spas and salons to
give discounts to the insurance holders. Some companies even run their wellness
programs for customer's fitness.

1.7 Regulatory or Legal aspects related to the topic

Regulation plays a major role in the health care industry and health care
insurance coverage. The various regulatory bodies protect the public from a
number of health risks and provide numerous programs for public health and
welfare. Together, these regulatory agencies protect and regulate public health at
every level. Health care regulations are developed and implemented not only by
all levels of government (federal, state and local) but by private organizations as
well.
IRDA - Insurance Regulatory Development and Authority is the statutory,
independent and apex body that governs and supervise the Insurance Industry in
India.
It was constituted by Parliament of India Act called Insurance Regulatory and
Development Authority of India (IRDA of India) after the formal declaration of
Insurance Laws (Amendment) Ordinance 2014, by then President of India Pranab
Mukherjee on December 26, 2014.

10
Establishment:

 IRDA Act was passed upon the recommendations of Malhotra Committee

report (7 Jan, 1994), headed by Mr. R.N. Malhotra (Retired Governor,
RBI).
 Main Recommendations - Entrance of Private Sector Companies and
Foreign promoters & an independent regulatory authority for Insurance
Sector in India.
 In April, 2000, it was set up as statutory body, with its headquarters at
New Delhi.
 The headquarters of the agency were shifted to Hyderabad, Telangana in
2001.
Objectives of IRDA:

 To promote the interest and rights of policy holders.

 To promote and ensure the growth of Insurance Industry.
 To ensure speedy settlement of genuine claims and to prevent frauds and
malpractices
 To bring transparency and orderly conduct of in financial markets dealing
with insurance.

Organizational Setup of IRDA:

 IRDA is a ten member body consists of One Chairman (For 5 Years &
Maximum Age - 60 years )
 Five whole-time Members (For 5 Years and Maximum Age- 62 years)
 Four part-time Members (Not more than 5 years)
 The chairman and members of IRDAI are appointed by Government of
India.
 The present Chairman of IRDAI is Mr T.S Vijayan.

11
Functions and Duties of IRDA:

Section 14 of IRDA Act, 1999 lays down the duties and functions of IRDA:
 It issues the registration certificates to insurance companies and regulates
them.
 It protects the interest of policy holders.
 It provides license to insurance intermediaries such as agents and brokers
after specifying the required qualifications and set norms/code of conduct for
them.
 It promotes and regulates the professional organizations related with
insurance business to promote efficiency in insurance sector.
 It regulates and supervise the premium rates and terms of insurance covers.
 It specifies the conditions and manners, according to which the insurance
companies and other intermediaries have to make their financial reports.
 It regulates the investment of policyholder's funds by insurance companies.

12
 CHAPTER 2: INTRODUCTION TO INDUSTRY

(a) Introduction of insurance industry.

The Insurance Regulatory Authority of India (IRDA) has come to the forefront in
tackling these service standard issues recently. Speaking at the first meeting of the India
Health Insurance Forum in Hyderabad last Thursday, IRDA chairman J Harinarayan said
the industry must now work to improve communication with its customers, particularly
with regard to health insurance policy documentation, as a third of all consumer
complaints this year have been directed towards health insurers. According to IRDA data,
of the 92,898 complaints levied at the non-life sector so far in 2012, 38,891, or 37.5
percent have been focused on health insurance issues. ―If one-third of complaints are
from the health side, I will conclude that the nature of communication on health
insurance policies and the understanding of the policy by the consumer are areas of
concern. Probably, the lack of clarity is reflected in the increasing number of complaints,‖
IRDA chairman J Harinarayan said, adding that ―good communication is the
responsibility of the insurance company and not of the policy holder. An insurance
policy, as a contingent contract, has to be specific and unambiguous.‖ With a reach of just
about 2% of the country‘s 1.2 billion population, India offers a huge potential in health
insurance market. There are over 30 health insurance products in the category offered by
both life and non-life insurers. While ICICI Lombard, Bajaj Allianz and Reliance General
are some of the prominent general insurers in the health insurance space, Apollo DKV,
Star Health & Allied Insurance are the standalone players. Health insurance‘s annual
premium collections are over Rs 6,000crores. Despite the high growth, 15 the business is
a huge challenge for insurers because of the high losses over soaring medical expenses

13
(b) Introduction of health industry.

How many accident you need to realize that you need Health Cover? It takes just one
visit to a hospital to make us realize how vulnerable we are, every passing second. For
the rich as well as poor, male as well as female and young as well as old, being diagnosed
with an illness and having the need to be hospitalized can be a tough ordeal. Heart
problems, diabetes, stroke, renal failure, cancer – the list of lifestyle diseases just seem to
get longer and more common these days. Thankfully there are more speciality hospitals
and specialist doctors – but all that comes at a cost. The super rich can afford such costs,
but what about an average middle class person. For an illness that requires
hospitalization/ surgery, costs can easily run into five digit bills. A Health insurance
policy can cover such expenses to a large extent. Read why Health Insurance is more
important these days compared to Old days Health is a human right, which has also been
accepted in the constitution. Its accessibility and affordability has to be insured. While
the well-to-do segment of the population both in rural & urban areas have acceptability
and affordability towards medical care, at the same time cannot be said about the people
who belong to poor segment of the society.

It is well known that more than 75% of the population utilizes private sectors for medical
care unfortunately medical care becoming costlier day by day and it has become almost
out of reach of the poor people. Today there is need for injection of substantial resources
in the health sectors to ensure affordability of medical care to all. Health insurance is 9 an
important option, which needs to be considered by the policy makers and planners. As
mentioned earlier, the cost of Health Insurance depends on the sum assured, age, current
health condition and your previous medical history. Higher the sum assured, higher the
premium. So what is the ideal health insurance cover requirement? There is no standard
answer or thumb rule for this. If we agree that health insurance is important, one has to
look at his/ her own lifestyle, health condition, age/ life stage, family history of illnesses
and affordability. Keep in mind that most insurance companies limit the sum assured to a
maximum of 5lakhs. Also note that many health insurance policies provide additional
benefits‖ such as daily allowance, ambulance charges, etc. for hospitalization. Not only
are such ―benefits‖ superfluous, they tend to drive the premiums higher.

14
The concept of health insurance was proposed in 1694 by Hugh the Elder Chamberlin
from the Peter Chamberlin family. In the late 19th century, "accident insurance" began to
be available, which operated much like modern 10 disability insurance. This payment
model continued until the start of the 20th century in some jurisdictions (like California),
where all laws regulating health insurance actually referred to disability insurance.
Patients were expected topay all other health care costs out of their own pockets, under
what is known as the fee-for-service business model. During the middle to late 20th
century, traditional disability insurance evolved into modern health insurance programs.
Today, most comprehensive private health insurance programs cover the cost of routine,
preventive, and emergency health care procedures, and also most prescription drugs, but
this was not always the case. Insurance may be described as a social device to reduce or
eliminate risk of life and property. Under the plan of insurance, a large number of people
associate themselves by sharing risk, attached to individual insurance plan that
exclusively covers healthcare costs and is called Health Insurance.

Some major health insurance companies in India include National Insurance Company,
New India Assurance, United India Insurance, ICICI Lombard, Tata 11 AIG, Royal
Sundaram, Star Allied Health Insurance, HDFC standard life, Bajaj Allianz, Apollo
Munich health insurance company , AG Health Insurance Company, Cigna TTK health
insurance company, Max Buppa insurance company among others.

The best time to avail a health insurance plan is when the insured is still in a good
physical condition. The normal logic among young people is that since they are rarely
afflicted by physical ailments they do not need such a plan. In reality people can fall prey
to a disease or other physical problem at any time - nobody can be absolutely sure of a
life fully free of such issues. Normally as someone gets older the problems increase and
the possibilities of some major disease are always there. A problem with trying to get a
medical insurance during old age is that since there are more chances of a medical
condition the premium is often high or the insurer is not ready to cover the individual in
question.

15
2.1 Industry Overview.

Health Insurance was introduced in 1912 in India after India got its independence in 1947
the Government sponsored Health Insurance in India. Life Insurance was the antecedent
of Health Insurance. In 1948 the government brought a new scheme for private sectors
workers that are employees State Insurance Scheme (ESIS). In 1954 the government
brought another scheme for employees of Central Government the scheme was named as
Central Government Health Scheme CGHS. In 1986 the mediclaim was began by
government insurance company and in 1999 the health insurance in India began a new
era where the IRDA (Insurance regulatory and Development Authority) allowed the
participation of private and foreign companies.

The insurance industry consists of 57 insurance companies out of these 24 are in

life insurance sector and 33 are in non-life insurance sector. Among the 33 insurance
companies, 5 are private sector insurers who provides health, accidental, personal and
travel insurance. They are Star Health and Allied Insurance, Max Buppa Health
Insurance, Apollo Munich Health Insurance, Relegate Health Insurance and Cigna TTK
Health Insurance. Health insurance industry has increased growth by 24242 Cr. to 29633
Cr. from the year 2017 to Jan 2018, so making an increase by 22% in the year 2018.
Health insurance industry is gaining importance day by day. Among the BRICS nations
India pays second highest the out of expenses for health care. In India 31% and 47% of
hospital admissions in urban and rural respectively are either financed by loans or
through sale of assets. 70% of Indians fall under the poverty line owing to high medical
bills. Rising cost health care expenses is where we need health insurance in India.

A person who has health insurance need not worry about quality treatment because
quality treatment comes with a price. Insured person's all hospitalization or surgery
charges are taken care of by Health Insurance Company. Now-a-days technology is
playing an important role in India; Health Insurance Company provides cashless
facilities. Even the treatments done by ayurvedic and homeopath are covered by health

16
insurance which people are not much aware of. The health insurance companies give top-
up and deductible facility to customers who want additional health cover.

As there is an increasing awareness of health insurance in our country the chances of

the growth of the industry is more. Earlier people used to consider health insurance as
additional expense which is not required but today as increasing knowledge people are
realizing the importance and necessity of health insurance. The health insurance
companies are bringing lot of benefits and facilities as per customer's need which is also
increasing factor of growth of the industry. Technological innovations are another factor
helping the growth of health insurance industry. Availing different policies and plans for
all types of people is another reason for growth. In India 20-30% of young populations
who are below the age of 40 are suffering from heart diseases. Now the government
health care centers facilities are decreasing due to the lack of funds and people neglect
and are uncomfortable to take treatment from government hospitals unless they have no
money. This leads a common man to have health insurance now-a-days. Each and every
day the importance and growth of health insurance is increasing among the young people
in India.

17
2.2CURRENT SCENARIO :

India’s life insurance industry is poised for higher growth in 2018 aided by low
penetration and rising share of financial assets in household savings. The savings habits
of Indian households is evolving structurally amid a low-interest rate scenario, thereby
bringing to fore the need for life insurance both as a life risk mitigation tool as well as a
lucrative investment avenue for the common man. Over the years, life insurance has
become a more customer-friendly product helped by pragmatic regulations and
guidelines. The broad focus on agency expansion, banc assurance, digitalization and
government policies are expected to support the industry in 2018.The year began on an
exciting note, as the effect of demonetization ensured that private sector individual
annual premium equivalent (APE) grew stronger on the back of higher financial savings.
Year-to-date (up to November 30), the first-year premium of life insurers has grown by
16% y-o-y to `1.81 lakh cores, while the number of policies served has crossed 1.5 crore-
mark vs. 1.37 crore a year ago. On the regulatory front, norms on revised
commission/remuneration structure and introduction of reward system, guidelines on
insurance e-commerce and electronic issuance, guidelines related to information and
cyber security given the global trends, thought leadership on risk-based capital regime,
life insurance portability and investment norms have enriched the industry. With
insurance regulator IRDA mandating PAN/Form 60 and Andhra linkage compulsory for
existing and new insurance policies, a slew of benefits for customers and stakeholders are
waiting to be reaped in the days to come. The linkage of Aadhaar with insurance plans
will prove to be beneficial, especially during claims settlement for establishing the unique
identity of the claimant. This will also weed out fraudulent claims and boost the speed of
settlement, therefore offering a better customer experience.

As 2018 unfolds, the life insurance industry is expected to forge a deeper connection with
customers and scale new highs in terms of customer engagement and servicing.
Technology will play a massive role in this, as life insurers’ dive deeper into product and
operating process innovation. Customization of the exact need-based product offering
will be the guiding principle under broader goal-based financial planning, instead of the
one-size-fits-all approach. Chat bots, e-insurance, artificial intelligence and analytics-

18
 driven products will become mainstream, as the ongoing digitalization drive picks up
more pace. The 2018-19 Budget will be important for the life insurance industry. Life
insurance should be given a separate tax exemption limit as in many Asian countries, and
not lumped with others in Section 80C to ensure more customer incentive for committing
to long-term savings, Health insurance already has a separate slab to its credit and having
a dedicated one for life insurance would facilitate long-term protection for every Indian.

2.3 Future Trends.

Every pillar of the “health” umbrella is now acknowledging the importance of

innovation, and more than ever we are seeing the prioritization of streamlined processes
through digital platforms. Startups are expected to bring innovation while refurbish the
sector by combining technologies. This is based on Indian market position, thereby
providing services to some of the rapidly growing companies in the healthcare industry.
Here are some of the emerging trends that talks about how digitization and transparency
are important for healthcare ecosystem.

1. Digital Health Interventions:

This is one of the broader categories within digital health .The idea of using digital
interventions to monitor and improve everything from sleep patterns to patient treatment.
The goal with digital interventions is to improve patient outcomes and empower people
to fix problems that are either chronic or acute. Insurance companies, in particular, are
realizing that there is value here because they can improve success rates for treatments
and reduce the amount of patient readmissions. The venture arms of insurers such as
Humana and Kaiser Permanente have made significant investments in this arena.
However, since this is also a fairly broad category, it should be noted that the results of
the studies related to digital interventions tend to be somewhat inflated.

2. Benefits of Electronic Health Record:

19
Our healthcare providers should pay attention to Electronic Health Record (EHR) to offer
reliable access to patient's complete healthcare information to diagnose the problem at an
early stage. These electronic health records give information such as new medication and
notify healthcare providers about any life-threatening or upcoming disease. With this, the
providers can make changes in the treatment as per the disease to avoid any serious
consequences for patients and provide better results in the treatment. It also helps to
quickly access and looks into the problem areas and correct operational problems.

3. Wearable devices:

The other technology that has come up is wearable medical devices that collect data
anytime and anywhere. They are sensor based accessories that are designed to help
people become active, eat well, sleep better, etc. These fitness or wearable devices are
available in several forms like watches, footwear, chest straps and sensible glasses, area
expected to grow within the coming years. It will manage patient's heart rate, blood
pressure and blood sugar levels to name a few. It will also prevent and maintain their life
as well as reduce trips to the doctor and save money. In the coming years, the new
technologies will redesign patient's experiences and will start using their experiences to
differentiate markets.

4. The Need for Transparency in Healthcare:

The need for transparency has become the most vital component in the healthcare
industry. Patients must avail their rights to the prescribed treatment, medical records and
history. Transparency in healthcare will drive positive patient outcomes and greater
satisfaction. The patients can provide their identifications like Adhere number to check
information online such as prescribed medicines, tests and doctor's information all at one
place from anywhere. They can also contact doctors and physicians through video call to
ensure that the correct procedures are carried out.

20
5. Artificial Intelligence and Cloud:

The adoption of artificial intelligence is on the rise, making the healthcare ecosystem
more organized. AI will help in solving many problems of the patients, doctors, hospitals
as well as the overall healthcare industry. Earlier, patients didn't have appropriate
information about the right doctor, hospital or the treatment. Now, with the help of AI-
based applications, people can directly talk to doctors, physician, and expertise for the
best treatment. Moreover, patients accustomed their medical record files every time,
however, with the introduction of electronic medical records system they can access data
anytime. The medical billing system, on the other hand, will help in making data
streamlined and structured. It is expected that by 2020, around 20 percent of healthcare
and 40 percent of science organizations will achieve productivity through the adoptions
of AI technology between 15 percent and 20 percent.

21
 Chapter 3: Introdcution to the Company

(i) CignaTTK Health Insurance Company Limited

3.1 Organization profile.

Cigna TTK is joint venture Company between Cigna and TTK group. Cigna TTK
provides health insurance service in India. It is one of the standalone companies among
health insurance companies in India. Cigna is a US based global healthcare service
provider; they provide medical, dental, life, disability and accident insurance while TTK
group is a Indian conglomerate. Cigna has Rs. 110 million customers worldwide and is
ranked as 78 in fortune 500 in the year 2017. David Cordani is the CEO of the company.
Cigna has more than 200 years of experience in the health service industry. TTK has
74%of the joint venture as per Indian Regulations. TTK group has Rs 22 billion Indian
business groups. Prestige Cookware is one of the famous brands of TTK. It has 86 years
of experience in Indian market. TTK has more than 6 laks customers.

Cigna TTK is growing at the rate of 54.24% as compared to its competitors in the last 3
years. Cigna TTK grew at 59% in sales for the FY 2017-18. The bench mark for claim
settlement ratio of standalone health insurance Company is 78-82%.The CEO of Cigna
TTK is Mr. Sandeep Patil. Cigna TTK provides the claim settlement ratio of 88% in the
year 2016-2017 which is above the bench mark. Cigna TTK has offices in different
places such as Ahmadabad, Bangalore, Chandigarh, Chennai, Cochin, Coimbatore, Delhi,
Hyderabad, Kolkata, Mumbai and Pune. Cigna TTK was awarded by economic times for
best promising brand in India. Preheat is the major product of the company. They also
have products such as critical care and accident care for individuals and family. Cigna
TTK also introduced a special product that is Cigna global health product for the
employees who travel to different countries. They have lot of products in health insurance
service and it is designed to meet the customer needs. The insurance covers all the
charges of hospitalization. Their family plan covers up to 7 members in a family which
consist of 2 adults and 5 children. Cigna TTK provides lots of benefits, features and

22
facilities like the additional feature of top-up and deductible facility, health check-up
between every 3 years for insurance holders. It also provides plans for individuals who
have pre-existing diseases. Cigna TTK has a network of more than 4000 hospitals.

3.2 Organizational Structure

Presume Skidder (MD & CEO)

Prasun brings more than 22 years of leadership
experience in financial services and deep insurance
knowledge to Cigna TTK. Before joining Cigna TTK,
Prasun was Group President and Global Head at Yes
Bank, where he managed and grew key banc assurance and mutual fund alliances and
partnerships. Prior to this he was a founding member and Senior General Manager –
Chief Sales & Distribution at ICICI Prudential Life Insurance. During his 17 years with
ICICI Prudential Life Insurance, he worked across several portfolios including
Operations & Underwriting, Banc assurance, Agency, Alternate Distribution, Health
Business and Sales Strategy. Before ICICI Prudential Life, he has been associated with
GE Capital (SBI Cards) and Citicorp.

Manoj Naik (Chief Finance Officer)

Manoj brings to Cigna TTK over 25+ years of experience

primarily in Financial Services serving GE Capital &
Fullerton Securities across India, Europe and Taiwan – of
this, 13+ years have been as a CFO. His diverse Treasury &
Retail Finance exposure brings international best practices to Cigna TTK. Manoj will
spearhead Finance & Treasury functions at Cigna TTK. Manoj is a postgraduate in
Management from the Indian Institute of Management, Bangalore. He has also completed

23
his Accredited Coach Training Program (ACTP) with International Coach Federation.

JYOTI PUNJA (Chief Customer Officer)

Jyoti Punja is Chief Customer Officer at Cigna TTK

Health Insurance. She’s been associated with reputed
insurance companies for almost two decades and knows
the nuances that come in the field. She brings with her
experience and in depth knowledge of the insurance industry from her previous senior
leadership positions in companies like LIC of India, Birla Sun Life Insurance and Bharti
AXA. To add to her knowledge, she holds dual Bachelor ’s degrees in both Science and
Lawfrom Mumbai University.

REENA TYAGI (Head - Human Resources)

Cigna TTK Health Insurance is in the hands of a strong
Human Resources leader. Reena Tyagi, the Head of
Human Resources department in Cigna TTK Health
Insurance has been a front-runner in the field of Human
Resources since 1993. She is capable of shaping and grooming acquired talent and
existing employees into future leaders due to her experience with top notch companies.
Having completed her MBA from University of Indore, she has since acquired ample
work experience and understanding of the field by working for high profile companies
such as NIIT, Tata Teleservices Ltd, ABN AMBRO and Bharti Airtel Ltd. As Cigna TTK
Health Insurance’s Head of Human Resources, you can expect only the best from her!

24
3.3 Product
Pro Health Accumulate Plan. Of CIGNA TTK

What is the Plan all About?

These plans aim at securing your health today and grow your reserves for tomorrow to
combat rising medical costs. Pro Health Accumulate Plan provides a higher insurance
coverage upto 25 lacs offering a bundle benefits ranging from in-hospital to home care.
This plan also caters to your smaller expenses towards consultation, diagnostic tests,
pharmacy charges and other outpatient expenses through Health Maintenance Benefit.

Key Features :

1. Avail a “Personal Health Wallet” that grows every year, even if you claim

2. Up to 10% discount on renewal for staying healthy

3. Of benefits with Protective Healing and Proactive Living

4. Covers non allopathic treatment as well

Policy Benefits :

1. The plan will offer the coverage for ambulance expenses up to Rs 2000 in case of
hospitalization.

2. Health check-up once every 3 years for all insured above 18 years.

3. No Claim Bonus offered, which increase the sum insured by 5% for each claim free
year upto a maximum of 100%.

4. This plan offers reward points equal to 1% of premium paid each year. In addition, you
can accumulate points by opting for our online wellness programs maximum upto 10% of
premium paid in the policy.

25
5. Critical Illness benefit and cumulative bonus booster can be opted as an add on to the
policy.

6. Avail tax benefits u/s 80D as per IT Act, 1961 for premium paid for this plan.

Sub Limits:

1. The hospital room sublimit is limited to a single private room under this plan.

2. Mandatory 10% or 20% Co Pay under this plan, if the insured is 65 years and above.

Waiting Period Clause:

1. Initial Waiting Period: 30 days waiting period is applicable from the policy inception
date apart from claims due to accidental hospitalization.

2. Specific Waiting Period: Two Years Waiting Period will be applicable for specific
illnesses.

3. Pre existing Disease Waiting Period: Any pre-existing ailment/injury that was
diagnosed /acquired within 4 years from the issuance of the first policy.

4. Critical Illness Add on Waiting Period: A waiting period of 90 days starting from
inception and 30 day survival period will also apply to get a claim under this add on.

26
Who Can Buy The Plan ?

Factor Minimum Maximum

Age (as
on last Adult - 18 Years, Child - 91 Days No Limit
birthday)

Sum
5.5 Lacks 25 Lacks
Assured

Cover
Individual/Family Floater -
Type

Policy
1 Years 3 Years
Tenure

Grace
30 Days -
Period

Free
Look 15 Days -
Period

Riders Critical Illness -

27
Exclusions:

1. Expenses attributable to self inflicted injury

2. Medical treatment expenses for treating AIDS

3. Childbirth related expenses

4. Convalescence/Recuperating Benefits

5. Genetic disorders, etc.

(ii) Apollo health insurance Co Ltd:

History of Apollo Munich

Apollo Munich’s History

Apollo Munich Health Insurance Company Limited was previously known as Apollo
DKV Insurance Company Limited. The company started as a joint venture between
Apollo Group of Hospitals and DKV AG, Europe's largest private health insurer
(Deutsche Krankenversicherung AG) on the 8th of August, 2007. Apollo DKV started on
a journey to re-define the health insurance sector in India. The stake holding of the two
companies were in the ratio of 74:26 (Apollo Group of Hospitals—DKV AG).

About the promoters:

DKV, with its headquarters in Cologne, Germany, was the market leader in Europe and
one of the top 5 health insurance providers in the world. The company was represented
across Europe and Asia. Since DKV was a part of the ERGO Group, it was a part of
Munich Re Group, one of the world’s largest re-insurers.

Apollo Group of Hospitals is the largest healthcare provider in Asia. The group changed
the way healthcare was perceived in the nation. Apollo Hospitals brought many modern
medical techniques which were previously not available in the country. This gave Indians
the chance to get world-class treatment without having to leave the country.

28
Branding and Positioning of Apollo DKV:

Apollo DKV changed the focus of the market and customers from ‘curative’ to
‘preventive’ healthcare. The brand identity of Apollo DKV, in the form of the joyful and
healthy man, depicted the innovative stand of the company. Since Apollo DKV started on
the journey with the prime aim of helping people stay healthy regardless of medical care
expenses, the ‘Happy Man’ also illustrated the company’s ‘Let’s Stay Healthy’
philosophy.

Apollo DKV was the only health insurance provider in the country that was backed by an
integrated healthcare group and one of the largest pure health insurance providers in the
international market. The mission of the company was to constantly provide customers
with innovative healthcare solutions to meet their healthcare needs.

Products launched by Apollo DKV:

Apollo DKV launched a number of health insurance products, which are till date, among
the best medical insurance policies in the nation. The plans launched by Apollo DKV
were:

 Easy Health Individual Health Insurance Plan

 Easy Health Family Health Insurance Plan
 Insure Health
 Maxima
 Easy Travel Insurance Plan
 Personal Accident Insurance Plan

Apollo DKV to Apollo Munich:

In December 2009, Apollo DKV was renamed as Apollo Munich Health Insurance. The
company continues to bring out innovative products. Apollo Munich offers a large
number of customer care services to help people stay healthy and fit always. The journey
of uncomplicating health insurance in the country has just begun and has a long way to
go.

29
3.1 Organization profile.

Overview

Company Overview
Apollo Hospitals is widely recognized as the pioneer of private healthcare in India, and
was the country’s first corporate hospital. The Apollo Hospitals Group, which started as a
150-bed hospital and today, operates 9200 beds across 64 hospitals. A forerunner in
integrated healthcare, Apollo has a robust presence across the healthcare spectrum. The
Group has emerged as the foremost integrated healthcare provider in Asia, with mature
group companies that specialize in insurance, pharmacy, consultancy, clinics and many
such key touch points of the ecosystem. The Apollo Group has touched the lives of over
45 million patients, from 121 countries.

Genesis
The first Apollo Hospital opened in Chennai, in 1983. It was borne out of the
determination to lead a complete transformation in Indian healthcare. Apollo’s Founder
Chairman, Dr. Prathap C Reddy was the driving force behind the inception. Credited as
the architect of modern Indian healthcare, Dr. Prather C Reddy started Apollo with the
mission of bringing world-class healthcare to India, at a price point that Indians could
afford! The backdrop to this development was the hopelessly inadequate healthcare
infrastructure prevalent in India, at that time.

Game-changer
Apollo’s first innovation was its business model itself; before Apollo, only the very
privileged had the access to quality treatment, as they could afford to travel abroad.
Apollo introduced healthcare that matched best-in-class outcomes, but cost only a
fraction of the global prices. This led to a revolution with democratized treatment in our
nation. This cost consciousness continues to be a key building block in our healthcare
strategy.

Clinical Excellence
This is not the only constant in the Apollo story. The Group is built on the bedrock of an
enduring value system, and continues to drive unwavering focus on key touchstones like
excellence, expertise, empathy and innovation.

Over the past three decades Apollo Hospitals’ transformative journey has forged a legacy
of excellence in Indian healthcare. The Group has continuously set the agenda and led by
example in the blossoming private healthcare space. One of Apollo’s significant

30
contributions has been the adoption of clinical excellence as an industry standard. Apollo
pioneered the concept – the group was the first to invest in the pre-requisites that led to
international quality accreditation like JCI and also developed centres of excellence in
Cardiac Sciences, Orthopaedics, Neurosciences, Emergency Care, Cancer and Organ
Transplantation.

Apollo’s prowess in excellence comes from the habit to rigorously re-evaluate and
reinvent. Protocols are built, taken apart and built again to ensure that infection control
are optimized to extreme levels; stringent internal scoring systems are constructed with
the sole objective of ensuring the group matches up with the very best. Apollo’s
initiatives like ACE@25 and TASSC are indicators of the commitment to better global
benchmarks in clinical excellence.

This focus on quality has become one of the group’s strongest credentials. It is the one of
the building blocks in the trust the Apollo brand name commands.

Strong value system

Along with excellence the Apollo philosophy rests on the pillars of technological
superiority, a warm patient- centric approach, and a edge in forward-looking research.
Apollo’s spectacular success rests on sustained commitment and investments in each of
these pillars.

Technology driven
At Apollo, healthcare systems leverage technology to build integrated healthcare delivery
models, which facilitate seamless electronic medical records, Hospital Information
systems and telemedicine-based health outreach initiatives, for enhanced access to
medical care. Another critical manifestation of widespread technology has been the
amazing advancement in medical equipment and Apollo has repeatedly pioneered the
introduction of such innovations in India. The future promises with revolutionary new
products like the Proton Beam Therapy. From leveraging new age mobility, to getting
futuristic equipment Apollo has always been ahead of the curve. Currently, the group
believes in the tremendous potential of robotics and is investing heavily in making it a
real and robust option for all.

TLC
Apollo pioneered Tender Loving Care (TLC) and it continues to be the magic that
inspires hope, warmth and a sense of ease in the patients. Processes are relentlessly
improved upon to ensure maximum patient-centricity.

31
Road ahead
Apollo Hospitals has taken the spirit of leadership well beyond business metrics. It has
embraced the onus of keeping India, healthy. Taking cognizance of the undeniable fact
that India is reeling under the onslaught of Non Communicable Diseases (NCD), the
Apollo Group has assumed the responsibility to educate, influence mindset. Increased
focus on tactical initiatives like personalized preventive healthcare bears testimony to this
new thrust. The Group has declared war on NCDs, and is leading the entire healthcare
fraternity into this battle.

across the nation. The Group actively leverages its telemedicine and Health capabilities
to take its screening programmers to even remote corners of the country.

Apollo’s remarkable story has captured India’s attention. For its service to the nation, the
Group was felicitated with the honor of a commemorative postage stamp bearing its
name. For his untiring pursuit of excellence in healthcare, Dr. Prather C Reddy, was
bestowed with the second highest civilian award, the ‘Padma Vibhushan’, by the
Government of India.

Recently Apollo Hospitals celebrated its 30th year. The Group, led by Dr. Prathap Reddy,
reaffirmed its goals and redefined their focus. With ambitious projects like Apollo Reach
Hospitals, a strong focus on preventive healthcare and an unabated commitment to
nurture excellence and expertise in healthcare, Apollo Hospitals envisions for a new
horizon – a future where the nation is healthy, where its people are fighting fit, and India
emerges as the preferred global healthcare destination.

 become the largest and most preferred health Insurance Company in India.
 To provide financial security for health care management.

Our Mission:

 To offer wide range of innovative Products / Services.

 To provide prompt, courteous and quality service to customers.
 To adopt best management practices in business operations.

32
Our Commitment:

 Make available insurance coverage to every segment of population.

 Expand product lines and services on continuing basis.
 Build and maintain enduring relationships with customers.
 Conduct business operations with customer as focal point.
 Create insurance awareness as part of corporate social responsibility.

 Cover for maternity (normal and caesarean delivery) and New born baby.
 Automatic restoration of entire Sum insured by 100%.
 Dental / ophthalmic cover on OPD basis.
 Hospital cash benefit.
 Cover for over 400 day care procedures.
 Personal accident cover against Death and Permanent total disablement (equal to the
Health Insurance cover) at no additional cost.
 100% Increase in Sum Insured upon a claim free renewal.

Eligibility

 Persons between 18 years and 65 years of age at the time of entry can take this
Insurance. Dependent children can be covered from 3 months and up to 25years of
age. There is no upper age limit for continuous renewals.
 This policy is both on Individual basis and on Family Floater basis. Family for the
purpose of this policy means self, spouse and dependent children.

33
(iii) SWOT ANALYSIS OF CIGNA TTK CO.

STRENGTHS:

• Cigna TTK is a Joint Venture of U.S. based co. Cigna & India's most reputed brand
TTK group. Hence it is a very famous and a reputed Co.

• The organization believes in quality over quantity.

• The features of the products are very good as compared to the premium.
• Industry is on the boom so there is chance of growth of the company.

WEAKNESS:

• Promotion of Cigna TTK is not done properly because of which many people are not
aware about the co.

• The organization is new in the market.

• The market share of the company is very low currently it has to grow.

OPPORTUNITIES:

• India is a very vast market and in which only 5% of the population has health
insurance. Hence the company has a larger scope to expand its business in Indian
market.

• The organization’s market potential is very high.

• Now a day’s government is supporting the health insurance.
• The government has encouraged the FDI so the rules have been softened.

THREATS:

• Competitors are in a very large number. Co. has to come up with something different
to survive in the competitive market.

• Lack of awareness among the people about the company is also one of the biggest
threat. Co. should invest a lot on promotional activities.

• Co. should try to educate people about how important it is to have a health insurance.
Low literacy level can become a threat soon.

34
 Chapter 4 : Research Methodology

This study is based on comparative analysis between Cigna TTK Health Insurance Co.&
Apollo health Insurance Co. The study is also been carried out to know the level of
awareness of health insurance among the people. The data has been compiled in the
following ways. They are:

(a) Primary data: Primary research involves the collection of original primary data. It is
often undertaken after researchers have gained some insight into an issue by
reviewing secondary research or by analyzing previously collected primary data. It can be
accomplished through various methods including questionnaires market research,
or experiments.

(b) Secondary data: It is secondary in nature i.e. already collected information. this can
be collected through company's Annual Report & interpretation of

1. Balance Sheet
2. Profit & Loss A/C
3. Annual reports.

(i) Research design

A Research design is purely and simply the framework of plan for a study that guides the
collection and analysis of data. The study is intended to find the level of awareness of
health insurance among the people and to analyze the ratios and comparison of different
companies. The study design is descriptive in nature.

(ii) Type Of Research

Descriptive Research:
As per the Objective defines that this Research will map the comparison of two
companies. Also it analyses the awareness among the customers & analysis financial
position of Cigna TTK health insurance co. Thus, this research can be termed as a
Descriptive type of research. It is the simplest type of research and is more specific.

35
(iii) Data Collection tools :From Questionnaire

(a) Sampling unit

Sampling may be defined as the selection of some part of an aggregate or totality on the
basis of which a judgment or inference is made about the aggregate or totality. It is the
process of obtaining information about an entire population by examining a part of it.

(b) Sample Size:

The size of the sample for the study is 81.

36
 Chapter 5: Data analysis & interpretation:-

A. PRIMARY DATA

B. SECONDARY DATA

Primary Data:

Interpretations: the above pie chart shows that the maximum no .of age is 20-30

Interpretations: The above pie chart shows students are more no. of having insurance.

37
 Interpretation: the above pie chart shows maximum no. of annual income is 200000

Interpretations: the above pie chart shows that the maximum no. of people are aware
about health insurance.

38
Interpretation: - People are aware about health insurance of various companies. People buys
insurance of those companies who gives better services and also product with best features .

Interpretation: most of the peoples are think health insurance is extremely important.

39
 Interpretation : People prefer having a family floater and indivisual so that they have
health insurance policy.

Interpretation : People prefer having a family floater so that they can secure their entire
family.

40
 Interpretation: most of the peopels having below 10000 annual premium.

Interpretation: - People have health insurance of various companies. People buys insurance
of those companies who gives better services and also product with best features.

41
Interpretation : Sum insured depends upon the peoples choice. Sum insured also depends upon
the number of people in one family. From the above graph we can say that maximum sum
insured ranges from below 200000..

42
Interpretations: to cover medical emergencies is one of the reason of to purchased health
insurance policy.

Interpretation: most of the peoples are satisfied with company features and benefits

43
 Interpretation: not every time.

Interpretations: not maximum no of peoples are facing any issue during medical emergency.

44
 Interpretation: most of the peoples are agreeing.

Interpretation: for other reason peoples are not having health insurance.

45
SECONDARY DATA

5.1: Ratio:

Meaning of Ratio:- A ratio is simple arithmetical expression of the relationship of one

number to another. It may be defined as the indicated quotient of two mathematical
expressions.
According to Accountant’s Handbook by Wixom, Kill and Bedford, “a ratio is an
expression of the quantitative relationship between two numbers”.

Ratio Analysis:- Ratio analysis is the process of determining and presenting the
relationship of items and group of items in the statements. According to Batty J.
Management Accounting “Ratio can assist management in its basic functions of
forecasting, planning coordination, control and communication”.
It is helpful to know about the liquidity, solvency, capital structure and profitability of an
organization. It is helpful tool to aid in applying judgement, otherwise complex
situations.

CLASSIFICATION OF RATIO :

Ratio may be classified into the four categories as follows:

A. Liquidity Ratio

a. Current Ratio

b. Quick Ratio or Acid Test Ratio

B. Leverage or Capital Structure Ratio

a. Debt Equity Ratio

b. Proprietary Ratio

46
C. Activity Ratio or Turnover Ratio

f. Fixed Assets Turnover Ratio

g. Working Capital Turnover Ratio

D. Profitability Ratio or Income Ratio

(A) Profitability Ratio based on Sales:

a. Gross Profit Ratio

b. Net Profit Ratio

c. Operating Ratio

47
(E) Annual Statements (includes Profit & Loss A/C, Revenue Statement, Balance
Sheet)

(i) Of Cigna TTK Co.

48
49
50
Ratios:

Sr. No.: Cigna TTK Health Insurance Co. Apollo Health Insurance CO.
2017 - 2018 2016 - 2017 2017 - 2018 2016 - 2017
1. Net
Working 854,633 -
Capital = 516,568 - 899,172 2,22,245- 212922-
1,202,008
Current = - 382604 1,58719=5480003 95526=4221671
Assets - = - 347375
Current
Liabilities
2. Current
Ratio = 854,633 / 516,568 /
Current 1,202,008 899,172 2,22,245/1,68,719 2,12,922/95,526=
Assets / = 0.71 : 1 = 0.57 : 1 =1.31:1
Current 2.23:1
Liabilities
3. Quick
Ratio = 729649 /
363475 / 899,172 37,784/168719= 50,452/95526=
Quick 1,202,008
Assets / = 0.40 : 1
= 0.60 : 1
Current 0.22:1 0.52:1
Liabilities
4. Asset
turnover
ratio = Net 26,61,391/ 18,17,686/ 8,24,347/8,36594 7,11,439/836594=
sales/ 37,85,731 = 0.70 28,85,578 = 0.63 =0.98
Average 0.85
Total
Asset
5. Proprietar
y Ratio = 36,47,258 / 25,13,651
Sharehold 338,398/861260* 3,43,777/811929*
42,78,225 *100= /32,93,236 *100=
er's Funds 100= 100=42.34
/ Total 85.25 76.32
Assets * 39.29
100

51
6. Fixed
Assets 2,661,391 / 1,817,686 /
8,24,347/50,8306 7,114,39/4,931,08
Turnover
Ratio = 68,101 16,616 =1.62 =1.44
Sales / = 39.08 = 109.39
Fixed
Assets

7. Debt to
asset =
6,22,862/8,61,260 4,88,152/8,11,929
Total 28,61,245 / 19,60,384 /
Liability / =0.72 =0.60
42,78,225= 0.67 32,93,236 = 0.59
Total
Asset

8. Return on
(1,049,476) / 1,350,537 / 8,27,562/2,85,69* 713688/3003*100
Investment
= Gross 4278225 32,93,236 =2370
100=2896
Profit /
Total = - 0.24 = - 0.41
Assets

9. Gross
Profit (1,049,476) / (1,350,537) / 5,956/8,243,44*1 13112/711439*10
Margin = 2,661,391* 100= 1,817,686 *100= 00=0.72 0=1.84
Gross - 40.48 - 75.41
Profit /
Sales*100

10. Operating
Profit (10,65,896) / (1,310,166) / 5956/824347*100 13112/711439*10
Margin = 2,661,391 * 100= 1,817,686 *100= =0.72 0=1.84
Operating – 40.05 - 72.07
Profit /
Sales*100

52
11. Net Profit (1,049,476) / (1,350,537) /
Margin = 5956/824347*100 13112/711439*10
2,661,391 * 100= 1,817,686 *100= =0.72 0=1.84
Net Profit
After Tax / - 39.43 -74.29
Sales*100

12. Return on
Equity = (1,049,476)/ (1,350,537) / 827562/338398*1 713688/34377*10
Net
36,47,258 * 100 = 25,13,651 *100 = 00=244.5 =207.6
Income /
total - 28.77 - 53.72
shareholde
r’s Equity

Interpretation:-

About Cigna TTK Co. and Apollo Co. :

Net working capital:

In Cigna ttk 2017 the firm’s ability to cover its net working capital of -382604 in Apollo
2017 its net working ratio it was 4221671 this tells that Apollo is improving. in 2018
Cigna ttk it was -347375 and Apollo it was 548000 this tells that this year also Apollo is
improving.

Current ratio:

In Cigna ttk 2017 the firm's ability to cover its current liabilities with its current assets
was 0.57.in Apollo 2017 the firm’s ability to cover its current liabilities with its current
assets was 2.23.as the definition says that higher the ratio, greater the liability of firms to
pay its bills. in 2018 Cigna ttk firms ability to cover its current liability with its current
asset was 0.71 and. in Apollo 2018 the firm’s ability to cover its current liability with its
current asset was 1.31 this that Apollo that Cigna ttk is improving their liquidity
efficiency. Because the current ratio is improving.

53
Quick Ratio:

According to the definition of quick asset ratio, In Cigna ttk 2017 the firm's ability to
cover its quick assests and current liabilities with its quick ratio of 0.40,in Apollo 2017 its
quick ratio it was 0.52.this tells that Apollo is improving in 2018 Cigna ttk it was 0.60
and Apollo it was 0.22 this tells that Cigna ttk is improving.

Assets turnover ratio:

In Cigna ttk 2017 the firm’s ability to cover assets turnover ratio of 0.63 in Apollo 2017
its ratio was 0.85 this tells that Apollo Munich is improving. in 2018 cigna ttk it was 0.70
and Apollo it was 0.98 this tells that Apollo this year also improving.

Proprietor ratio:

In Cigna ttk 2017 the firm’s ability to cover proprietor ratio of 76.32 in Apollo 2017 its
ratio was 42.34 this tells that Cigna ttk is improving in 2018 Cigna ttk it was 85.25 and
Apollo it was 39.29 this tells that Cigna ttk this year also improving.

Fixed assets turnover ratio:

In Cigna ttk 2017 the firm’s ability to cover fixed asserts turnover ratio of 109.39 in
Apollo 2017 its ratio was 1.44 this tells that Cigna ttk was improving. In 2018 Cigna ttk
its was 39.08 and Apollo it was 1.62 this tells that Cigna ttk was improving.

Debt to assets :

In Cigna ttk 2017 the firm’s ability to cover debt to assets ratio of 0.59 in Apollo 2017 its
ratio of 0.59 in Apollo 2017 its ratio was 0.60 this tells that Apollo is improving in 2018
Cigna ttk it was 0.67 and Apollo it was 0.72 this tells that Apollo was improving.

54
Return on investment ;

In Cigna ttk 2017 the firm’s ability to cover return on investment ratio of 410 in Apollo
2017 its ratio was 2370 this tells that Apollo is improving. In 2018 Cigna ttk it was 240
and Apollo 2796 this tells that this year also Apollo is improving.

Gross profit margin :

In Cigna ttk 2017 the firm’s ability to cover return on gross profit margin of 75.41 in
Apollo 1.84 this tells that Cigna ttk is improving .in 2018 Cigna ttk it was 40.48 and
Apollo 1.84 this tells that this year also Cigna improving.

Operating profit margin :

In Cigna ttk 2017 the firm’s ability to cover operating profit margin of 72.07.in Apollo
1.84 this tells that Cigna ttk is improving. in 2018 Cigna ttk it was -40.05 and Apollo
0.72 this tells that this year also Cigna ttk is improving.

Net profit margin :

In Cigna ttk 2017 the firm’s ability to net profit margin of 74.29 in Apollo 1.84. This tells
that Cigna ttk is improving. in 2018 Cigna ttk it was 39.43 and Apollo 0.72 this year also
Cigna ttk is improving.

Return on equity:

In Cigna ttk 2017 the firm’s ability to return on equity of 53.72 in Apollo 207.6.this tells
that Apollo is improving in 2018 Cigna ttk it was -28.72 and Apollo 244.5 this tells that
this year also Apollo is improving.

55
 Chapter 6:
Conclusion and suggestions:

Health coverage to all should be the motto off the health insurance sector. There should
be easy access to healthcare facilities and cost control measures should be in place.
Health insurance is going to develop more in the current liberal economic scenario. but a
completely unregulated or very less regulated health insurance sector may concentrate
only on those who have the ability to pay for the insurance cover. So, the challenge is in
helping the benefits percolate to the economically weaker sections of the populations.
Transparent and accountable government and non-government participation should be
encouraged. Developing and marketing social health insurance schemes through
comparatives and rural association would go along way in benefiting the vast
unorganized employment sectors currently neglected under the existing schemes. Also a
thorough revamp of scheme like ESIS and CGHS in necessary for them to be more
purposeful and efficient.

6.2 Suggestion & Recommendations:

1. I would like to recommend the company to make a lot of advertisement and arrange an
awareness campaign so that many people come to know about the insurance and buy it.

2. The company should advertise because people will know about the company and start
trusting it and it would be less difficult in the part of the agent or the employee to make
the people understand the creditability of the company.

3. The company should invite more and more agents and advisors to join hands with the
company and make the best possible use of the policy and make them understand that
each and every feature should be explained to the customers.

4. The company should keep a track record of the agents who sells the policy and keep a
regular update on it.

56
 Chapter 7: Learning Experience from the project.

I learned many things while doing my project that includes -

 Importance of a salesman in an organization

 Comparing the company's ratios with the help of revenue a/c, profit & loss statement
and balance sheet.
 Making people aware about the health insurance and product offered by Cigna TTK.
 Convincing the people and making them realize how important it is to buy the health
insurance.
 Conducting a survey and the interpretations of survey..
 Importance of customer satisfaction..
 Lastly, nothing is simple, we need to work hard.

57
 Annexure

QUESTIONAIRE:

Survey Regarding Health Insurance

Q. Name

Q. Age

a. Below 20
b. 20-30
c. 31-40
d. 41-50
e. Above 50

Q. Occupation

a. Students
b. Service
c. Business
d. Profession
e. Retired

Q. Annual Income

a. Less than 200000

b. 200000-500000
c. 500000-1000000
d. 1000000 & above

Q, Are you aware about health insurance?

a. Yes
b. No

58
Q. Which health insurance company are you aware of ?

a. Star heath and allied insurance

b. Apollo Munich
c. Aditya Birla health insurance
d. Cigna ttk
e. Other

Q. How important do you think health insurance is?

a. Somewhat important
b. Neutral
c. Somewhat unimportant
d. Extremely unimportant

Q. Do you have health insurance policy?

a. YES
b. NO

Q. Which type of health insurance do you have?

a. Individual plan
b. Corporate plan
c. Family floater plan

Q. How much is your annual premium?

a. 0-10000
b. 10000-20000
c. 20000-30000
d. 50000 & above

Q. Which company’s health policy do you have?

a. Star heath and allied insurance

b. New india assurance
c. Cigna ttk
d. Apollo Munich
e. Other

59
Q. What is the sum insured in your policy?

a. Below-200000

b. 200000-500000

c. 500000-1000000

d. 1000000 & above

Q. What influenced you to purchase health insurance premium?

a. To cover medical emergencies

b. Tax benefits
c. Parents purchase for you
d. Friends, family suggested
e. other

Q .Are you satisfied with you company features and benefits of insurance policy?

a. YES
b. NO
c. Don’t know about features and benefits

Q. Do you claim health insurance any time?

a. YES

b. NO

Q. If yes, did you face any kind of issue related to claim during emergency?

a. YES

b. NO

60
Q. Are you satisfied with you company features and benefits of your health insurance
policy?

a. YES

b. NO

c. Don’t know about features and benefits?

Q. Do you claim health insurance any time?

a. YES

b. NO

Q. If yes, did you face kind of issue related to claim during medical emergency?

a. YES

b. NO

Q. Did the company not currently not have health insurance?

a. Employees does not pay for insurance

b. insurance company refused coverage for health reason

c. dissatisfied with previous insurance plan or provider

d. other

61
 Chapter 8: BIBILOGRAPHY

https://www.businesstoday.in/opinion/columns/trends-healthcare-industry-
healthcare-sectors-artificial-intelligence/story/267321.html

https://www.forbes.com/sites/quora/2017/09/29/4-trends-in-digital-health-
to-keep-an-eye-on-in-2018/#6423e7e064ac

https://www.ibef.org/industry/insurance-sector-india.aspx

https://www.policybazaar.com/health-insurance/individual-health-
insurance/articles/best-health-insurance-plans-in-india/

https://www.financialexpress.com/industry/life-insurance-in-2018-this-is-
what-will-support-the-industry-in-new-year/997975/
https://www.cignattkinsurance.in/sites/default/files/disclosures/Annual%20R
eport_2016-17.pdf

https://www.cignattkinsurance.in/sites/default/files/disclosures/Public%20Di
sclosure%20Q4%202017-18.pdf

62