International Journal of Management (IJM), ISSN 0976 – 6502(Print), ISSN 0976 -6510(Online), Volume 4, Issue 3, May- June (2013)831. INTRODUCTIONEven in the healthiest of families, if one member has an accident (or falls sick) theresulting medical expenses can affect the financial and economic stability of the wholefamily. The impact depends, in part, on whether the injured person was insured, the size ofthe bills, and the family’s income and other resources (Uninsurance, 2002). With Healthcarefinancing still a vex issue; the burden of health care spending is passed on to the individualconcern. Financial constraint is a bottle neck for funding Universal Healthcare. Tax-payers’money can’t pay for healthcare as life expectancy is increasing (Shetty, 2012).Insufficient public health provision has compelled the population to turn to privatehealth providers pushing out of pocket (OOP) spending higher. In India OOP spending isover four times higher than the public spending on health care (Choudhury, 2012). OOPspending by households occupies about 72% of the total health expenditure (WHR, 2006) andit pushes 2.2 percent of the population below the poverty line each year (Peters, A S, R S, GN V, L H, & A, 2002). OOP expenditures aggravate poverty for those living in both rural andurban, with more severity (though the impact is felt more) in rural areas (Garg & Karan,2009). Alternate financing strategy through health insurance (HI) can be an effective option(Churchill, 2007). Health insurance coverage can give a cushion to impeding financial andeconomic burden of a family.WHO (World Health Organization) considers health insurance a promising means forachieving universal health-care coverage (WHO, 2010). In India, only 10 percent Indian hassome form of health insurance, mostly inadequate. In terms of the market share, the size ofthe commercial insurance is barely 1% of the total health spending in the country. The Indianhealth insurance scenario is a mix of mandatory social health insurance (SHI), voluntaryprivate health insurance and community-based health insurance (CBHI). Health insurance isthus really a minor player in the health ecosystem (Dhar, 2012).With the enactment of the Insurance Regulatory Development Authority of India(IRDA), the industry now has a regulatory framework to protect the interests of policyholders. Stricter regulatory framework is required as is evident in countries where HealthInsurance (HI) plays a dominant role in financing of health expenditures (IRDA, 2003). Newinitiatives like Health Insurance (HI) portability can make it more users friendly. Furtherreforms like increasing the FDI cap to 49% and reducing capital requirement for healthinsurers from the present Rs. 100 to Rs. 50 crores may invite more players in HealthInsurance (HI) and increase the level of Health Insurance (HI) penetration (TOI, 2012).2. PURPOSE OF THE STUDYConsumerism, Changes in the Demographic Profile of the consumers, Changes inLife Style etc, all these factors will have an impact on the overall demand for better healthcare services including Health Insurance (HI). The ultimate burden for these health careservices will be passed on to the general public. If the general public is aware of HealthInsurance (HI), it can play a bigger role in reducing this impeding burden of Health careexpenses. In this perspective this paper “Customer perception of Health Insurance (HI)Products: A study in Imphal City, Manipur (India)” was carried out.
International Journal of Management (IJM), ISSN 0976 – 6502(Print), ISSN 0976 -6510(Online), Volume 4, Issue 3, May- June (2013)843. REVIEW OF LITERATUREAwareness and Perception: Many studies have been carried out to understand the awarenessand perception of Health Insurance. For a consumer to be interested in an offering, theconsumer must have awareness of the offering and find it acceptable, available at the righttime and place, and affordable (J.N. Seth, R.S. Sisodia, 2008). A study conducted in BahraichDistrict, Uttar Pradesh has clearly highlighted that respondent’s perception towards insuranceand savings and their understanding of the benefits are still nascent. Out of all types ofinsurance, awareness for Life insurance (38 percent) is by far, the highest followed by vehicleinsurance (15%) and property insurance (10%) (Constella, 2008). It is estimated that onlyabout 3% to 5% of Indians are covered under any form of health insurance (Rao, 2005). Intheir study found out that the need for education for rural and urban population was alike onthe concept of health information which is a crucial aspect on extending awareness abouthealth insurance on a large-scale (Gumber A, 2000).Bhatt, Professor, Finance and Accounting at IIM, Ahmadabad writes that thepenetration of insurance critically depends on the availability of insurance products andservices (Bhatt & Jain, 2006). Almost 79 per cent of health expenditure is borne by privatebodies and the rest by the public. Authors argue that to stimulate private health insurancegrowth, the Indian government should recognize health insurance as a separate line ofbusiness and distinguish it from other non-life insurance (Gupta, 2007). If Parliamentapproves the recent increase in FDI cap of 49%, the change in law is expected to come as ahuge boon for the health insurance business (TOI, 2012).With entry of Private players in Insurance Industry in India, aggressive promotion hasresulted in growth of this sector. However, no one in the industry is taking responsibility todevelop knowledge and awareness of health insurance among the public nor is specificexpertise in health insurance being developed within the private sector, an expertise that isessential to dealing effectively with providers of health care services. Because of this absenceof specific capacity, Indian companies writing health insurance seem to have focused oncontrolling claims payout by following strategies designed to minimize the insured person’sability to collect on claims. Because of these practices health insurance has become one of thelargest litigation areas for insurers, exceeded only by motor third party cases (Mathur, VolVIII No. 1 January - March 2011). Spread of awareness of all information for health policiesand claim settlement procedure thereof must be ensured by service providers (USAID, 2008).Also more knowledge about health insurance will help them in making an informed choiceabout their purchase (Bhatt & Jain, 2006).Service Industry: Health Insurance is a service industry. A person taking up a policy isgoing to be a customer for 15/20 years, any good or bad experience echoes good and badmessages to other probable customers. For most first time buyers it is the brand of thecompany which acts a catalyst for buying any product/service. Blackshaw identifies sixdrivers to brand credibility as trust, authenticity, transparency, listening, responsiveness andaffirmation (Blackshaw, 2008). Health Insurance (HI) falls under the ambit of Service Sector.A glimpse of 7Ps of marketing mix for service industry is represented in the Figure below.
International Journal of Management (IJM), ISSN 0976 – 6502(Print), ISSN 0976 -6510(Online), Volume 4, Issue 3, May- June (2013)85Figure 2The Marketing MixProduct management, New product development,Branding ,Packaging} ProductPricing ,Discount structures, Terms of business } PriceAdvertising , Sales promotion, Public relations,Personal selling , Merchandising} PromotionChannel management, Customer service,Physical distribution} PlaceEmployee selection, Employee training,Employee motivation} PeopleLayout, Décor, Ease of access, Forms ofpresentation} Physical EvidenceHow customers are handled and managed fromthe point of very first contact with theorganization through to the point of very lastcontact} Process ManagementSource: Adapted from (Wilson & Gilligan, 2001)Agents: Private Health Insurance (HI) in India is based on the partner – agent model andinsurance agents are important stakeholder between the Insurer and the Clients. Insuranceagents are the main source of information about HI schemes (Vellakkal, 2009).4. OBJECTIVE OF THE STUDYThe main objective of this study is to determine the customer perception of HealthInsurance (HI) Products in Imphal City. In doing so, the article aims to study(i) The major source of money to finance the bill in case a family member falls ill.(ii). The choice of Company from which Health Insurance (HI) policies are bought.(iii).Whether agents are actively selling Health Insurance (HI) products.(iv). Major reasons why people who are aware of Health Insurance (HI) intends to stayaway from buying a Health Insurance (HI) Product.Under these objectives following null hypotheses are framed.Null Hypotheses:(i). H01: There is no relationship between Occupation and Source of Money to financethe bill for treatment.(ii). H02: There is no difference in the awareness level of Health Insurance (HI) betweenmales and females (Gender), Age, Education Qualification, Income and Occupation.(iii).H03: There is no difference in opinion among respondents with different Gender,Educational Qualification and Occupation that agents are actively selling HealthInsurance (HI) products.
International Journal of Management (IJM), ISSN 0976 – 6502(Print), ISSN 0976 -6510(Online), Volume 4, Issue 3, May- June (2013)865. RESEARCH METHODOLOGY5.1 Methods of Data Collection, Sample Size and Statistical tools usedPopulation could not be determined conclusively. Initially, random sampling sizes of280 respondents are taken for this study. Out of these 16 samples are rejected. So, Randomsampling size of 264 is taken for the final analysis. Information is collected by usingquestionnaire.5.2 Schematic Representation of all steps of how the analysis has been done:Figure 1: Flow Chart showing the schematic stepwise analysis of the questionnaireSource: Primary Data5.3 Data AnalysisData collected through structured questionnaire were analyzed using SPSS. Thestatistical techniques namely descriptive statistics that is mean, standard deviation, percentageand Chi Square test are mainly used to test the hypotheses.
International Journal of Management (IJM), ISSN 0976 – 6502(Print), ISSN 0976 -6510(Online), Volume 4, Issue 3, May- June (2013)876. Data Analysis and Discussion6.1 Demographic profile of the SampleTable 1Profile of SamplePersonal information No. of respondents PercentGenderFemale 100 37.9Male 164 62.1Age<20 36 13.620-40 148 56.140-60 64 24.2>60 16 6.1EducationalQualificationUndergraduate 44 16.7Graduate 80 30.3Post-graduate 100 37.9Professional degrees 40 15.2MonthlyIncomeBelow Rs. 15000 64 24.2Rs. 15000 to 30000 120 45.530000 to 45000 52 19.745000 and above 28 10.6OccupationPrivate employee 60 22.7Govt. employee 92 34.8Own business 60 22.7Others 52 19.7Source: Primary DataThe above Table No. 1 indicates the overall profile of the Sample. It consists of aSample size consists of 37.9% Females and the remaining 62.1% Males. 56.1% ofRespondents belong to the Age Group (20 – 40) years, where 24.2% belongs (40-60) yearsand 6.1% belongs to above 60 years of Age. In case of Educational Qualification 37.9% ofthe Sample were Post Graduate, 30.3% were Graduate and 15.2% were Professional DegreeHolders. 45.5% of the Sample belongs to the Monthly Income Group of Rs. (15,000 –30,000), 24.2% were below Rs. 15,000 and 10.6% were Rs. 45,000 and above. 34.8% of theRespondents were Government Employee and 22.7% were Private Employees & OwnBusiness. The Remaining 19.7% of the Respondents belongs to Others Group.
International Journal of Management (IJM), ISSN 0976 – 6502(Print), ISSN 0976 -6510(Online), Volume 4, Issue 3, May- June (2013)886.2 Data Analysis on Family Member falling sick, Expense incurred in Treatmentand Source of Money:Table 2Percentage of Sickness, Expense incurred in Treatment and Source of MoneyPersonal information No. of PercentageFamily member (s)falling sickNo 60 22.7Yes 204 77.3Expense incurredin treatmentBelow Rs. 5000 12 4.5Rs.5000 to Rs. 10000 20 7.6Rs.10000 to Rs. 15000 100 37.9Above Rs.15000 72 27.3Mean(SD) 10189(6590)Source of moneyOut of pocket 88 33.3Reimbursement from 96 36.4Insurance 16 6.1Others 4 1.5Source: Primary DataFrom the above Table 2, it is observed that 77.3 % of respondents agree with thestatement that in the past one year a family member (within the family) had fallen sick.37.9% of those who falls sick spend Rs. 10,000 to Rs. 15000 in a year for treatment. Everyfamily spends on an average of Rs. 10189 for treatment with standard deviation Rs. 6590.Majority (36.4%) of the Respondents reimburse their expense for the treatment from service.33.3% of the respondents met the expenses from their pocket (Out of Pocket) while a meager6.l% and 1.5% through Insurance and Others respectively.6.3 Data Analysis on Occupation and Source of Money to finance treatmentTable 3Occupation and Source of Money to finance treatmentSource of money Total Chi -SquareP-ValueOcccupationOut of Reimburs. Insurance OtherPvt.Empl.16(28.6) 24(42.8) 4(7.2) 0(0) 44(100)36.825 <0.001Govt.Empl.4(5.6) 68(94.4) 0(0) 0(0) 72(100)OwnBusi.44(78.6) 0(0) 8(14.3) 0(0) 52(100)Others 24(50) 4(8.3) 4(8.3) 4(8.3) 36(100)Total 88(37.9) 96(41.4) 16(6.9) 4(1.7) 204(100)N.B. – Figures in brackets indicate percentage Source: Primary DataIn the Table above, majority of the respondents (94.4%) employed in Government and42.8% in Private sectors reimbursed their expenses for treatment. While maximum (78.6%)of Business Owners and 50% Others financed though Out of Pocket (OOP) for treatment. It isstatistically tested that the relation between Occupation and Source of Money for treatment ishighly significant with p-value less than 0.001(i.e. <0.001). Null Hypothesis (H01) is rejected.
International Journal of Management (IJM), ISSN 0976 – 6502(Print), ISSN 0976 -6510(Online), Volume 4, Issue 3, May- June (2013)896.3 Awareness of Health Insurance (HI)Table 3Awareness of Health Insurance (HI)N.B. – Figures in brackets indicate percentage Source: Primary DataTable 3 above indicates that 57.6 % of the respondents are not aware of HealthInsurance (HI). Higher percentages, i.e., 53.7% of the male respondents are aware of HeathInsurance (HI) in contrast to 24% for Females. And, it is statistically tested that there is asignificant difference in the level of awareness of Health Insurance (HI) between male andfemale with p-value 0.018. It is observed that a significant percentage, 54.1% of theRespondents in the age group (20 – 40) years are aware about Health Insurance (HI). But itis statistically tested that there is no significant difference in the level of awareness of HealthInsurance (HI) between different age groups with p-value 0.097. It is also observed that 100%of the Respondents with Professional Degrees are aware of Health Insurance (HI). It isstatistically tested and observed that there exists a highly significant difference in the level ofPersonalinformationAwareness of HITotalChi-squareP-valueNo (%) YesGenderFemale 76 (76.0) 24 (24.0) 1005.593 0.018Male 76 (46.3) 88 (53.7) 164Total152(57.6)112 (42.4) 264Age in Year<20 32 (88.9) 4 (11.1) 366.318 0.09720-40 68 (45.9) 80 (54.1) 14840-60 40 (62.5) 24 (37.5) 64>60 12 (75.0) 4 (25.0) 16Total152(57.6)112 (42.4) 264EducationalQualificationUndergraduate 40 (90.9) 4 (9.1) 4419.865 <0.001Graduate 56 (70.0) 24 (30.0) 80Post-graduate 56 (56.0) 44 (44.0) 100Professionaldegrees0 (0.0) 40 (100.0) 40Total152(57.6)112(42.4) 264MonthlyIncomeBelow Rs. 15000 52 (81.3) 12 (18.8) 6414.273 0.003Rs.15000 to 30000 76 (63.3) 44 (36.7) 12030000 to 45000 24 (46.2) 28 (53.8) 5245000 and above 0 (0.0) 28 (100.0) 28Total 152(57.6) 112(42.4) 264OccupationPrivate employee 20 (33.3) 40 (66.7) 607.410 0.060Govt. employee 48 (52.2) 44 (47.8) 92Own business 44 (73.3) 16 (26.7) 60Others 40 (76.9) 12 (23.1) 52Total152(57.6)112(42.4) 264
International Journal of Management (IJM), ISSN 0976 – 6502(Print), ISSN 0976 -6510(Online), Volume 4, Issue 3, May- June (2013)90awareness of Health Insurance (HI) among individuals with different Education Qualificationwith p-value less than 0.001. 100 % of the Respondents with monthly income Rs. 45,000 andabove are aware of Health Insurance (HI). And, it is statistically tested that there is significantdifference in the level of awareness of Health Insurance (HI) among respondents belonging todifferent income groups (monthly income) with p-value 0.003. Higher percentage, 66.7% ofthe Respondents with Occupation in Private Sector are aware of Health Insurance (HI) asagainst other sectors. But it is statistically tested that there is no significant difference in thelevel of awareness of Health Insurance (HI) among respondents belonging to differentoccupation with p-value 0.060.6.4 Data Analysis on Reason for not aware, Willingness to buy, Purchase Percentageand Source of Information about Health Insurance (HI)Table 4Reason for not aware, Willingness to buy, Purchase of HI and InformationSource for HINo. of respondent PercentageReason fornot awareNever heard about it 132 86.8Not aware about the benefit 12 7.9Nobody approach 4 2.6Others 4 2.6Total 152 100.0Willingness tobuyNo 4 2.6Yes 148 97.4Total 152 100Purchase HINo 60 53.6Yes 52 46.4Total 112 100Informationabout HIcomes fromAgent 44 84.6Friend 4 7.7Others 4 7.7Total 52 100Source: Primary DataFrom the table above, it is observed that 86.8% of the Respondents cited “Never heardabout it” as the reason for ‘not aware’ of Health Insurance (HI). 97.4% of the Respondentssay that they are willing to buy Health Insurance (HI). But only 46.4% of the Respondentshave purchased a Health Insurance (HI) policy. Main (84.6%) source of Information aboutHealth Insurance (HI) comes from Agents (Insurance Agents).
International Journal of Management (IJM), ISSN 0976 – 6502(Print), ISSN 0976 -6510(Online), Volume 4, Issue 3, May- June (2013)916.5 Data Analysis on Agents activity in Selling Health Insurance (HI)Table 5Agents Actively Selling Health Insurance (HI)Actively selling Chi-squareP-valueDisagreed Neutral AgreedGenderFemale 4 16.7 16 66.7 4 16.74.176 0.124Male 36 40.9 20 22.7 32 36.4Total 40 35.8 36 32.1 36 32.1EducationalQualificationUndergraduate 0 0.0 0 0.0 4 100.013.089 0.042Graduate 8 33.3 4 16.7 12 50.0Post-graduate 4 9.1 20 45.5 20 45.5Professionaldegrees28 70.0 12 30.0 0 0.0Total 40 35.8 36 32.1 36 32.1OccupationPrivate employee 20 50.0 4 10.0 16 40.015.105 0.019Govt. employee 16 36.4 28 63.6 0 0.0Own business 4 25.0 0 0.0 12 75.0Others 0 0.0 4 33.3 8 66.7Total 40 35.8 36 32.1 36 32.1Source: Primary DataFrom the Table above it is statistically tested that there is no significant difference inopinion among respondents with different Gender (male and female) that agents are activelyselling Health Insurance (HI) with p-value 0.124. Whereas statistically there is significantdifference in the opinion among respondents with different Educational Qualification (p-value at 0.042) and Occupation (p-value at 0.019) that agents are actively selling HealthInsurance (HI).6.6 Data Analysis on Reasons for not purchasing Health Insurance (HI)Table 6Reason for not purchasing Health Insurance (HI)Reason for not purchase Frequency PercentageI do not need it 0 0.0No return from investment 60 25.9High premium charge 52 22.4Poor service provider 56 24.1Alternate sources to fund health related cost 8 3.4No empanelled hospitals in Imphal 56 24.1Others 0 0.0Multiple response tabulated Source: Primary DataFrom the Table above, it is observed that “No return from Investment”, “Poor ServiceProvider”, and “No empanelled Hospitals in Imphal” as the reason for not purchasing HealthInsurance (HI).
International Journal of Management (IJM), ISSN 0976 – 6502(Print), ISSN 0976 -6510(Online), Volume 4, Issue 3, May- June (2013)926.7 Choice of Company from which Health Insurance (HI) policies are boughtTable 7Company from which Health Insurance (HI) are boughtParameter Analyzed Name of the Company Frequency PercentCompany from which HIpolicies are boughtICICI Prudential 14 26.9NIC 4 7.7LICI 8 15.4Bajaj Allianz 4 7.7Amsure (Max Life) 7 13.5Birla Sunlife 2 3.8HDFC Life 2 3.8Metlife 0 0.0SBI Life 3 5.8TATA AIA 1 1.9Reliance 3 5.8IDBI Fortis 1 1.9ICICI Lombard 3 5.8Others 0 0Source: Primary DataFrom the above Table, respondents say ICICI Prudential Life, LICI and Amsure (MaxLife) are the top three companies; respondents bought Health Insurance (HI) policies from.6.8 Analysis of awareness of Health Insurance (HI), Scheme, Diseases not covered,Premium and Claim ProcedureTable 8Awareness of Health Insurance (HI), Scheme, Diseases not covered, Premium andClaim ProcedureNo. of respondents %Awareness of HIMedium 44 84.6Highly aware 8 15.4Total 52 100Awareness of schemeMedium 48 92.3Highly aware 4 7.7Total 52 100Awareness of disease not cover byHILess aware 24 46.2Medium 24 46.2Highly aware 4 7.7Total 52 100Awareness of HI premiumLess aware 4 7.7Medium 44 84.6Highly aware 4 7.7Total 52 100Aware of claim procedureLess aware 32 61.5Medium 16 30.8Highly aware 4 7.7Total 52 100Source: Primary Data
International Journal of Management (IJM), ISSN 0976 – 6502(Print), ISSN 0976 -6510(Online), Volume 4, Issue 3, May- June (2013)93From the above Table, the awareness level of Health Insurance, Awareness ofScheme, Premium in Imphal are ‘medium’ with a score of 84.6% , 92.3% and 84.6%respectively. In case of Awareness of diseases not covered by Health Insurance (HI),respondents awareness level is in ‘medium’ and ‘less aware’ with a score of 46.2%. Theawareness of Claim procedure for Health Insurance in Imphal is “less aware” having score of61.5% out of the Total Respondents.6.8 Analysis on the reason for the purchase of Health Insurance (HI)Table 9Reason for the purchase of Health Insurance (HI)Reason for the purchase of HI No. of respondents %Attractive schemes 36 22.0Tax benefit 32 19.5Expecting health problems 8 4.9Better health care to family 12 7.3To protect from rising cost of health care 44 26.8Cover big expenses 32 19.5Total 164 100*Multiple responses tabulated Source: Primary DataFrom the Table above, 26.8% attributes “To protect from rising cost of Health Care”as the major reason for purchasing Health Insurance. “Attractive schemes”, “Tax benefit”and “Cover big expenses” are also important reasons for purchase of Health Insurance (HI).6.9 Analysis on factors that influence purchase of Health Insurance (HI)Table 10Factors that influence purchase of Health Insurance (HI)Factors that influence in purchase of HINo. ofrespondents*%Trust worthiness of company 52 17.1Better Schemes Offer 32 10.5Existing insurance with the Company 8 2.6Personal Relationship 32 10.5Easy claim settlement 28 9.2More Coverage of Diseases 24 7.9Low Premium Cost 20 6.6Better marketing by Agent 44 14.5Tax Saving 28 9.2Advertisement 36 11.8Total 304 100*Multiple responses tabulated Source: Primary Data
International Journal of Management (IJM), ISSN 0976 – 6502(Print), ISSN 0976 -6510(Online), Volume 4, Issue 3, May- June (2013)94From the Table above, Trust worthiness of company, Better marketing by Agent andAdvertisement are the three important factors that influence purchase of Health Insurance(HI).7. CONCLUSIONOne important observation is people intend to take up HI if they are explainedexplicitly about it. But in contrast majority of people who know about health insurance doesnot own a HI policy. So, there seems to be a gap. And all stakeholders in Health Insurance(HI); Insurance companies, insurance agents, probable customers, existing clients etc. have amajor role to play in increasing enrolment for Health Insurance (HI) policies. For a societylike ours, level of unemployment is very high. Since major chunk of the population areunemployed, financing for treatment through Out Of Pocket (OOP), which occupies asizeable section of respondents, will have a dent on the socio-economic pattern of the masses.Overall increase in the enrolment of Health Insurance (HI) therefore will be a “win win” forall stakeholders.BIBLIOGRAPHY1. Bhatt, R., & Jain, N. (2006). Factors Effecting the Demand for Insurance in a MicroHealth Insurance Scheme. Indian Institute of Management Ahmedabad. India; W.P.No.2006-07-02 , 1-29.2. Blackshaw, P. (2008). The Six Drivers to Brand Credibility, - It is time to tell crediblestories. MM .3. Choudhury, M. G. (2012). Health Care Financing Reforms in India. National Instituteof Public Finance and Policy.4. Churchill, C. (2007). Insuring the Low-Income Market: Challenges and Solutions jforCommercial Insurers. The International Association for the Study of InsurnaceEconomics , 401-412.5. Constella, F. (2008). Health Insurance Needs, Awareness.6. Dhar, A. (2012, September 2). The Hindu. Retrieved from The Hindu:www.thehindu.com/news/national/article3849441.ece7. Garg, C. C., & Karan, A. K. (2009). Reducing out of pocket expenditure to reducepoverty: A disaggregated analysis at rural-urban and state level in India. Health Policyand Planning . Journal of Health Management, Volume 12 Issue 3 , 116-28.8. Gumber A, K. V. (2000). Health Insurance for Informal Sector: A case study of Gujarat.Economic and Political Weekly , 3607-13.9. Gupta, H. (2007). The Role of Insurance in Health Care Management in India.International Journal of Health Care Quality Assurance; Vol. 20: Iss: V , 379-391.10. IRDA. (2003). The Report of Sub-Group on Health Insurance constituted by theMinistry of Health and Family Welfare. Hydrabad: IRDA.11. J.N. Seth, R.S. Sisodia. (2008). 4P’s of Marketing. American Marketing Association ,p.8.12. Mathur, V. (Vol VIII No. 1 January - March 2011). Ethical Questions Regarding HealthInsurance in India. Indian Journal of Medical Ethics , 23-27.13. Peters, D. H., A S, Y., R S, S., G N V, R., L H, P., & A, W. (2002). Better HealthSystems for Indias Poor. World Bank, Washington DC.
International Journal of Management (IJM), ISSN 0976 – 6502(Print), ISSN 0976 -6510(Online), Volume 4, Issue 3, May- June (2013)9514. PHILIP KOTLER, J. S. (2008). STRATEGIC MARKETING FOR HEALTH CAREORGANIZATIONS. San Francisco: Jossey-Bass A Wiley Imprint.15. Rao, K. S. (2005). Commission on Macroeconomics and Health Insurance in India.New Delhi: National Commission on Macroeconomics and Health, Government ofIndia.16. Shetty, D. (2012, May 8). Devi Shetty: India will become the first country in the worldto dissociate health care from affluence. Retrieved October 18, 2012, fromhttp://blogs.bmj.com: http://blogs.bmj.com/bmj/2012/05/08/devi-shetty-india-will-become-the-first-country-in-the-world-to-dissociate-health-care-from-affluence/17. TOI. (2012, October 6). FDI in Insurance: Health Insurance Biz to get a fillip, newPlayers boon for consumers. Business Column, Times of India . New Delhi, Delhi,India: Times Group.18. Uninsurance, C. o. (2002). Health Insurance Is a Family Matter. Washington, DC: TheNational Academies Press.19. USAID. (2008). Health Insurance Needs, Awareness and Assessment in the BahraichDistrict, Uttar Pradesh. New Delhi: USAID, India.20. Vellakkal, S. (2009). Adverse Selection and Private Health Insurance Coverage in India. Indian Council For Research on International Economic Relations , 1-29.21. WHO. (2010). The World Health Report - Health Systems Financing and The Path toUniversal Coverage. Switzerland: World Health Organization.22. WHR. (2006). Working together for health. Geneva: World Health Organization.23. Wilson, R. M., & Gilligan, C. (2001). Strategic Marketing Management . New Delhi:Viva Books Private Limited.24. V. Thamodaran, Dr. M. Ramesh, “Awareness of Ict by the Rural Customers TowardsInsurance Services”, International Journal of Management (IJM), Volume 1, Issue 1,2010, pp. 59 - 70, ISSN Print: 0976-6502, ISSN Online: 0976-6510.25. D. Dhanuraj, “Health Insurance Scheme for Low Income Groups in India with a Focuson Urban Poor in Cochin”, International Journal of Management (IJM), Volume 2,Issue 2, 2011, pp. 182 - 197, ISSN Print: 0976-6502, ISSN Online: 0976-6510.