Project Synopsis -A STUDY ON AWARENESS OF HEALTH INSURANCE PRODUCTS AND CLAIM SETTLEMENT PROCESS WITH REFERENCE TO THE UNITED INDIA INSURANCE COMPANY LIMITED

1. A STUDY ON AWARENESS OF HEALTH INSURANCE PRODUCTS AND
CLAIM SETTLEMENT PROCESS WITH REFERENCE TO THE
UNITED INDIA INSURANCE COMPANY LIMITED
PROJECT SYNOPSIS
Submitted in partial fulfillment of the requirements
for the award of the degree of
POSTGRADUATE DIPLOMA IN HEALTH INSURANCE MANAGEMENT [2019-2020]
By
DR.VIBHUTI AMIN
(PRN NO.19040764007)

2. No-Plagiarism Declaration
Title of the article: A Study on Awareness of Health Insurance Products And
Claim Settlement Process With Reference To The
United India Insurance Company Limited
Name of the learner: Dr.Vibhuti Amin
PRN: 19040764007
Name of Project Guide: Mrs.Usha Jain
Designation: Chief Regional Manager
Qualification: Fellowship in Insurance
Contact Details: 0771-2259377
I hereby state and declare that, this project report is submitted as part of partial fulfillment of the
requirements of by me as per my own intellect. This synopsis is the result of my independent
scholarly work and I have not copied any contents of the said synopsis from anyplace. Proper
references have been cited for all the material used to give credit to original author if I have
borrowed any sentences / ideas of such author. Further, I declare that, the synopsis has not been
published by me earlier in any form. I am aware that, plagiarism is an offence and if committed
same will lead to non-evaluation and rejection of my project report and appropriate action
against me.
Dr.Vibhuti Amin

3. Introduction
Socio-Economic development and health of community are related with each other in such a
Way that it is impossible to achieve one without other i.e. one cannot be achieved in isolation.
No doubt, the economic development in India is gaining momentum over the last few
decades because of the government initiatives in public health care facilities, yet its health
System is at crossroad today. As these initiatives outcome are only moderate by international
Standards, because India is ranked 118 among 191 WHO members countries on the basis of
overall health performance. To a large extent the health indices of a country is determined
with reference to the ways with which its health cares gets financed. Although, in India the
total health care expenditure is increasing steadily, but the mix of public and private spending
is a major area of concern (Bhatt and Jain, 2006). As the various studies reveal that in India
more than 80 percent of health care’s expenditure is borne by individuals i.e. health care
financing is mainly in the form of out-of-pocket which gradually pushing them in to a vicious
circle of poverty. In such a situation health insurance is a widely recognized and preferable
mechanism to finance the health care expenditure of the individuals. The credit for the
origination of concept of health insurance goes to Hugh the Elder Chamberlin from the Peter
Chamberlin family, who proposed it for the first time in the year 1694.
In the late 19th century “accidental insurance” began which operated much like modern
“disability insurance”.
It was firstly offered by Franklin Health Assurance Co of US, which was founded in 1850. It
provides coverage for the accident arising from rail, road and steamboat accident. This
payment model continued until the start of 20th century in some jurisdictions (like California),
where all laws regulating health insurance actually referred to disability insurance. As far as the
stage of development of health
insurance in India is concerned, it is in the embryonic stage. As the people of India are not
much aware about it and very few part of the population is taking the advantages of it.
Moreover those who are aware about it are not actively participating for one reason or
another and thereby making it difficult to bring it to the stage of expansion. Beside this, very
few insurers are actively venturing in it and thereby making it difficult to construct inroads
for health insurance in India. But there is terrible need of health insurance in India as the
World Bank Report reveals that 85% of the working populations in India do not have Rs.

4. 5,00,000 as instant cash; 14% have Rs. 5,00,000 instantly but will subsequently will face a
financial crunch; Only 1% can afford to spend Rs. 5,00,000 instantly and easily; and 99% of
Indians will face financial crunch in case of any critical illness.
Hence the need for health insurance in India cannot be overlooked

5. AIM AND OBJCTIVE
The aim of the study is to know the Survey & Findings on awareness of health insurance in
Raipur(C.G) area, and claim settlement process of health insurance. A review of literature
regarding health insurance in India and abroad has been made.
The need for the study arises to know about the awareness of health Insurance policy by the all
sections of the society, for the knowledge of health insurance claim settlement procedure in India
and explore the possibilities for its better and easy settlement.
The main objectives of the study are:-
• To find awareness level of health insurance for Raipur (C.G) location.
• To estimate the percentage of population having health insurance product.
• To study claim settlement process in the health insurance policy.
• To determine the satisfaction level of the customer regarding Claim settlement
Limitations of the study
There were certain limitations in undertaking this research work. As it is understood that
the limitations are a part of the project, they have been overshadowed by the benefits of
the study.
• The survey conducted may not be considered as comprehensive as only limited
respondents could be contacted because of the time constraint.
• Objectives, the purposes of the study and the questions had to be explained to the
respondents and in this context their responses may be biased.
• Some of the respondents were reluctant to give their responses.
• Only limited sample size had been considered for the study and therefore, the
conclusions drawn based on this may not be a reflection of the entire population

6. Literature Review
Various studies related directly or indirectly with the objectives of the present study were
reviewed. Purohit and Siddiqui (1994) examined the utilization of health services in India
by making the comparison of Indian states in terms of low, medium and high household
expenditure on health care and concluded that there is no serious government initiative to
encourage utilization of health services by means of devising health insurance. Sanyal (1996)
examined that the burden of health care expenditure in rural areas was twice in 1986-87 as
compared to 1963-64 and also provided that household is the main contributor to the
financing of health care in India, so the health planners would have to pay more consideration
regarding this. Gumber and kulkarni (2000) undertaken a case study in Gujarat and
provided that SEWA a type of health insurance scheme is strongly preferred by those who
can’t afford and also not access the services of various other schemes. Asgary, Willis,
Taghvari and Refeian (2004) estimated the demand and willingness to pay for health
insurance by rural households in Iran and concluded that a significant percentage of
population (more than 38%) live in rural areas, but the health care insurance currently
operating in urban areas.
In order to provide rural areas with same level of protection as urban areas, the difference
would have to be subsidized. Ahuja and De (2004) confirmed that the demand for health
insurance is limited where supplies of health services is weak and explained interstate
variation in demand for health insurance by poor in relation to variation in healthcare
infrastructure. Beside this the study also provided that healthcare infrastructure is positively
related to demand for health insurance by poor, whereas the proportion of Below Poverty
Line (BPL) population is negatively related. In order to build demand for health insurance, it
is necessary to address the demand side and at the same time design the insurance schemes by
taking into consideration the paying capacity of the poor. Ahuja and Narang (2005)
provided an overview of existing forms and emerging trends in health insurance for low
income segment in India and concluded that health insurance schemes have considerable
scope of improvement for a country like India by providing appropriate incentives and
bringing these under the regulatory ambit. The study suggested that in order to develop health
insurance for poor in a big way, health care provisions need to be strengthened and
streamlined as well as coordination among multiple agencies is needed.

7. Dror (2006) laid seven myths regarding health insurance and examined the realities behind
these myths. The evidence shown that most people are willing to pay 1.35% of income or
more for health insurance and the solvent market for health insurance business exist in India;
however tapping of it is contingent upon understanding the customer’s needs and wants.
Dror (2007) examined why the “one-size-fits-all” health insurance products are not suitable
to low income people in India and provided that there is presence of considerable variability
to pay for health insurance which is because of multiple reasons like variability in income,
frequency of illness among households, quality and proximity of providers (private, public) in
different locations.
Joglekar (2008) examined the impact of health insurance on catastrophic out-of-pocket
(OOP) health expenditure in India and taken zero percent as threshold level to define and
Examine such impact. It showed that in India, OOP health expenditure by households account
for around 70% of total expenditure on health and thereby pushes households in to poverty.
Garg and Karan (2009) assessed the differential impact of out-of-pocket (OOP) expenditure
and its components between developed and less developed regions in India. The results
Showed that OOP expenditure is about 5% of total households’ expenditure (ranging from
about 2% in Assam to 7% in Kerala) with higher proportion in rural areas. Further in order to
reduce OOP expenditure targeted policies are needed which in turn could help to prevent
almost 60% of poverty
.

8. Research Methodology
For the purpose of present study specified area selected on the assumption that specific area
based studies expected to give more meaningful and significant information. Accordingly the
present study will be carried out in Raipur, Chhattisgarh. Thereafter selection of sample of
respondents will be made by following random sampling and on the whole a sample size of 100
respondents is planned from the general public. In the view of fact that in the present study
general public considered as unit of investigation, a sample framework consisting of equal
number of respondents will be taken. In other words the questionnaire will get filled from 100
respondents; the data will be collected from the general public by administering the self-
structured questionnaire from them. The preliminary draft of the questionnaire will pretested on
20 respondents. This will help in improving the questionnaire and also gave an indication as to
kind of responses that would be forthcoming with few addition and deletion; the final
questionnaire will be developed and used for collection of information from respondents. The
analysis of data collected will be carried out by using :
Tools to be used for analysis are:
• Percentage Analysis
• Graph
• Simple Correlation
• Chi-square test
• Sample Size
• Data collected
• Methods / tools of analysis
Sample Size:
The sample size of the survey is 100 from different strata of total population. The respondents
were ensured complete confidentiality of their opinion and view.
Population:
Our sample population belonged to the Raipur(C.G.)Our sample population belonged to all
sections of the society such different income group, different occupation group, different age etc.
Data collected:
Data includes facts which are required to be collected to achieve the objectives of

9. the project. In order to determine the present position and claim satisfaction level of customers.
The main source of information for this study is based on the data collection. Data
collected are both primary and secondary in nature.
Primary Data: Primary data have been directly collected from insured through well structured
Interview Schedule in hospitals and general public.
Secondary Data: The secondary data was collected from the websites of IRDA & III,GI Council
Data,UIIC Data, books.

10. REFERENCE
• IRDA
• UIIC Website & Office
• GI Council
• Annual Reports