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

A STUDY ON AWARENESS OF HEALTH INSURANCE PRODUCTS ANDCLAIM SETTLEMENT PROCESS WITH REFERENCE TO THE

UNITED INDIA INSURANCE COMPANY LIMITED

PROJECT REPORT

Submitted in partial fulfillment of the requirementsfor the award of the degree ofMASTER OF BUSINESS ADMINISTRATIONByMD MUBARAK HUSSAIN

(Regd. No: 12395019)

Under the Guidance ofDr. M. Dharmalingam, M.B.A, MCA, M.Phil, Ph.D.Associate Professor

DEPARTMENT OF MANAGEMENTPONDICHERRY UNIVERSITYKARAIKAL CAMPUSKARAIKAL – 609 6052013-2014

CERTIFICATE

This is to certify that Mr. MD MUBARAK HUSSAIN, Reg. No.12395019has completed a summer project titled “A study on awareness of Health

Insurance products and claim settlement process” with reference to the

United India Insurance Company Limited in partial fulfillment of therequirements for the award of MBA Degree in Insurance Managementof Pondicherry University, Karaikal Campus during the academic year2012-2014 under my supervision and guidance.(Prof. Lalitha Ramakrishnan) (Dr. M. Dharmalingam)Head of the Department Faculty guide

Mr. MD MUBARAK HUSSAIN

Register number: 12395019

Department of Management

Pondicherry University

Karaikal Campus

Karaikal – 609605

DECLARATION

I hereby declare that the project entitled “A study on awareness of Health

Insurance products and claim settlement process” with reference to the United

India Insurance Company Limited is carried out Pondicherry University inpartial fulfillment of the requirements for the award of the degree of Masterof Business Administration in Insurance Management carried out under theguidance of Dr. M. Dharmalingam, Associate Professor

Department of Management from 14TH MAY to 08TH JULY 2013 is my originalwork and that no part of it has been submitted for any degree, diploma orany other similar title.

Date:Place: Karaikal Mr. MD MUBARAK HUSSAIN

CERTIFICATE

Submitted for viva-voce examination held at Pondicherry University on……………………………

Internal Examiner ExternalExaminer

1.2.

ACKNOWLEDGEMENT

This project has been a great learning experience for me and I would like toexpress my gratitude towards all the people who guided me throughout andwithout whose guidance and support, this project would not have beencompleted successfully.I consider my privilege for giving me the opportunity to work with United

India General Insurance Company I express deep sense of gratitude to myproject guide Mr. Loveleen Awasthi(Senior Divisional Manager) for his co-operation, assistance and guidance.I am highly indebted to my faculty members in particular to the H.O.D Prof.

Lalitha Ramakrishnan and my guide Dr. M. Dharmalingam for theirsupport and encouragement.My sincere gratitude to all of staff who helped and gives their assistant to meduring my project. Especially I want to give thanks to Mr. Rajveer Singh, Mr.

A. Hoda (General Manager) and Mrs. Asha Nair for their guidancesupervision and valuable opinion which helped me lot at the completion ofthis project report.I want to express my heartfelt thanks to Dr. S.K. Roy (Regional Manager)who helped me to make industrial relations.Special thanks to Mr. Shaad A Siddiqui, Mr. Syed Irfan Shafi, Syed Manzer

Ali Rizvi, and Mr. Gunjan Kumar for their support and encouragement,which helped me lot for completion of this project report.

I also want to keep record my heart-felt thanks to my Father Late MD

Nazimuddin, my family members and friends for their moral support.

MD MUBARAK HUSSAIN

CONTENTS

CHAPTERNO.

INDEX PAGE NO.

1 INTRODUCTION 1-91.1 Executive Summary of General Insurancebusiness

21.2 Industry Profile 41.3 Important milestones in general insurance 61.4 Insurance sector reforms 61.5 IRDA 71.6 Insurance Companies operating in India 82 COMPANY PROFILE 10-142.1 About the company 112.2 Recent Developments 112.3 Profit and Performance 112.4 Future Plans 122.5 Awards and recognitions 132.6 Vision & Mission 132.7 Top Management 143 RESEARCH METHODOLOGY 15-173.1 Need of the study 163.2 Purpose of the study 163.4 Objectives of the study 163.5 Limitations of the study 163.6 Sample size 163.7 Data collection 17

3.8 Methods / tools of analysis 174 CLAIM SETTLEMENT PROCESS 18-234.1 Introduction 194.2 Appointment of Surveyor 194.3 Appointment of Investigator 204.4 Processing of Claims 204.5 Co Insurance 214.6 Close Proximity Cases 214.7 Rectification of policy after a loss 214.8 Repudiation of Claims 214.9 Re-opening of Claim files 224.10 How do I file a claim 224.11 Cashless Claim 224.12 Reimbursement Claim 224.13 Documents required for processing of the claim in a Health

Policy234.14 Documents required for processing of the claim in a Critical

Care Policy23

5 DATA ANALYSIS AND INTERPRETATION 24-465.1 Percentage Analysis 25Correlation Analysis 33Chi- Square 355.2 Findings 395.3 Conclusion 405.4 Suggestions 405.5 Managerial Implications 415.6 Bibliography 42Appendix 435.7 Questionnaire 44

List of Tables

Sr. No. Table No Page No.1 Table No 1 252 Table No 2 263 Table No 3 274 Table No 4 285 Table No 5 296 Table No 6 307 Table No 7 318 Table No 8 329 Table No 9 3310 Table No 10 3411 Table No 11 3512 Table No 12 3613 Table No 13 3714 Table No 14 3715 Table No 15 3816 Table No 16 38

1

Chapter I

Introduction

Executive Summary of General Insurance

business

Industry Profile

Important milestones in general insurance

industry

Insurance sector reforms

IRDA

Insurance Companies operating in India

2

Executive Summary of General Insurance business

The service industry is one of the fastest growing sectors in India today. The upcoming

sectors which are really showing the graph towards upwards are - Telecom, Banking, and

Insurance. These sectors really have a lot of responsibility towards the economy. Amongst the

above-mentioned areas insurance is one sector, which took a lot of time in positioning itself.

Insurance in India had its origins in the United Kingdom with the establishment of a

British firm, the Oriental Life Insurance Company in 1818 in Calcutta, followed by the Bombay

Life Assurance Company in 1823, the Madras Equitable Life Insurance Society in 1829 and the

Oriental Life Assurance Company in 1874. However, till the establishment of the Bombay

Mutual Life Assurance Society in 1871, Indians were charged an extra premium of up to 20% as

compared to the British. The first statutory measure in India to regulate the life insurance

business was in 1912 with the passing of the Indian Life Assurance Companies Act, 1912 (“Act

of 1912”) (which was based on the English Act of 1909). Other classes of insurance business

were left out of the scope of the Act of 1912, as such kinds of insurance were still in rudimentary

form and legislative controls were not considered necessary.

General insurance on the other hand also has its origins in the United Kingdom. The

first general insurance company Triton Insurance Company Ltd. was promoted in 1850 by

British nationals in Calcutta. The first general insurance company established by an Indian was

Indian Mercantile Insurance Company Ltd. in Bombay in 1907. Eventually, with the growth of

fire, accident and marine insurance, the need was felt to bring such kinds of insurance within the

purview of the Act of 1912. While there were a number of attempts to introduce such legislation

over the years, non-life insurance was finally regulated in 1938 through the passing of the

Insurance Act, 1938 (“Act of 1938”). The Act of 1938 along with various amendments over the

years continues till date to be the definitive piece of legislation on insurance and controls both

life insurance and general insurance. General insurance, in turn, has been defined to include “fire

insurance business”, “marine insurance business” and “miscellaneous insurance business”,

whether singly or in combination with any of them.

On January 19, 1956, the management of life insurance business of two hundred and

forty five Indian and foreign insurers and provident societies then operating in India was taken

over by the Central Government. The Life Insurance Corporation (“LIC”) was formed in Sept

3

ember 1956 by the Life Insurance Corporation Act, 1956 (“LIC Act”) which granted LIC the

exclusive privilege to conduct life insurance business in India. However, an exception was made

in the case of any company, firm or persons intending to carry on life insurance business in India

in respect of the lives of “persons ordinarily resident outside India”, provided the approval of the

Central Government was obtained. The exception was however not absolute and a curious

prohibition existed. Such company, firm or person would not be permitted to insure the life of

any “person ordinarily resident outside India”, during any period of their temporary residence in

India. However, the LIC Act, 1956 left outside its purview the Post Office Life Insurance Fund,

any Family Pension Scheme framed under the Coal Mines Provident Fund, Family Pension and

Bonus Schemes Act, 1948 or the Employees' Provident Funds and the Family Pension Fund Act,

1952.

The general insurance business was also nationalized with effect from January 1,

1973, through the introduction of the General Insurance Business (Nationalisation) Act, 1972

(“GIC Act”). Under the provisions of the GIC Act, the shares of the existing Indian general

insurance companies and undertakings of other existing insurers were transferred to the General

Insurance Corporation (“GIC”) to secure the development of the general insurance business in

India and for t he regulation and control of such business. The GIC was established by the

Central Government in accordance with the provisions of the Companies Act, 1956 (“Companies

Act”) in November 1972 and it commenced business on January 1, 1973. Prior to 1973, there

were a hundred and seven companies, including foreign companies, offering general insurance in

India. These companies were amalgamated and grouped into four subsidiary companies of GIC

viz. the National Insurance Company Ltd. (“National Co.”), the New India Assurance Company

Ltd. (“New India Co.”), the Oriental Insurance Company Ltd. (“Oriental Co.”), and the United

India Assurance Company Ltd. (“United Co.”). GIC undertakes mainly re-insurance business

apart from aviation insurance. The bulk of the general insurance business of fire, marine, motor

and miscellaneous insurance business is under taken by the four subsidiaries.

4

Industry Profile:

The concept of insurance has been prevalent in India since ancient times. Overseas

traders practiced a system of marine insurance. The joint family system, particular to India, was a

method of social insurance of every member of the family on his life. The law relating to

insurance has gradually developed, undergoing several phases from nationalization of the

insurance industry to the recent reforms permitting entry of private players and foreign

investment in the insurance industry. The Constitution of India is federal in nature in as much

there is division of powers between the Centre and the States. Insurance is included in the Union

List, wherein the subjects included in this list are of the exclusive legislative competence of the

Centre. The Central Legislature is empowered to regulate the insurance industry in India and

hence the law in this regard is uniform throughout the territories of India. The development and

growth of the insurance industry in India has gone through three distinct stages.

1. Formation of the Insurance Industry in India

Insurance law in India had its origins in the United Kingdom with the establishment of a British

firm, the Oriental Life Insurance Company in 1818 in Calcutta, followed by the Bombay Life

Assurance Company in 1823, the Madras Equitable Life Insurance Society in 1829 and the

Oriental Life Assurance Company in 1874. However, till the establishment of the Bombay

Mutual Life Assurance Society in 1871, Indians were charged an extra premium of up to 20% as

compared to the British. The first statutory measure in India to regulate the life insurance

business was in 1912 with the passing of the Indian Life Assurance Companies Act, 1912 (“Act

of 1912”) (which was based on the English Act of 1909). Other classes of insurance business

were left out of the scope of the Act of 1912, as such kinds of insurance were still in rudimentary

form and legislative controls were not considered necessary.

General insurance on the other hand also has its origins in the United Kingdom. The first general

insurance company Triton Insurance Company Ltd. was promoted in 1850 by British nationals in

Calcutta. The first general insurance company established by an Indian was Indian Mercantile

Insurance Company Ltd. in Bombay in 1907. Eventually, with the growth of fire, accident and

marine insurance, the need was felt to bring such kinds of insurance within the purview of the

Act of 1912. While there were a number of attempts to introduce such legislation over the years,

5

non-life insurance was finally regulated in 1938 through the passing of the Insurance Act, 1938

(“Act of 1938”). The Act of 1938 along with various amendments over the years continues till

date to be the definitive piece of legislation on insurance and controls both life insurance and

general insurance. General insurance, in turn, has been defined to include “fire insurance

business”, “marine insurance business” and “miscellaneous insurance business”, whether singly

or in combination with any of them.

2. Nationalization of the Insurance Business in India

On January 19, 1956, the management of life insurance business of two hundred and

forty five Indian and foreign insurers and provident societies then operating in India was taken

over by the Central Government. The Life Insurance Corporation (“LIC”) was formed in

September 1956 by the Life Insurance Corporation Act, 1956 (“LIC Act”) which granted LIC the

exclusive privilege to conduct life insurance business in India. However, an exception was made

in the case of any company, firm or persons intending to carry on life insurance business in India

in respect of the lives of “persons ordinarily resident outside India”, provided the approval of the

Central Government was obtained. The exception was however not absolute and a curious

prohibition existed. Such company, firm or person would not be permitted to insure the life of

any “person ordinarily resident outside India”, during any period of their temporary residence in

India. However, the LIC Act, 1956 left outside its purview the Post Office Life Insurance Fund,

any Family Pension Scheme framed under the Coal Mines Provident Fund, Family Pension and

Bonus Schemes Act, 1948 or the Employees' Provident Funds and the Family Pension Fund Act,

1952.

The general insurance business was also nationalized with effect from January 1, 1973, through

the introduction of the General Insurance Business (Nationalization) Act, 1972 (“GIC Act”).

Under the provisions of the GIC Act, the shares of the existing Indian general insurance

companies and undertakings of other existing insurers were transferred to the General Insurance

Corporation (“GIC”) to secure the development of the general insurance business in India and for

the regulation and control of such business. The GIC was established by the Central Government

in accordance with the provisions of the Companies Act, 1956 (“Companies Act”) in November

1972 and it commenced business on January 1, 1973. Prior to 1973, there were a hundred and

seven companies, including foreign companies, offering general insurance in India. These

companies were amalgamated and grouped into four subsidiary companies of GIC viz. the

6

National Insurance Company Ltd. (“National Co.”), the New India Assurance Company Ltd.

(“New India Co.”), the Oriental Insurance Company Ltd. (“Oriental Co.”), and the United India

Assurance Company Ltd. (“United Co.”). GIC undertakes mainly re-insurance business apart

from aviation insurance. The bulk of the general insurance business of fire, marine, motor and

miscellaneous insurance business is under taken by the four subsidiaries.

Important milestones in general insurance industry:

1907: The Indian Mercantile Insurance Ltd. set up, the first company to transact all

classes of general insurance business.

1957: General Insurance Council, a wing of the Insurance Association of India, frames a

code of conduct for ensuring fair conduct and sound business practices.

1968: The Insurance Act amended to regulate investments and set minimum solvency

margins and the Tariff Advisory Committee set up.

1972: The General Insurance Business (Nationalisation) Act, 1972. Nationalised the

general insurance business in India with effect from 1st January 1973. 107 insurers

amalgamated and grouped into four companies’ viz. the National Insurance Company

Ltd., the New India Assurance Company Ltd., the Oriental Insurance Company Ltd. and

the United India Insurance Company Ltd. GIC incorporated as a company.

Insurance sector reforms:

In 1993, Malhotra Committee, headed by former Finance Secretary and RBI Governor R. N.

Malhotra, was formed to evaluate the Indian insurance industry and recommend its future

direction. The Malhotra committee was set up with the objective of complementing the reforms

initiated in the financial sector. The reforms were aimed at “creating a more efficient and

competitive financial system suitable for the requirements of the economy keeping in mind the

structural changes currently underway and recognizing that insurance is an important part of the

overall financial system where it was necessary to address the need for similar reforms…” In

1994, the committee submitted the report and some of the key recommendations included.

7

1997: Insurance regulator IRDA set up

2000: IRDA starts giving licenses to private insurers: Kotak Life Insurance ICICI

prudential and HDFC Standard Life insurance first private insurers to sell a policy

2001: Royal Sundaram Alliance first non-life insurer to sell a Policy.

2002: Banks allowed selling insurance plans.

Insurance Regulatory & development authority (IRDA):

The Insurance Act, 1938 had provided for setting up of the Controller of Insurance to

act as a strong and powerful supervisory and regulatory authority for insurance. Post

nationalization, the role of Controller of Insurance diminished considerably in significance since

the Government owned the insurance companies. But the scenario changed with the private and

foreign companies foraying in to the insurance sector. This necessitated the need for a strong,

independent and autonomous Insurance Regulatory Authority was felt. As the enacting of

legislation would have taken time, the then Government constituted through a Government

resolution an Interim Insurance Regulatory Authority pending the enactment of a comprehensive

legislation.

The Insurance Regulatory and Development Authority Act, 1999 is an act to provide for

the establishment of an Authority to protect the interests of holders of insurance policies, to

regulate, promote and ensure orderly growth of the insurance industry and for matters connected

therewith or incidental thereto and further to amend the Insurance Act, 1938, the Life Insurance

Corporation Act, 1956 and the General insurance Business (Nationalization) Act, 1972 to end the

monopoly of the Life Insurance Corporation of India (for life insurance business) and General

Insurance Corporation and its subsidiaries (for general insurance business).

The act extends to the whole of India and will come into force on such date as the

Central Government may, by notification in the Official Gazette specify. Different dates may be

appointed for different provisions of this Act. The Act has defined certain terms; some of the

most important ones are as follows appointed day means the date on which the Authority is

established under the act. Authority means the established under this Act. Interim.

8

Insurance Regulatory Authority means the Insurance Regulatory Authority set up by the Central

Government through Resolution No. 17(2)/ 94-lns-V dated the 23rd January, 1996. Words and

expressions used and not defined in this Act but defined in the Insurance Act, 1938 or the Life

Insurance Corporation Act, 1956 or the General Insurance Business (Nationalization) Act, 1972

shall have the meanings respectively assigned to them in those Acts A new definition of "Indian

Insurance Company" has been inserted. "Indian insurance company" means any insurer being a

company.

a) which is formed and registered under the Companies Act, 1956.

b) In which the aggregate holdings of equity shares by a foreign company, either by itself or

through its subsidiary companies or its nominees, do not exceed twenty-six per cent. Paid

up capital in such Indian insurance company.

Insurance Companies operating in India

Sl Insurers Foreign Partners Reg.No.

Date ofRegistration

Year ofOperation

Life Insurers1 LIC Public sector 512 01.09.1956 1956-572 HDFC Standard Standard Life Assurance, UK 101 23.10.2000 2000-013 Max Life ––– 104 15.11.2000 2000-014 ICICI Prudential Prudential Plc, UK 105 24.11.2000 2000-015 Kotak Mahindra Old Mutual. Old Mutual, South Africa 107 10.01.2001 2001-026 Birla Sun Life Sun Life, Canada 109 31.01.2001 2000-017 TATA AIA American International Assurance 110 12.02.2001 2001-028 SBI Life BNP Paribas Assurance SA, France 111 29.03.2001 2001-029 ING Vysya ING Ins. InternationalB.V,Netherlands

114 02.08.2001 2001-0210 Bajaj Allianz Allianz, Germany 116 03.08.2001 2001-0211 Metlife Metlife International Holdings Ltd.,USA

117 06.08.2001 2001-0212 Reliance ––– 121 03.01.2002 2001-0213 Aviva Aviva International Holdings Ltd.,UK

122 14.05.2002 2002-0314 Sahara ––– 127 06.02.2004 2004-0515 Shriram Sanlam, South Africa 128 17.11.2005 2005-0616 Bharti AXA AXA Holdings, France 130 14.07.2006 2006-0717 Future Generali Generali, Italy 133 04.09.2007 2007-0818 IDBI Federal Ageas, Europe 135 19.12.2007 2007-0819 Canara HSBC OBC HSBC, UK 136 08.05.2008 2008-09

9

20 Aegon Religare Aegon ,Netherlands 138 27.06.2008 2008-0921 DLF Pramerica Prudential of America, USA 140 27.06.2008 2008-0922 Star Union Dai-ichi Dai-ichi Mutual Life Insurance,Japan

142 26.12.2008 2008-0923 IndiaFirst Legal& General Middle EastLtd,UK

143 05.11.2009 2009-1024 Edelweiss Tokio Tokio Marine Holding Inc, Japan 147 12.05.2011 2011-12Non-Life Insurers1 New India Assur. Public sector 190 1919 1919-202 National Insurance Public sector 58 1906 1906-073 Oriental Insurance Public sector 556 1947 1947-48

4 United India Ins. Public sector 545 1919 1919-205 Royal Sundaram Royal Sun Alliance, UK 102 23.10.2000 2000-016 Reliance General ––– 103 23.10.2000 2000-017 IFFCO-TOKIO Tokio Marine Asia Pte. Ltd, Japan 106 04.12.2000 2000-018 TATA AIG American International Group ,USA

108 22.01.2001 2000-019 Bajaj Allianz Allianz, Germany 113 02.05.2001 2001-0210 CholamandalamMS Mitsui Sumitomo, Japan 123 15.07.2002 2002-0311 ICICI Lombard Fairfax Financial Holding Ltd,Canada

115 03.08.2001 2001-0212 HDFC ERGO ERGO, Germany 125 27.09.2002 2002-0313 Future Generali Ind. Generali, Italy 132 04.09.2007 2007-0814 Universal Sompo Sompo, Japan 134 16.11.2007 2007-0815 Shriram General Sanlam, South Africa 137 08.05.2008 2008-0916 Bharti AXA AXA Holdings, France 139 27.06.2008 2008-0917 Raheja QBE QBE, Australia 141 11.12.2008 2008-0918 SBI General Insurance Australia Group Ltd ,Australia

144 15.12.2009 2009-1019 L & T General ––– 146 12.07.2010 2010-1120 Magma HDI HDI-Gerling, German 149 22.5.2012 2012-1321 Liberty Videocon Liberty Mutual Insurance Group,USA

150 May 2012 2012-1322 Star Health&Allied Individual Promoters, UAE(Stand Alone Health Insurers)

129 16.03.2006 2006-0723 Apollo Munich Munich Re (Stand Alone HealthInsurers)

131 03.08.2007 2007-0824 Max Bupa Bupa Finance PLC, UK(Stand Alone Health Insurers)

145 26.02.2010 2009-1025 Religare Health (Stand Alone Health Insurers) 148 30.9.2012 2012-1326 ECGC Specialised Insurers 124 1957 1957-5827 Agriculture Ins. Co. Specialised Insurers 126 2003 2003-0428 GIC Reinsurer 112 2001 2001-02

10

Chapter II

Company Profile

About the company

Recent Developments

Profit and Performance

Future Plans

Awards and recognitions

Vision

Mission

Top Management

11

About the company

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

United India has been in the forefront of designing and implementing complex covers to largecustomers, as in cases of ONGC Ltd, GMR- Hyderabad International Airport Ltd, MumbaiInternational Airport Ltd Tirumala-Tirupati Devasthanam etc. It has been also the pioneer intaking Insurance to rural masses with large level implementation of Universal Health InsuranceProgramme of Government of India & Vijaya Raji Janani Kalyan Yojana (covering 45 lakhswomen in the state of Madhya Pradesh), Tsunami Jan Bima Yojana (in 4 states covering 4.59lakhs of families), National Livestock Insurance and many such schemes.

Recent Developments

In November 2007, at Pune, company's top management launched an enterprised leveltransformation project named UNISERGE, under this historic initiative, company identified andset up 6 themes in order to remain a leader in Indian General Insurance market and also stressedon the effective use of IT. In Addition, it has been also decided to create incentive system andlink to rigorous performance management system for the Enhancement of organizationalaccountability and to strengthen HR structure of the company.

Recently, on January 11, 2012, The Company has been entrusted by The Govt. of Tamil Nadufor implementing the new Comprehensive Health Insurance Scheme. This scheme wouldcover 1.34 crore families of Tamil Nadu State and has an annual outlay of Rs. 750 crore. TamilNadu Chief Minister, on the launch, handed over first quarterly insurance premium installmentof Rs. 183.64 crore to Mr. Milind Kharat, CMD of the United India Insurance.

Profit and Performance

The United India Insurance reported over 50% jump in its profit after tax at Rs 341.07 crore forthe first 6 months of the financial year 2011-12. The Chennai-based insurer had reported Rs. 218crore profits during the same period last year. Declaring the half-yearly results, United IndiaInsurance Chairman and Managing Director G Srinivasan told reporters the company's growthhas exceeded that of the industry. "We grew by 27% over the industry's growth of 23% ... ourmarket share also increased," he said.

12

During the half-year period ended September 30, 2011, the company collected a total premiumof Rs 4,033 crore, up by 27% from Rs 3,178 crore in the year-ago period. "We have set a targetpremium of Rs 8,000 crore this year," he said. On plans for the year 2011-12, he said thecompany would focus on retail, micro-small and medium enterprises and rural insurancesegments. "We will focus on agency channel and bancassurance. Agency channel contributed40% and bancassurance 7% (in the first half of the year). We expect it to increase in the years tocome," he said. Replying to a question, he said the company would bid for the Tamil Nadugovernment's health insurance scheme. The investment income of the company for the first-halfof the year stood at over Rs 803 crore as of September 30, 2011.

A steep reduction in management expenses(to 25% from 37%) claims outgo and an increase inpremium income across segments has enabled the company to post 57% growth in net profit forthe first half of the current fiscal. United India earned Rs.803 crore from its investments duringthe first six months of the 2011-12. The market value of the company's investments at the end ofsecond quarter stood at Rs.15,803 crore.

Future Plans

Logging an average business growth of 27% in 2011-12, India's leading non-life insurer UnitedIndia Insurance Company Ltd. declared that it is targeting a gross premium of Rs.10,000 crorein fiscal year 2013-14 and sizeable reduction in underwriting losses - premium less claims outgo- to Rs.900 crore from last year's figure of Rs.1,760 crore.

The company would focus the retail, and small and medium enterprises (SME) segments forgrowth. It is in the process of adding further to its 48,000 agents and also to open around 100one-man offices across the country. Currently, there are 400 such micro-offices bringing inaround Rs.275 crore premium.

Company is waiting for approval from the IRDA to introduce three products under the healthportfolio.

13

Awards and recognitions

United India wins The Skoch Financial Inclusion Award 2013 for M-Power project in theICT based innovation category. M-Power is a premium payment service running throughmobile.

United India gets Skoch award 2010; United India Insurance Company has won the awardfor successful implementation of the financial inclusion initiatives. The company hasimplemented the “Rashtriya Swasthya Bima Yojana” in Kerala. Skoch awards, distributed bySkoch Consultancy Services, are meant to honour extraordinary achievements in governance,capacity building, empowerment, inclusive growth, citizen services delivery, technology,academics and changes in management.

United India Insurance Company has been selected as one among the top three GeneralInsurance companies in Asia by Asia Insurance Review at the 14th Asia Insurance IndustryAwards held in Bali, Indonesia.

United India Insurance Co. Ltd. has been awarded the Best Non-Life Insurance Companyby NDTV Profit-Business Leadership Awards 2010.

United India Insurance Co. Ltd. has been awarded 'iAAA' rating for its claims paying abilityby ICRA (Investment Information and Credit Rating Agency) for the third successive year.This rating indicates company's highest claims paying ability, its strong fundamental and itsoverall financial strength for meeting the policy holder’s obligations.

PC Quest, one of India's premier IT magazines has selected MPLS VPN project of UIIC asone of the best implemented IT projects in the year 2007. The details of the same arepublished in the June 2007 issue of the PC Quest magazine. MPLS VPN project of UIIC wasselected after a rigorous screening process in which 250 IT projects of various companies inthe country were evaluated. Subsequently, a jury of eminent personalities selected the top 21IT projects implemented in 2007, in which the MPLS project of UIIC figures prominently.

Vision

The most preferred insurer in India with global footprint & recognition.

Trusted brand admired by all stakeholders.

The best-in-class customer service provider leveraging technology & multiple channels.

The provider of a broad range of innovative products to meet the needs of all customersegments.

Great place to work with highly motivated and empowered employees.

Recognized for its contribution to the society

14

Mission

To bring peace of mind to our clients by protecting them from financial risks.

To provide Insurance protection to all. To ensure customer satisfaction. To function on sound business principles. To help minimize national waste and develop the Indian economy.

Top Management

Sr. No. Name Designation

1 Shri Milind A Kharat Chairman cum Managing Director

2 Shri S. Surenther Director & General Manager

3 Smt Asha Nair Director & General Manager

4 Shri N Tobdan General Manager

5 Shri B. Krishnamurthy General Manager

6 Shri M V V Chalam General Manager

7 Shri A. Hoda General Manager

8 Shri V. Easwara Kaimal General Manager

9 Smt T.L. Alamelu General Manager

10 Smt Ramma Bhasin General Manager

11 Shri Rajasekharan Chief Vigilance Officer

15

Chapter III

Research Methodology

Need of the study

Purpose of the Study

Objectives of the study

Limitations of the study

Sampling technique/tools

Sample Size

Data collected

Methods / tools of analysis

16

Purpose of the study:The purpose of the study is to know the Survey & Findings on awareness of health insurance inMoradabad (UP) area, and claim settlement process of health insurance.

Need for the study:The need for the study arises to know about the awareness of health Insurance policy by the allsections of the society, for the knowledge of health insurance claim settlement procedure in Indiaand explore the possibilities for its better and easy settlement.

Objectives of the study:The main objectives of the study are:-

To find awareness level of health insurance for Moradabad (UP) 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 thatthe limitations are a part of the project, they have been overshadowed by the benefits ofthe study.

The survey conducted may not be considered as comprehensive as only limitedrespondents could be contacted because of the time constraint.

Objectives, the purposes of the study and the questions had to be explained to therespondents 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, theconclusions drawn based on this may not be a reflection of the entire population.

Sample Size:The sample size of the survey was 80 from different strata of total population. The respondents

were ensured complete confidentiality of their opinion and view.

Population:Our sample population belonged to the Moradabad (UP). Our sample population belonged to allsections of the society such different income group, different occupation group, different age etc.

17

Data collected:

Data includes facts which are required to be collected to achieve the objectives of

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 structuredInterview Schedule.

Secondary Data: The secondary data was collected from the websites of IRDA & III, books,magazines, journals and daily newspapers.

Methods / tools of analysisTools used for analysis are:

Percentage Analysis Graph Simple Correlation Chi-square test

18

Chapter IVClaim Settlement Process

Introduction

Appointment of Surveyor

Appointment of Investigator

Processing of Claims

Close Proximity Cases

Rectification of policy after a loss

Repudiation of Claims

Re-opening of Claim files

How do I file a claim

Cashless Claim

Reimbursement Claim

Documents required for processing of the claim

in a Health Policy

Documents required for processing of the

claim in a Critical Care Policy

19

GENERAL GUIDELINES

Introduction:

The Guidelines laid down here are not exhaustive and are of general nature. It may bepossible that some of the Guidelines laid down cannot in practice be complied with due toparticular circumstances of a case. Such non-compliance need not, therefore, render theclaim as invalid. The Claim Settling Authority can use discretion by recording thereasons.

Appointment of Surveyor:

The Insurance Act stipulates that all claims of Rs.20,000/- and above are to be surveyed by alicensed surveyor. Therefore, for claims less than Rs.20,000, survey by a licensed surveyoris not mandatory. Such losses may be surveyed by the Company’s officials (In-houseSurvey) if survey is required.

Ministry of Finance vides Gazette Notification No. Part II Section 3(ii) dated 30/5/70 haveexempted certain clauses of claims from the operation of Section 64 UM sub-section (10)irrespective of the claim amount and hence such claims can be processed without insistingon a report from a licensed surveyor.

The following must be kept in view before a surveyor is appointed for any claim:

a) The surveyor should be holding a valid licenseb) The surveyor should be selected depending upon the type of loss and the nature

of the subject matter involved.c) For assessment of some losses specific technical expertise may be required and

consultants having such technical expertise may be associated with the surveyors.The consultants’ remuneration should be negotiated in advance bearing theexpertise in mind. This will be in addition to the survey fee payable.

d) Wherever business interruption losses are involved, the surveyors for the materialdamage and the business interruption losses, if several, should be competent tocomplement one another. One surveyor can be utilized for both the losses if theCompany is satisfied about the surveyor’s competence for both the jobs.

e) Appointment of Joint Surveyors may be done on the merits of the case.Companies may frame guidelines on Authority for appointment of surveyor if they so desire.

Where a servicing DO is approached for appointment of surveyor even though they are notthe policy issuing office, surveyor must be appointed by the servicing DO immediately, withintimation to the policy issuing office.

20

Appointment of Investigator:

Depending upon circumstances it may be necessary to appoint an investigator to verify theclaimed version of loss. A separate surveyor appointment may be considered if any actualphysical survey/assessment is possible and called for.

The letter appointing the investigator should mention the terms of reference and make itclear that the report should contain no inferences or doubts unless these are well documentedand substantiated and can stand the scrutiny of a court if so required.

In the absence of a laid down schedule of fees for investigators, it is advisable to negotiateand decide the fees to be paid in addition to expenses actually incurred before formally

appointing the investigator and the determined/decided fee recorded in the letter ofappointment.

Processing of Claims:

Documents generally required for processing of claims are specified in the respectivesections and as far as possible all documents must be called for from the insured in onego and not in piecemeal.

“On Account” Payment: Pending final assessment of a claim an “on account” payment maybe considered subject to confirmation of the following:

Loss due to Occurrence of a peril covered by the policy establishment of liability The minimum liability that might arise under the policy.

After approval of the claim by the competent authority, the insured/claimant should beadvised of the final amount of claim approved, with details thereof.Remaining formalities of obtaining full and final discharge and bank/financial institution’sdischarge (where required) should be completed before release of the amount of claim.

If the loss or any part thereof is recoverable from a Third Party, a letter of subrogationand/or assignment and special Power of Attorney, to suit special cases, is to be sent to theinsured for completion on requisite stamp paper and return before settlement.

21

Co Insurance:

The leader will process the claim on behalf of all the coinsurers. A decision by the leaderregarding claim settlement, taken at the appropriate level according to the existing tenets ofdelegation of financial authority, shall be final and binding on the coinsurers. Claimsdecided at the appropriate level by the leader will not be processed again by coinsurer(s),regardless of the amount. The leader will intimate to the coinsurer details of a claim settledby him with copies of all relevant reports and documents. The coinsurer will settle his shareof the claim within 15 days from the date of receipt of such intimation from the leaderwithout any delay.

In case of a claim requiring Board decision, the decision taken by the Board of the leadershall be binding on the other coinsurers. There shall be no separate need for the coinsurersto approach their respective Boards for decision in respect of such claims. A suitable notemay, however, be placed by the coinsurers before their respective Boards for information insuch cases.

Close Proximity Cases:

Detailed investigation should be immediately instituted when a loss occurs in closeproximity, i.e. within 5 days for all classes of insurances (except marine voyage policies), ofthe date of inception of risk. The close proximity mentioned here is in reference to newinsurance or where there has been a break in insurance. Close proximity investigationshould also be carried out in cases where it is found that insurance has been taken outsignificantly later than it ought to have been taken, i.e. the risk has remained un-insured orinadequately insured prior to the insurance cover under reference.

Rectification of policy after a loss:

Rectification of a policy after a loss is reported for reasons other than breach ofcondition/warranty should be carried out as under:

[a] Where rectification involves collection of additional premium, the additional premiummay be charged only on the affected policy period in which the claim has arisen.

[b] Rectification can be done by the Authority Competent for settlement of the claim.

Repudiation of Claims:

If a claim warrants repudiation, the competent authority would be the authority competent tosettle the claim. Letter of repudiation may state the reasons and/or the policy condition underwhich it is repudiated.

22

Re-opening of Claim files:

Reopening of claim file can be done by the authority one step higher than the appropriateclaim settlement authority.

How do I file a claim?

The United India Insurance Company Limited health policies cover medical expenses incurredtowards the ailment provided that it is admissible under the policy. Following are the broadheads of expenses payable on a health policy.

Hospital (Room & Boarding and Operation Theatre) charges Fees of Surgeon, Anesthetist, Nurse, Specialists Cost of diagnostic tests, medicines, blood, oxygen, internal appliances like pacemaker (if

prescribed medically)

Cashless Claim:

In the event that an insured is hospitalized in a network hospital / nursing home,he / she need not pay the medical expenses (as per coverage) up to the sum insured specifiedunder the policy. This is subject to claim intimation to United India Insurance Co. Ltd. andapproval of the request as per terms of the policy. United India Insurance Co. Ltd. will co-ordinate with the hospital / nursing home directly and settle the bills once the insured patient isdischarged.The insured has to approach the TPA desk of the hospital along with the United India InsuranceCo. Ltd. Health Card, a Photo ID card and the investigation reports. The hospital will thereonsend the request for authorization of treatment to United India Insurance Co. Ltd. In case wedeny the request, the insured has to pay the bills and submit the claim documents for areimbursement.

Reimbursement Claim:

In the event that an insured is hospitalized in any hospital / nursing home (within India) asdefined in the policy and pays the treatment expenses at the time of discharge, he / she needs tofile a claim with United India Insurance Co. Ltd. for the amount due under the policy. UnitedIndia Insurance Co. Ltd. will process the claim as per the terms of the policy and reimburse themedical expenses covered to the insured if he claim is admissible.

23

Documents required for processing of the claim in a Health Policy:

Claim form duly filled and signed Prescription of doctor advising the admission Discharge card issued by the hospital Final hospital bill (in original) and payment receipt Medical investigation reports Medicine bills with the supporting prescriptions Invoice / sticker for implants if used in the surgery Other bills or documents related to the treatment

Documents required for processing of the claim in a Critical Care Policy:

Claim form duly filled in and signed All supporting reports to prove diagnosis of the critical illness (pathological, imaging or any

other reports) Detailed attending physician's report mentioning the past medical and surgical history of the

patient with duration and confirming the diagnosis First Consultation paper.

24

Chapter V

Data Analysis andInterpretation

Percentage Analysis

Graphs

Correlation

Chi- Square Test

Findings

Suggestions

Conclusion

25

Percentage Analysis

Age of the respondents

Satisfaction level No of Respondents Percentage

Highly Satisfied 15 24.2%

Satisfied 25 40.3%

Neutral 5 8.1%

Dissatisfied 11 17.7%

Highly Dissatisfied 6 9.7%

Total 62 100%

Inference:

From the above graph It is shown that maximum number of respondent 40 (i.e.50%) is coming under age group of 26 - 45 years and minimum number ofrespondents 7 (i.e. 8.7%) above age group of 60 years.

0

5

10

15

20

25

30

35

40

45

Highly Satisfied Category 2 Neutral Dissatisfied Highly Dissatisfied

Table No. 1

26

Educational Qualification of Respondents

A SSC 10 12.5%

B HSSC 19 23.8%

C Graduate 33 41.2%

D Post graduate or Above 18 22.5%

Total 80 100%

Inference:

Here we can find out that more number of respondents are Graduates (41.2%)and less no of respondents among our target population is SSC (12.5%).

SSC

HSSC

Graduate

Post Graduate

Table No. 2

27

Occupation of Respondents

A Government Employee 22 27.5%

B Corporate Employee 34 42.5%

C Self Employee 17 21.2%

D Others 7 8.8%

Total 80 100%

Inference:

Here we can find out that more number of respondents are corporate employee(42.5%) and less no of respondents among our target population is Others (8.8%).

0

10

20

30

40

50

Govt. Employee

Table No. 3

27





D Others 7 8.8%

Total 80 100%

Inference:


CorporateEmployee Self Employee

Others

Table No. 3

27





D Others 7 8.8%

Total 80 100%

Inference:


Others

Table No. 3

28

Aware about Health Insurance Plan available in the market

Yes 70 87.5%

No 10 22.5%

Total 80 100%

Inference:

From the above graph it is evident most of the respondent (87.5%) are awareabout the health insurance plan.

Table No. 4

28


Yes 70 87.5%

No 10 22.5%

Total 80 100%

Inference:


Table No. 4

28


Yes 70 87.5%

No 10 22.5%

Total 80 100%

Inference:


Yes No

Table No. 4

29

Having Health Insurance Policy

Yes 62 77.5%

No 18 22.5%

Total 80 100

Inference:

From the above graph it is shown that most of the respondents (77.5%) havehealth insurance policy i.e. 62.

Table No. 5

30

Annual premium of the policy.

A Below 5000 9 14.5%

B 5001 – 10,000 28 45.2%

C 10,001 – 25000 15 24.2%

D Above 25,000 10 16.1%

Total 62 100%

Inference:

Table shows that most of the respondents are handling policies with a maximumpremium of 5 to 10 thousand annually (45.2%), and respondents with minimumpremium <5 thousand per annum (14.5%).

0

10

20

30

40

50

Below 5000

Table No. 6

30


A Below 5000 9 14.5%

B 5001 – 10,000 28 45.2%

C 10,001 – 25000 15 24.2%

D Above 25,000 10 16.1%

Total 62 100%

Inference:


5001 - 10,00010,000 - 25,000

Above 25,000

Table No. 6

30


A Below 5000 9 14.5%

B 5001 – 10,000 28 45.2%

C 10,001 – 25000 15 24.2%

D Above 25,000 10 16.1%

Total 62 100%

Inference:


Above 25,000

Table No. 6

31

Coverage Sum Insured in Lakhs

A Below 1 Lakh 17 27.41%

B 1 - 5 Lakhs 20 32.25%

C 5 - 10 Lakhs 16 25.8%

D Above 10 Lakhs 9 14.5%

Total 62 100%

Inference:

Among our respondents we can conclude that 32.25% have sum assured 5-10lakhs and respondents who have sum assured above ten lakhs are 14.5%.

0

10

20

30

40

Below 1 Lakh

Table No. 7

31



B 1 - 5 Lakhs 20 32.25%

C 5 - 10 Lakhs 16 25.8%


Total 62 100%

Inference:


Below 1 Lakh1 - 5 Lakhs

5 - 10 LakhsAbove 10 Lakhs

Table No. 7

31



B 1 - 5 Lakhs 20 32.25%

C 5 - 10 Lakhs 16 25.8%


Total 62 100%

Inference:


Above 10 Lakhs

Table No. 7

32

Satisfaction levels of the customers towards claim settlement


AHighly Satisfied 15 24.2%

BSatisfied 25 40.3%

CNeutral 5 8.1%

DDissatisfied 11 17.7%

EHighly Dissatisfied 6 9.7%

Total 62 100%

Inference:

Table shows here that 43.3% of respondents are satisfied with claim settlementtowards their health insurance policy and some 8.7 % of respondent are neithersatisfied nor dissatisfied with this process.

0

10

20

30

40

50

HighlySatisfied Satisfied

Table No. 8

32




BSatisfied 25 40.3%

CNeutral 5 8.1%



Total 62 100%

Inference:


SatisfiedNeutral

DissatisfiedHighly

Dissatisfied

Table No. 8

32




BSatisfied 25 40.3%

CNeutral 5 8.1%



Total 62 100%

Inference:


HighlyDissatisfied

Table No. 8

33

Correlation AnalysisCorrelation technique to find the correlation between Annual Premium and SumInsured.

From the above table correlation result shows that annual premium and sum insured ofhealth insurance product are positively correlated with each other and it is significant.

Result:

There is a significant positive relationship between annual premium and suminsured.

Table No. 9

33



Result:


Table No. 9

33



Result:


Table No. 9

34

Correlation technique to find the correlation between duration of the policy andselection of United India Co.

From the above table correlation result shows that duration of the policy and selection ofUnited India Co are negatively correlated with each other and it is not significant.

Result: There is a negative but not significant relationship between duration of the policyand selection of United India Co.

Table No. 10

34




Table No. 10

34




Table No. 10

35

Chi- Square AnalysisChi-Square test for comparing the occupation and satisfaction level of claimsettlement.

H0: There is no significant relation between occupation and satisfaction level of claimsettlement of the respondents.

H1: There is a significant relation between occupation and satisfaction claim settlementof the respondents.

Table No. 11

35




Table No. 11

35




Table No. 11

36

Since the P value 0.927 is greater than 0.05, the null hypothesis (H0) is accepted.

Result: There is no significant relation between occupation and satisfaction level of therespondents.

Table No. 12

36



Table No. 12

36



Table No. 12

37

Chi-Square test for comparing the Annual Premium and surveyor reach.

H0: There is no significant relation between Annual Premium and surveyor reach.

H1: There is a significant relation between Annual Premium and surveyor reach.

Since the P value 0.493 is greater than 0.05, the null hypothesis H0 is accepted.

Inferenc: There is no significant relation between the annual premium and surveyorreach.

Table No. 13

Table No. 14

37






Table No. 13

Table No. 14

37






Table No. 13

Table No. 14

38

Chi-Square Test for comparing the time period of claim settlement andsatisfaction level of the respondent.

H0: There is no significant relation between time period of claim and satisfaction level of

respondents.

H1: There is a significant relation between time period of claim and satisfaction level of

respondents.


Inference: There is no significant relation between time period of claim and satisfactionlevel of respondents.

Table No. 15

Table No. 16

38



respondents.


respondents.



Table No. 15

Table No. 16

38



respondents.


respondents.



Table No. 15

Table No. 16

39

FINDINGS

1. From the above graph It is shown that maximum number of respondents are comingunder age group of 26 - 45 years and minimum number of respondents are above agegroup of 60 years.

2. The major finding of the study is that the maximum numbers of respondent are graduateswhile the minimum numbers of respondents are SSC.

3. Here we find out that maximum numbers of respondent are corporate employee and lessno of respondents are others among our target population.

4. It is concluded that most of the respondents are aware about the health insurance plans.

5. It observed most of the respondents have health insurance policy.

6. It is observed that most of the respondents are handling policies with a maximumpremium of Rs. 5001- 10,000.

7. Among our respondents we can conclude that most of them have sum assured 5-10 lakhsand less number of respondents have sum assured above 10 lakhs.

8. It is founded that almost all the respondents are satisfied towards claim settlement.

9. There is a significant relationship between annual premium and sum insured.

10. There is no significant relationship between duration of the policy and selection of UnitedIndia Co.

11. There is no significant relation between occupation and satisfaction level of therespondents.

12. There is no significant relation between the annual premium and surveyor reach.

13. There is no significant relation between time period of claim and satisfaction level.

40

CONCLUSION

1. The study has been able to accomplish its objectives, by thoroughly analyzing and

identifying the awareness of the customers of United India Insurance Company Limited

strengths and weaknesses of health policy among the clients of United India Insurance

Company and to identify claim settlement process of health policies.

2. The outcome of the study has proved that the performance of the company is outstanding

in making awareness about health insurance plan in the non-life insurance segment and

that the company has a higher reputation among customers and company have great

awareness among respondents. We can also conclude that respondents of the study are

satisfied with Company products and services.

3. It is also concluded that the company could initiate various steps based on the

suggestions. The company by adopting some of the recommendations, if not all, can

further improve its performance and occupy a leading position among other competitors

in the non-life insurance market in future years.

SUGGESTIONS

1. The company should conduct an effective research for making more and more awareness

about its products among potential customers by means of advertisements and efficient

insurance agents, which in turn will help in increasing its customers.

2. Company may motivate all the agents and intermediaries to suggest the policy according

to individual requirement.

3. Company has to do new process and strategies to create a product with less expensive

and which gives more coverage.

4. The present scenario demands almost all the customers to have a general insurance cover

in order to protect from future uncertainty.

41

MANAGERIAL IMPLICATIONS

1. The outcome of the present research is useful for the decision makers in the company to

understand the satisfaction level and accordingly they can formulate their strategies for

promoting their business.

2. This research results will enable the marketing personal to explore the ways to satisfy the

existing customers and consequently, to attract new customers with the motive of

financial inclusion.

3. Further, the research outcome will be very useful to the general insurance business

involved in them to know the existing customers and new customers expecting from the

company.

42

BIBLOGARAPHY

BOOKS:-

Insurance in India, Regal Publication

Insurance institute of India books

JOURNALS

IRDA journals

A.M. Best

Business Insurance

Website

www.cholainsurance.org

www.archives.gov/research/holocaust/articles-and-papers/symposium-papers/insurance-in-national-socialist-period.html.

42

BIBLOGARAPHY

BOOKS:-



JOURNALS

IRDA journals

A.M. Best

Business Insurance

Website



42

BIBLOGARAPHY

BOOKS:-



JOURNALS

IRDA journals

A.M. Best

Business Insurance

Website



43

Appendix

44

QUESTIONNAIRE

“A study on awareness of health insurance products, underwriting practicesand claim settlement process“ with reference to The United India General

Insurance Company, Moradabad (UP)

SECTION - IDEMOGRAPHIC

1. Name:__________________________________________________________________

2. Gender:(a) Male (b) Female

3. Age:(a)Below 20 Yr (b) 21-40 Yr(c)41-60 Yr (d)Above 60 Yr

4. Occupation: (a) Govt. employee (b) Corporate employee(c)Self employee (d) Others

5. Educational Qualification:(a) SSC (b)HSSC(c)Graduate (d)Post graduate or Above

6. Income PA: (a) Below 1 lakh (b) 1 to 3 Lakhs(c) 3 to 5 Lakhs (d) Above 5 Lakhs

7. Are you aware of Health Insurance products of the United India GIC.?(a) Yes (b) No

SECTION-2CUSTOMER AWARENESS

45

8. If yes, what is the source of awareness?(a)Company (b) Newspapers(c)Television (d) Internet

9. Do you have any Health Insurance Policy for you or your family members?(a) Yes (b)No

10. How long you are carrying the Health Insurance policy?(a) Below 1 Yr (b) 1 – 5 yr(c) 5-10yr (d) Above 10yr

11. Whether your policy has covered all family members?(a) Yes (b) No

12. What is your Annual Premium?(a) Below 5000 (b) 5000 - 10000(c) 10,000- 25,000 (d) Above 25,000

13. What is your coverage Sum Insured (SI)?(a) Below 1 Lakh (b) 1 -5 Lakhs(c) 5 - 10 Lakhs (d) Above 10 Lakhs

14. Do you think coverage SI is enough for you?(a) Yes (b) No

15. Do you have Free Health Check-Up?(a) Yes (b) No

16. Whether your policy is life time policy?(a) Yes (b) No

17. Do you wish to take low premium policies with limited benefits or high premiumpolicies with more benefits?

(a) Yes (b) No

18. Does your policy give daily cash for regular hospitalization?(a) Yes (b) No

19. Do you have any policy which gives double the daily cash for ICU confinement?(a) Yes (b) No

20. Whether your spouse is working?(a) Yes (b) No

21. How is the service offered by the United India GIC.?(a) Poor (b) Average(b) Good (c) Excellence

46

22. Why you have chosen the product of United India GIC.?(a)Brand Value (b) Near By Area(c) Govt. company (d) Others

23. Have you ever made a claim on Health Insurance?(a) Yes (b) No

24. How soon does the surveyor reach?(a) Within 3 hours (b)3-8 hours(c) 8-24 hours (d) Above 24 Hours

25. After Reporting, within how many days has claim been settled by the United IndiaGIC.?

(a)Within 7 days (b) 7 – 15 days(c)15 – 30 days (d) Above 30 days

26. Are you satisfied with claim settlement of Health insurance offered by United IndiaGIC.?

(a) Highly satisfied (b) satisfied(c)Dissatisfied (d)Highly dissatisfied

27. Are you being continued as customer after made claim in United India GIC.?(a) Yes (b) No

SECTION-3Claim Settlement Process

47

NOTE

Economy & Finance

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