University Guide: Dr. M. Dharmalingam Company Guide: Mr. P. K Saxena (Development Officer)

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University guide:
Dr. M. Dharmalingam
Presented By:
Md Mubarak
Hussain
MBA (IM), 2nd Year
Reg. No. 12395019
Pondicherry
University
Karaikal Campus
Company guide:
Mr. P. K Saxena
(Development
Officer)
Copyright 2006 Biz/ed
http://www.bized.co.uk
TITLE OF THE PROJECT

A study on awareness of Health Insurance
products and claim settlement process with
reference to the United India Insurance Company
Limited, Moradabad (UP).
Content
Introduction
Company Profile
Scope, objectives &
Limitation of study
Research Methodology
Data Sources
Sampling Design
Data Collection
Data
Representation
Data Analysis
Findings
Conclusion
Suggestions
Reference
Definition of Health Insurance

Health Insurance is an insurance, which covers the
financial loss arising out of poor health condition or due to
permanent disability, which results in loss of income.
Health Insurance Industry-Introduction

The term Health Insurance is used to describe a form of
insurance that pays for medical expenses. It is used more broadly
to include insurance that covers disability or long-term nursing.
In simple words, if we are covered under Health Insurance, we
pay some amount of premium every year to an insurance
company and if we have an accident or if we have to undergo an
operation or a surgery, the insurance company will pay for the
medical expenses.
Contd
According to the governments Insurance Information
Bureau, Indias health insurance market is growing fast. In
2010, private insurance companies had 6.8 million policies
covering nearly 55 million Indians (or 4.6 percent of the
population).
The Indian government also provides subsidized health
coverage to 25.3 million poor families.
Health Insurance Product

Family medicare
Senior citizen
Topup
Super topup
Gold
Platinum
Company Profile
Type
Public
Industry
Insurance
Founded
1938
Headquarter
Chennai
Employee
17,361
Key people
Mr. Milind Kharat (CMD)
Contd
United India Insurance Company Limited (UIIC) ( A Govt. Of

India Undertaking) is the one among the 4 public General
Insurance Companies of India and a leading General Insurance
player. With the net worth of Rs 4,587 crores as on September 30,
2011.
United India Insurance Company Limited was incorporated as a
Company on 18 February 1938.
12 Indian Insurance Companies, 4 Cooperative Insurance
Societies and Indian operations of 5 Foreign Insurers, besides
General Insurance operations of southern region of Life Insurance
Corporation of India were merged with United India Insurance
Company Limited.
Ratings
United India Insurance Co. Ltd. has been awarded 'iAAA`
rating for its claims paying ability by ICRA (Investment
Information and Credit Rating Agency) for the third successive
year.
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 customer segments.
Great place to work with highly motivated and empowered
employees.
Recognized for its contribution to the society.
Mission
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.
Management Team
Chairman cum Managing Director

Mr. Milind A Kharat
Director & General Manager
Mr. S. Surenther
Director & General Manager
Mrs. Asha Nair
General Manager
Mr. N Tondan
General Manager
Mr. B. Krishnamurthy
Chief Vigilance Officer
Mr. Rajasekharan
Deputy General Manager
Mr. S.P. Nanda
Scope, Objectives & Limitations

of the Study
Scope
The purpose of the study is to know the Survey on
awareness of health insurance and claim settlement with
reference to Moradabad.
OBJECTIVE
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
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.
Contd
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.
Claim settlement process in the

Health Insurance policy
The United India Insurance Company Limited provides
tow types of health claim: Cashless and
Reimbursement
Cashless Claim:
In the event that an insured is hospitalized in a network
hospital/ nursing home, he/ she need not to pay the
medical expenses up to the sum insured amount specified
under the policy.
Process of Cashless Claim

Search the networked hospital, as cashless is available only for
networked hospitals.
For planned hospitalisations, intimations to be sent to the TPAs in
advance with Name and address of the hospital.
In case of an emergency hospitalisation, intimation to be sent to the
TPA immediately on admission.
On admission, a Pre-Authorisation Request for cashless is to be sent
to the TPA by the hospital.
On discharge from Hospital, pay (if any) the difference of amount
disallowed under the policy or limited by the sum insured.
All documents in original to be submitted within 7 days to TPA,
after completion of Post Hospitalisation treatment.
Reimbursement Claim
In the event that an insured is hospitalized in any hospital /
nursing home (within India) and pays the treatment
expenses at the time of discharge, he/she needs to file a
claim with United India Insurance Company Limited for
the amount due under the policy.
Process of Reimbursement Claim

Written intimation about hospitalisation to be sent to TPA
immediately, and within 24 hours of hospitalisation in the case of
emergency hospitalisation.
Before leaving the hospital, Discharge Summary, Copy of
investigation report and other relevant documents may be obtained
from the hospital authorities. All the documents in original to be
submitted to TPA / Office within 7 days from date of discharge.
Documents include claim form issued by insurer, discharge
summary of hospital, doctor's certificates and prescriptions, final
hospital bills, laboratory and other investigation reports and bills,
pharmacy bills and all related documents.
All documents in original to be submitted within 7 days after
completion of Post Hospitalisation treatment.
RESEARCH METHODOLOGY: RESEARCH DESIGN:- Descriptive Research

SAMPLING DESIGN:- Non Probability sampling in
particular convenient sampling techniques is used.
Sample size:-The sample size of the survey is 80.
Population:Our target population belongs to Moradabad (UP). It
covers all the groups of the society such as income,
occupation, and age.
Methods/ tools of analysis:Tools used for analysis are: Charts & Diagrams
Simple Percentage
Simple Correlation
Chi Square Test
Data Sources
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 by survey
method through structured questionnaire.
Secondary Data
The secondary data was collected from various websites, books,
magazines, journals and daily newspapers published and
unpublished literature from the company, IRDA & III.
ANALYSIS &
INTERPRETATION
1. Age of the respondents

A
Below 25 year
12
15%
26 45 year
40
50%
46 60 year
21
26.3%
Above 60 year
8.7%
Total
80
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 of
respondents 7 (i.e 8.7%) above age group of 60 years.
2. Educational Qualification of Respondents

A
SSC
10
12.5%
HSSC
19
23.8%
Graduate
33
41.2%
Post graduate or Above 18
22.5%
Total
100%
80
Inference:
From the above table and graph we can conclude that the maximum number of
respondents are graduates with a percentage of 41.2 and minimum are SSC with
percentage of 12.5.
3. Occupation of Respondents
A
Government
Employee
22
27.5%
Corporate
Employee
34
42.5%
Self
Employee
17
21.2
Others
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%) .
4. Aware about Health Insurance Plan available

in the market
Yes
70
87.5%
No
10
22.5%
Total
80
100%
28%
73%
YES
NO
Inference:
From the above graph it is evident most of the respondent
aware about the Health insurance plan.
(87.5%) are
5. Having Health Insurance Policy

YesT
No
Total
62
77.5%
18
22.5%
80
100
15%
85%
YES NO
Inference:
From the above graph It is shown that most of the respondents (77.5%) have
health insurance policy i.e. 62.
6. Annual premium of the policy.

A
Below 5000
14.5%
5001 10,000
28
45.2%
10,001 25000
15
24.2%
Above 25,000
10
16.1%
Total
62
100%
Inference:
Table shows that most of the respondents are handling policies with a maximum premium
of 5 to 10 thousand annually (45.2%) , and respondents with minimum premium <5
thousand per annum (14.5%).
7. Coverage Sum Insured in Lakhs

A
Below 1 Lakh
17
27.41%
1 - 5 Lakhs
20
32.25%
5 - 10 Lakhs
16
25.8%
Above 10 Lakhs
14.5%
Total
62
100%
20
16
17
Inference:
Among our respondents we can conclude that 32.25% have sum assured 5-10 lakhs and
respondents who have sum assured above ten lakhs are 14.5%.
8. Satisfaction levels of the customers towards

claim settlement
Satisfaction
level
Highly Satisfied
Satisfied
Neutral
Dissatisfied
Highly
Dissatisfied
30 Total
No of
Respondents
15
25
5
11
Percentage
24.2%
40.3%
8.1%
17.7%
9.7%
62
100%
20
10
Series 1
0
Inference:
Table shows here that 43.3% of respondents are satisfied with claim settlement towards
their health insurance policy and some 8.7 % of respondent are neither satisfied nor
dissatisfied with this process.
Coefficient of Correlation
Correlation technique to find the

correlation between Annual Premium and
Sum Insured.
H0: There is no significant relationship between Annual premium and Sum Insured.
H1: There is a significant relationship between Annual premium and Sum Insured.
From the above table correlation result shows that annual

premium and sum insured of health insurance product are
positively correlated with each other because, the correlation
value is greater than 0.5.
Inference: There is a significant relationship between annual

premium and sum insured.
Correlation technique to find the correlation

between duration of the policy and selection of
United India Co.
H0: There is no significant relationship between duration of the policy and selection of United
India Co.
H1: There is significant relationship between duration of the policy and selection of United
India Co.
Contd
From the above table correlation result shows that duration of the policy
and selection of United India Co are negatively correlated with each
other. Since the correlation value is less than 0.5, the correlation is not
significant
Inference : There is no significant relationship between duration of the

policy and selection of United India Co.
CHI-SQUARE TEST
Chi-Square Test for comparing the

occupation and satisfaction level of claim
settlement.
Occupation and satisfaction level Crosstabulation
Count
Satisfaction Level
Highly
Highly
Satisfie
Dissatis
Total
Satisfi
Neutral
Dissatis
d
fied
ed
fied
Govt.
Employ
ee
Corpor
ate
Occupation Employ
ee
Self
Employ
ee
Others
Total
15
14
29
13
1
14
2
25
1
5
0
11
1
5
6
62
Copyright
2006 Biz/ed
Contd
H0: There is no significant relation between occupation and satisfaction level of
claim settlement of the respondents.
H1: There is a significant relation between occupation and satisfaction claim
settlement of of the respondents.
20
Chi-Square Tests
Value
df
Asymp.Sig.(2sided)
PearsonChiSquare
5.783a
12
.927
Likelihood
Ratio
6.216
12
.905
Linear-byLinear
Association
.058
.809
NofValid
Cases
62
a.15cells(75.0%)haveexpectedcountlessthan5.The
minimumexpectedcountis.40.
Since the P value 0.927 is greater than 0.05, the null hypothesis (H 0) is
accepted.
Inference : There is no significant relation between occupation
and satisfaction level of the respondents.
Chi-Square Test for comparing the

Annual Premium and surveyor reach.
Annual Premium * How soon reach the surveyor Crosstabulation
Count
SurveyorReach
Within3
8-24 Above24 Total
3-8Hrs.
Hrs.
Hrs.
hrs.
Below5000
5000-10,000
28
15
3
16
2
17
4
18
1
11
10
62
Annual
Premium 10,000-25,000
Above25,000
Total
H0: There is no significant relation between Annual Premium and surveyor reach.
H1: There is a significant relation between Annual Premium and surveyor reach.
Chi-Square Tests
Value
df
Asymp.Sig.(2sided)
PearsonChi-Square
8.416a
.493
LikelihoodRatio
10.813
.289
Linear-by-Linear
Association
3.307
.069
NofValidCases
62
minimumexpectedcountis1.60.
Since the P value 0.493 is greater than 0.05, the null hypothesis H 0 is
accepted.
Inference:
Hence, There is no significant relation between the annual
premium and surveyor reach.
Chi-Square Test for comparing the time period of

claim settlement and satisfaction level of the
respondent.
Claim being settled * Satisfaction level towards claim
settlement
Crosstabulation
Count
Satisfactionlevel
Within7
Days
Time 7-15Days
periodof15-30Days
Claim
Above30
Days
Total
Highly
Highly
Total
Dissatisfie
Satisfie Satisfied Neutral
Dissatisfie
d
d
d
5
15
7
3
9
10
3
0
4
2
2
0
25
15
15
25
11
62
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.
Chi-Square Tests
PearsonChiSquare
LikelihoodRatio
Linear-by-Linear
Association
Value
df
Asymp.Sig.(2sided)
16.046a
12
.189
18.863
12
.092
.008
.927
NofValidCases
62
minimumexpectedcountis.56.
Since the P value 0.189 is greater than 0.05, the null hypothesis H 0 is accepted.
Inference:
There is no significant relation between time period of claim and satisfaction
level of respondents.
Findings
1. It is concluded that most of the respondents are aware about the health
insurance plans.
2. It is founded that almost all the respondents are satisfied towards claim
settlement.
3. The major findings of the study is that the maximum number of
respondents are Graduates while the minimum number of respondents
are SSC.
4. It is observed that most of the respondents are handling policies with a
maximum premium of Rs. 5001- 10,000.
5. It observed most of the respondents have health insurance policy.
6. Among our respondents we can conclude that most of them have sum
assured 5-10 lakhs and less number of respondents have sum assured
above 10 lakhs.
Contd
7. There is a significant relationship between annual premium and sum
insured.
8. There is no significant relationship between duration of the
policy and selection of United India Co.
9. There is no significant relation between occupation
and satisfaction level of the respondents.
10. 10. There is no significant relation between the annual premium and
surveyor reach.
11.There is no significant relation between time period of
claim and satisfaction level.
Conclusion: 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.
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.
Contd
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
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.
Company may motivate all the agents and intermediaries to suggest the
policy according to individual requirement.
Company has to do new process and strategies to create a product with
less expensive and which gives more coverage.
Managerial Implications:
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.
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.
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.
Reference
BOOKS:
IC-27 (Health insurance), Insurance Institute of India: Mumbai.
Kothari. C.R. Research Methodology, New Age International Publishers, New
Delhi 2004
WEBSITES:
www.uiic.co.in
www.irdaindia.org
www.economywatch.com/insurance/general-insurance
MAGAZINES AND JOURNALS

Outlook Money.
IRDA Journal.
Insurance watch
Insurance world

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TITLE OF THE PROJECT

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Definition of Health Insurance

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Health Insurance Industry-Introduction

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Health Insurance Product

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Mr. Milind Kharat (CMD)

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United India Insurance Company Limited (UIIC) ( A Govt. Of

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To provide Insurance protection to all.

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Chairman cum Managing Director

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Scope, Objectives & Limitations

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Claim settlement process in the

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Process of Cashless Claim

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Process of Reimbursement Claim

RESEARCH METHODOLOGY: RESEARCH DESIGN:- Descriptive Research

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1. Age of the respondents

2. Educational Qualification of Respondents

Post graduate or Above 18

4. Aware about Health Insurance Plan available

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5. Having Health Insurance Policy

6. Annual premium of the policy.

7. Coverage Sum Insured in Lakhs

8. Satisfaction levels of the customers towards

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Correlation technique to find the

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From the above table correlation result shows that annual

Inference: There is a significant relationship between annual

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Correlation technique to find the correlation

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Inference : There is no significant relationship between duration of the

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Chi-Square Test for comparing the

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Chi-Square Test for comparing the

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Chi-Square Test for comparing the time period of

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

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