Microinsurance experience at Shepherd AOA Seminar Colombo, Sri Lanka, August 2014

1. SHEPHERD –TAMILNADU, INDIAAugust 2014

2. AOACONFERENCESRI LANKA26THAUGUST 2014

3. Shepherd is a Social Development Organization Working with 70,000 low income families in 7 districts of central Tamilnadu, India, working with women (only)

4. Promoted 4865 Surabhis (SHG)
Providing services like
Savings
Credit
Health initiatives
Micro insurance (Life & Health package)
Community Health Mutual
Livelihood Promotion

5. Surabhi (SHG) Meeting

6. Micro insurance started in the year 1999 because: -Six women from surabhidied naturally with in one year. -700 huts were burnt in communal riots. -40% of internal loans from surabhihad been spent for “curative” purposes.

7. Health Security: Three Attributes. 1. Prevention –Medical Camps2. Protection -Micro / Mutual health insurance3. Promotion –Health Education

8. WHY ?

9. Issues in Health Insurance
Poor women are asking refund of premium, when there is no claim
Poor people don’t know where to take treatment (hospital) during emergency.
Poor don’t have adequate money to pay as advance for treatment in hospitals
Insurance companies are asking all original reports and bills from hospitals

10. Bureaucratic approach (Top down)
Unable to get full pledged medical reports with bills from some hospitals. Poor women also don’t know how to collect all reports
The choice of hospital left with poor people??
Delay in claim settlement by insurance companies more than 50 days
No fund for operational cost
Unsettled amount goes to ins. Company corpus
Un willingness of ins. Company to do rural micro insurance (life & health)

11. HOW ?

12. Health Education -TOT

13. Health Education

14. Health Conferences

15. Community Mutual
Community mutual is an initiative by women leaders of Surabhi(SHG)
Objectives:
To share their knowledge, experiences and best practices in order to provide quality health care services to the poorest sections of the society in a professional manner there by improving the overall efficiency of health care delivery system.

16. Shepherd is promoting community based Health mutual fund
The contribution (Premium) divided in to 3 parts
60% towards benefit (claim)
20% for operating cost
20% for Benefit (claim) reserve

17. Community Mutual Committee

18. Social Protection Committee consists of women leaders
Initially we work with surabhi (SHG)women on Health
Doctors are working as advisory group to the claim (benefit) committee.

19. Operational Coverage
YEAR
ENROLMENT
CONTRIBUTION RS.
NO OF CLAIMS
BENEFIT AMOUNT RS.
2011-12
3250
4,06,250
32
1,16,954
2012-13
5704
7,13,000
17
68,776
2013-14
2881
3,60,125
28
57,858
TOTAL
11,835
14,79,375
77
2,43,588

20. RATIO’S
Average claim ratio –27.4%
Average enrollment No.–3,945
Claim rejection ratio –12%
Renewal rate –51%
OSS –82.1%

21. Impact
Claim settlement duration reduced
Timely assistance for post treatment services
Women are willing to take early treatment of disease
Moving towards self management approach (cost coverage)

22. Health Camp

23. Health education created good awareness on primary and secondary care
Transparent operation system fund managed by women leaders (Self –reliance)
Mutual health insurance provide timely support to women borrowers

24. Limitations
Still willingness level is low
TN state Govt.’s free health insurance up to Rs.1,00,000
(US$ 1666) / family / year ???
Regulator is not considering people’s initiatives (Mutual)
NGO’s/ MFIsare reluctant to do health mutual (complications & paper work)
Yet to reach operational self sufficiency

25. Way forward
Keen to upscale at least 20000 families / year
Establishing mutual as core programe
Sensitization of government officials towards people’s initiatives (Regulations)
Capacity building of women staff
Networking among NGO/MFIsfor larger coverage

26. Health Education Posters

28. THANK YOU……. E-mail: shepherddevorg@gmail.com