Chapter VIII Customers Perception Regarding Health Insurance

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1 Chapter VIII Customers Perception Regarding Health Insurance This chapter deals with the analysis of customers perception regarding health insurance and involves its examination at series of stages i.e. analysis is multidimensional in nature. In other words, an effort was made in present study to examine the customers perception regarding health insurance and the peculiar feature of it lies in multi-dimensions. As firstly, it examines the respondents who are aware or not aware about health insurance as well as various sources of awareness; secondly, those who are aware have subscribed it or not; thirdly, those who have subscribed what are the reasons behind their subscription; also to investigate and examine various factors affecting the selection of health insurance by an individual.; fourthly, those who have not subscribed what are the reasons behind their non-subscription i.e. to examine and explore the various factors, which act as barriers and ultimately obstruct the subscription of health insurance; and last but not least to determine, are the non health insurance policyholders willing to join and pay for it and also to explore and examine various factors having impact upon their willingness to pay for health insurance. 8.1 Introduction 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 is 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. As far as the stages of development of health insurance in India are 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.

2 But there is terrible need of health insurance in India. As according to World Bank Report (WBR) some relevant studies reveals that 85% of the working populations in India do not have Rs. 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. (Source: assessed as 15th March, 2010 Thereby, in the present study an effort was made to evaluate state of health insurance in India both in term of its performance as well as its prospects. For this purpose, on one side performance evaluation of health insurance business of general insurance companies was made. Alternatively, customers were also included in the present study, because the real worth of the performance of the company can be evaluated only with the word-of-mouth of the ultimate consumer. Accordingly, customers perception with respect to health insurance was also studied in order to get insight into their awareness; satisfaction; willingness to join and pay for health insurance. 8.2 Empirical Results, its Analysis and Interpretation Personal Profile of Respondents: A significant proportion of the sample was male members. Majority of the respondents belonged to the age groups of years and were married and living in nuclear families. Maximum respondents were graduate followed by higher education and post graduation and were employed. As far as level of income is concerned, a major percentage of the respondents fall in the annual income category of less than Rs and Rs

3 Table 8.1 Personal Profile of the Respondents Gender Frequency Percentage Male Female Total Age Frequency Less than Above Total Marital Status Frequency Single Married Total Type of Family Frequency Joint Nuclear Total Education Frequency Illiterate Primary Middle Matric Higher Education Graduation Contd 150

4 Post Graduation Vocational Other Total Occupation Frequency Employed Self employed Labour Housewife Unemployed Professional Family owned business Retired Total Income per annum Frequency Less than Rs Rs Rs Rs Above Rs Total Awareness, Exposure and Knowledge of Respondents for Health Insurance: Although, health insurance is not a new concept and people are also getting familiar/aware about it, yet this awareness has not reached to the level of subscription of health insurance products. 151

5 Table 8.2 Awareness Level and Sources of Awareness for Health Insurance Awareness/ Subscription of health insurance Sources of Awareness Particulars Frequency Percentage Not Aware/ not exposed Aware/exposed and subscribed Aware/exposed and unsubscribed Total Particulars Responses % of Responses TV Newspaper Agents Family Friends Movies Employee of insurance company Tax consultants & doctors Any other Total Table 8.2 depicts that although, a significant portion of respondents were aware about health insurance as they heard about it from one or more sources, yet their awareness has not reached to the level of subscription as 71.9% of respondents were still without any form of health insurance and presently only 19.4 % were having any form of health insurance. As far as the sources of awareness is concerned, there are number of sources generating awareness regarding health insurance. The results of the study provided that the main source of awareness about health insurance is TV as the percentage of response is 26.5%, followed by newspaper (21.2%), agents (17.8%), friends (10.5%), employees of insurance companies (8.8%), family (6.9%), movies (5.9%), tax consultant and doctors (1.3%) and any other (1.2%). Overall it can be concluded that the main sources of awareness is TV, newspaper, agents and friends as in these cases percentage of response is more than 10%. 152

6 8.2.3 Reasons for Having Health Insurance: There are numerous reasons for having health insurance. The respondents were requested to rank these in the order of their preference and thereafter calculation of Weighted Average Scores (WAS) was made in order to find out the most governing reason behind their subscription of health insurance. Table 8.3 Weights and Ranks of Various Reasons for Health Insurance S. No. Particulars WAS Rank 1 Tax planning measure Risk Coverage against future illness Avail good quality medical treatment Employer s contribution Travelling abroad Existing illness While analyzing the reasons for having health insurance, it was found that most governing reason behind the subscription of health insurance was risk coverage against future illness as its weighted average score is The second main governing reason behind subscription of health insurance was to avail good quality medical treatment with weighted average score of 4.18, followed by employers contribution, travelling abroad, tax planning measures and existing illness as their respective weighted average scores are 3.75, 3.15, 2.92 and Insurer, Approach and Policy opted: After the analysis of numerous reasons behind subscription of health insurance, an effort was made towards the examination of insurers, approach and policy opted for subscription of health insurance. For this, the respondents were requested to give their response for followings: insurers opted either public or private company; type of policy taken group health insurance, individual health insurance, family floater health insurance etc; and the approach adopted i.e. whether insurance agent seeked you or you seeked insurance agent for the subscription of health insurance. 153

7 Table 8.4 The Insurer, Approach and Policy Opted by Health Insurance Policy Holders Insurer opted Frequency Percentage Public company Private company Total Type of policy Frequency Percentage Group health insurance Individual health insurance Family floater insurance Any other - - Total Approach adopted Frequency Percentage Insurance agent seeked you You seeked insurance agent Total The table 8.4 shows that a significant portion of respondents with health insurance opted for public insurance company for the subscription of group health insurance policy and has himself seeked the insurance agent for the subscription of health insurance Claim logged aspects: These were examined to know about the perceived level of experience of respondents regarding claim logging aspects. For this purpose firstly, the respondents with health insurance policy were categorized into: those who have ever logged claim and those who have never logged claim, as shwn in table 8.5. Secondly, all the variables associated with the claim logged aspect were taken in the form of statements and respondents with health insurance policy, who have ever logged claim were requested to give their response on five point likert scale ranging from strongly agree to strongly disagree. Where 5 signifies Strongly Agree (SA), 4 signifies Agree (A), 3 signifies Indifferent (I), 2 signifies Disagree (D) and 1 signifies Strongly Disagree (SD). Afterward the calculation of Weighted Average Scores (WAS) as shown in table 8.6 were 154

8 made to arrive at meaningful inference regarding respondents perception from the claim filling till claim settlement of health insurance. Table 8.5 Statistics Related with Claim Logged Aspects of Health Insurance Policy Holders Have u ever logged claim Frequency Percentage Yes No Total The table 8.5 shows that 38.5% of respondents with health insurance has so far logged claim with the insurance company. Alternatively, approximately 62% of respondents with health insurance policy have never logged claim with their respective insurers. Table 8.6 Weighted Average Scores for Various Statements Related With Claim Logged of Health Insurance Policy Statements SA A I D SD WAS Rank Hassle free claim application process (61.9) (19.0) (9.5) (0.0) (9.5) Hassle free claim settlement (50.0) (38.1) (11.9) (0.0) (0.0) Claim settlement within a limited period (19.0) (61.9) (19.0) (0.0) (0.0) Claim logged fully settled (21.4) (50.0) (19.0) (9.5) (0.0) Claim logged partially settled (11.9) (73.8) (9.5) (4.8) (0.0) Claim settled with limited terms and conditions (7.1) (57.1) (35.7) (0.0) (0.0) Cooperation and attitude of TPAs (28.6) (50.0) (19.0) (2.4) (0.0) Cooperation and attitude of surveyors (40.5) (47.6) (2.4) (9.5) (0.0) Cooperation and attitude of the insurance company (28.6) (45.2) (16.7) (9.5) (0.0) Time taken by TPAs (35.7) (23.8) (38.1) (2.4) (0.0) Time taken by surveyors 15 (35.7) 16 (38.1) 11 (26.2) 0 (0.0) 0 (0.0)

9 Table 8.6 shows that hassle free claim settlement and hassle free claim application process were mostly experienced by the respondents, while logging the health insurance claim as its weighted average scores were 4.38 and Whereas the least weighted average score is in the case of Claim settled with limited terms and conditions and Claim logged fully settled as its weighted average scores were 3.71 and Perceived Level of Satisfaction: We also tried to analyze the perceived level of satisfaction of health insurance policy holders by asking them about the followings: Is the services provided delivered effectively? What is the chance of renewing it? Are you willing to pay more for additional services? Table 8.7 Perceived Level of Satisfaction of Health Insurance Policyholders Services provided delivered effectively Frequency Percentage Yes No Indifferent Total Chances of renewing Frequency Percentage 100% % % % Total Are you willing to pay more for additional services Frequency Percentage Yes No Total Table 8.7 shows that approximately 62% of the health insurance policy holders were of the view that services provided are delivered effectively by the insurance companies; 48% of policy holders were having 100% chance of renewing the same and 156

10 66.1 % of the policyholders were even willing to pay more if additional services added with the existing policy. Overall, perceived level of satisfaction of the health insurance policyholders found to be satisfactory as approximately half or near half of health insurance policyholders were agree with services provided delivered effectively; 100% chance of renewability; and even willing to pay more for additional services Factors Considered While Buying/Selecting Health Insurance Policy: Beside above, the respondents with health insurance policy were requested to give their response regarding various factors which they considered while buying/selecting health insurance policy? There are number of factors which affect the selection of health insurance or considered by an individual when buying health insurance policy. All these factors are considered in the form of variables and are shown in table 8.8 along with their description. For all these factors the respondents were requested to give their response on five pont likert scale ranging from strongly agree to strongly disagree. Where 5 signifies Strongly Agree (SA), 4 signifies Agree (A), 3 signifies, Indifferent (I), 2 signifies Disagree (D) and 1 signifies Strongly Disagree (SD). Before the application of factor analysis the reliability of scale items were tested with the application of cronbach s alpha. The value of all factors ranges between 0.82 to 0.93, indicating the presence of internal consistency. Further to test the sampling, Kaiser- Meyer-Olkin measure of sampling adequacy is computed which is found to be It indicates that sample is good enough for sampling. Moreover the overall significance of correlation matrices has been tested with Bartlett Test (approx. Chi-square= and significant at 0.000) provided as well as support for the validity of data for factor analysis. All this provided that we can proceed with factor analysis and the result of factor analysis over 23 factors shown that there are 7 factors, which were determined by clubbing the similar variables and consider being most important, while buying/selecting health insurance policy. The table 8.9 shows the respective percentage of variance of all the factors derived from factor analysis, having impact on the selection of health insurance or considered while buying health insurance. 157

11 Table 8.8 List of Variables Having Impact on the Selection of Health Insurance or Considered while Buying Health Insurance Variable Description V1 V2 V3 V4 V5 V6 V7 V8 V9 V10 V11 V12 V13 V14 V15 V16 V17 V18 V19 V20 V21 V22 V23 Name and Reputation of the insurance company Use of modern technology by insurance company Courteousness of employees, brokers and corporate agents Capability and knowledge of employees, brokers and corporate agents Services provided by the employees, brokers and corporate agents Availability of maximum consumable income Use of extensive promotional activities Maximum customers satisfaction Prompt claim processing with least of formalities Availability of loan facility to meet all associated cost of health insurance Minimum copayment involved Minimum deductible applicable Nominal premium charged Wide policy options Reliability of services offered Employer s contribution toward premium payment Comprehensive coverage Cash less facility Easy accessibility of linked hospitals Easy availability of services in hospitals Flexibility of policy offered Availability of tax benefits Goodwill and Linkage of company with Third Party Administrators (TPAs) 158

12 Table 8.9 Explain the Total Variance of Various Factors Having Impact on the Selection of Total Health Insurance or Considered while Buying Health Insurance Initial Eigenvalues % of Variance Cumulative % Total Extraction Sums of Squared Loadings % of Variance Cumulative % Total Rotation Sums of Squared Loadings % of Variance Cumulative % V V V V V V V V V V V V V V V V V V V V V V V Extraction Method: Principal Component Analysis. 159

13 It was observed from table 8.9 that only 7 factors has Eigen value more than one, so accordingly we preceded with these factors. The total variance explained by factor 1, 2, 3, 4, 5, 6 and 7 is , , , , 7.685, and 6.804, whereas the cumulative variance explained by all these factors is percent and rest of the variance is due to the factors which are beyond the scope of the study. Table 8.10 Rotated Component Matrix of Various Factors Having Impact on the Selection of Health Insurance or Considered while Buying Health Insurance Components V V V V V V V V V V V V V V V V V V V V V V V Extraction Method: Principal Component Analysis. Rotation Method: Varimax with Kaiser Normalization. Rotation converged in 11 iterations. 160

14 The table 8.10 shows that each statement corresponding to the highlighted factor loading is correlated with the factor corresponding to that factor loading. Higher the factor loading, stronger is the correlation between the factor and statement. On the basis of rotated component matrix the factor extraction table has been prepared. Table 8.11 Is a Factor Extraction Table Which Shows the Variables under Each Factor with Corresponding Loading and Percentage of Variance Factors % of Variance Factor Interpretation F Ease of Services to Obtain F Minimum Consideration F Availability of Funds (whether in hand or from outside) F Intermediaries Outreach and Capabilities F Multiplicity of Benefits with Extensive Promotional Activities F Goodwill and Linkage of the Company F Use of modern technology Variables Included in the factor Prompt claim processing (V9) Comprehensive coverage (V17) Cash less facilities (V18) Easy accessibility of linked hospital (V19) Easy availability of services in hospitals (V20) Minimum copayment involved (V11) Minimum deductible applicable (V12) Nominal premium charged (V13) Wide policy options (V14) Reliability of services (V15) Availability of maximum consumable income (V6) Availability of loan facility for making premium payment (V10) Employer s contribution toward the premium payment (V16) Courteousness of the employees, brokers and agents (V3) Capability and knowledge of the employees, brokers and agents (V4) Services provided by the employees, brokers and agents (V5) Use of extensive promotional activities (V7) Tax benefits (V21) Flexibility of policy offered (V22) Name and reputation of the company (V1) Linkage with Third Party Administrator (TPA) and their services (V23) Use of modern technology (V2) Maximum satisfaction to customers (V8) Loading

15 The above stated factors are in the order of degree of importance i.e. factor 1 is more important than factor 2; factor 2 is more important than factor 3 and so on. The factor 1 and 2 has %, % of variance which is the highest variance as compared with factor 3, 4, 5, 6 and 7 where % of variance is , , 7.685, and Hence it is found that ease of Services to obtain and minimum consideration are the most important factor affecting the selection of health insurance. In nutshell, we can say that there are seven key factors by clubbing the related variables, which widely affect and govern the selection of health insurance by an individual. These key factors are namely: Ease of Services to Obtain; Minimum Consideration; Availability of Funds (whether in hand or from outside); Intermediaries Outreach and Capabilities; Multiplicity of Benefits with Extensive Promotional Activities; Goodwill and Linkage of the Company with Third Party Administrators (TPAs); and Operating with Customers Oriented Modern Technology Barriers in the subscription of health insurance: Unlike reasons for having health insurance, there are numerous reasons for not having health insurance i.e. there are number of factors which act as barriers in the subscription of health insurance. All these variables along with their description are shown in the table All these reasons/barriers were taken in the form of variables and respondents who are without health insurance were asked to give their response on five point likert scale ranging from strongly agree to strongly disagree. Where 5 signifies Strongly Agree (SA), 4 Signifies Agree (A), 3 signifies Indifferent (I), 2 signifies Disagree (D) and 1 signifies Strongly Disagree (SD). Thereafter, factor analysis was run in order to condense these variables. Before the application of factor analysis the reliability of scale items were tested by applying cronbach s alpha. The value of all factors ranges between 0.81 to 0.91, indicating the presence of internal consistency. Further to test the sampling, Kaiser- Meyer-Olin measure of sampling adequacy is computed which is found to be It indicates that sample is good enough for sampling. Moreover the overall significance of correlation matrices has been tested with Bartlett Test (approx. Chi-square = and significant at 0.000) at 171 degree of freedom which provided as well as support for the validity of data for factor analysis. 162

16 Table 8.12 List of Variables Which Act as Barrier and Obstruct the Subscription of Health Insurance Variable Description V1 Low salary/non availability of funds V2 Don t like to buy V3 Don t feel the need for it V4 Prefer to invest money in some other areas V5 Unaware about it V6 No one suggested about it V7 Not taken by friends, relatives etc V8 Saving in some other areas to meet health care needs V9 Lack of comprehensive coverage V10 Lack of reliability and flexibility V11 Difficulty to approach insurance agents V12 Inadequacy of knowledge on the part of insurance agents V13 Behavior of insurance agents was not satisfactory V14 Linked hospitals are not easily accessible V15 Difficulty in availing services in hospitals V16 Narrow policy options V17 More copayment involved V18 More deductible applicable V19 More hidden cost involved All this provided that we can proceed with factor analysis and the result of factor analysis over 19 factors shown that there are 7 key factors, which was determined by clubbing the similar variables and ignoring the rest, which majorly consider being most acting barriers in the subscription of health insurance. The table 8.13 shows the respective percentage of variance of all these factors derived from factor analysis. 163

17 Table 8.13 Explain the Total Variance of Various Factors Which Act as Barrier and Obstruct the Subscription of Health Insurance Initial Eigenvalues Extraction Sums of Squared Loadings Rotation Sums of Squared Loadings Total % of Variance Cumulative % Total % of Variance Cumulative % Total % of Variance Cumulative % V V V V V V V V V V V V V V V V V V V Extraction Method: Principal Component Analysis. 164

18 It is observed from table 8.13 that only 7 factors has Eigen value more than one, so accordingly we preceded with these factors. The total variance explained by factor 1, 2, 3,4,5,6 and 7 is , , , , 9.129, and percent of variance, whereas the cumulative variance explained by all these factors is percent and rest of the variance is due to the factors which are beyond the scope of the study. Table 8.14 Rotated Component Matrix of Various Factors Which Act as Barrier and Obstruct the Subscription of Health Insurance Components V V V V V V V V V V V V V V V V V V V Extraction Method: Principal Component Analysis. Rotation Method: Varimax with Kaiser Normalization. a Rotation converged in 17 iterations. 165

19 The table 8.14 shows that each statement corresponding to the highlighted factor loading is correlated with the factor corresponding to that factor loading. Higher the factor loading, stronger is the correlation between the factors and statement. On the basis of rotated component matrix the factor extraction table has been prepared which is as: Table 8.15 Is a Factor Extraction Table Which Shows the Variables under Each Factor with Corresponding Loading and Percentage of Variance Factors % of Variance Factor Interpretation F Lack of Funds to Meet Costly Affair Variables Included in the factor Low salary/non availability of funds (V1) More copayment involved (V17) More deductible applicable (V18) More hidden cost involved (V19) Loading F Lack of Awareness and Willingness to Join F Lack of Intermediaries Outreach and Capabilities F Lack of Reliability and Comprehensive Coverage F Lack of Availability and Accessibility of Services F Narrow Policy Options F Prefer Other Mode to Invest (followed by friends, relatives etc) Don t like to buy (V2) Don t feel the need for it (V3) Unaware about it (V5) No one suggested about it (V6) Difficulty to approach insurance agents (V11) Inadequacy of knowledge on the part of insurance agents (V12) Behavior of insurance agents was not satisfactory (V13) Lack of comprehensive coverage (V9) Lack of reliability and flexibility (V10) Linked hospitals are not easily accessible (V14) Difficulty in availing services in hospitals (V15) Narrow policy options.842 Prefer to invest money in some other areas (V4) Not taken by friends, relatives etc (V7) Saving in some other areas to meet health care needs V

20 The above stated factors are in the order of degree of importance i.e. factor 1 is more important than factor 2; factor 2 is more important than factor 3 and so on. The factor 1 and 2 has %, and of variance which is the highest variance as compared with factor 3, 4, 5, 6 and 7 where % of variance is , , 9.129, and Hence it is found that Lack of Funds to Meet Costly Affair; Lack of Awareness and Willingness to join; Lack of Intermediaries Outreach and Capabilities; Lack of Reliability and Comprehensive Coverage; Lack of Availability and Accessibility of Services; Narrow Policy Options; and Prefer Other Mode to Invest (followed by friends, relatives etc) are acting as main barriers in the subscription of health insurance Willingness to join and pay for health insurance by non health insurance policy holders: Further the analysis of non health insurance policy holders was made in order to know about their willingness to join and pay for health insurance. For this purpose, the respondents without health insurance policy were requested to give their response for followings: ready to buy; still need some time; not ready to buy; no response or buy, if certain conditions fulfilled. As far as conditional buying of health insurance is concerned, the respondents without health insurance policy were further requested to rank these conditions in the order of priority. Thereafter calculation of Weighted Average Scores (WAS) was made in order to find out the most governing condition for subscription of health insurance by non health insurance policy holders. It is clear from the table 8.16 that 30.6%, 23.1% and 14.6% of respondents without health insurance policy are not ready to buy, not provided any response and still need sometime. Alternately, a very few percentage i.e. 11.9% are ready to buy health insurance without any conditions and remaining are willing to buy only if certain conditions will fulfill. As far as ranking of conditions for subscription of health insurance are concerned, 1 rank is assigned to if comprehensive coverage provided with least cost as its weighted average score is 3.36 is more as compared with all other conditions. 167

21 Table 8.16 Willingness Level of Non Health Insurance Policy Holders and Weighted Average Scores (WAS) of Conditions for Subscription of Health Insurance Particulars Frequency Percentage Ready to buy Not ready to buy No response Still need some time Buy if conditions fulfilled Total Conditions to buy WAS Rank If comprehensive coverage provided with least cost If some contribution will employer made If available with least formalities If friends and relatives buy If someone suggest about it Whereas 2 rank is assigned to if some contribution will employer made, followed by If available with least formalities, If friends and relatives buy, If someone suggest about it. Overall, a few respondents without health insurance are ready to buy and most governing conditions behind subscription by non health insurance policyholders is if comprehensive coverage provided and that too at low cost Preferred insurance company, policy, age and mode of premium payment: Further, the respondents without health insurance policy, who were ready to take health insurance policy with or without conditions were requested to their response about their preference for insurance company; policy; age for subscription of health insurance policy as well as preferred mode for premium payment. 168

22 Table 8.17 Preferred Insurance Company, Policy, Mode of Premium Payment and Age to get Insured by Non Health Insurance Policy Holders Insurance company preferred Frequency Percentage Public Private Any other Total Type of policy prefer Frequency Percentage Family floater insurance Group health insurance Individual health insurance Any other Total Age preferred for insurance Frequency Percentage Less than 30 year year year year Above 60 year Total Premium payment preferred Frequency Percentage Half monthly Monthly Quarterly Half yearly Yearly Total

23 Table 8.17 depicts the preference of non health insurance policy holders, who were ready to buy health insurance with or without conditions for insurance company; type of policy; age preferred; and for mode of premium payment. A significant portion of respondents shown their preference for public insurance company, for group health insurance policy, with the possible age to get insured between years followed by years. As far as premium payment is concerned, maximum number of respondents preferred for monthly premium payment Analysis of variables associated with the individuals having impact on their ability and willingness to join and pay for health insurance: There are numerous variables which influence or have an impact on the individuals ability and willingness to join and pay for health insurance. The analysis of all these variables also forms a part of present study and for this following hypothesis were formulated and tested: : There is no significant association between the gender of respondents and their willingness to pay for health insurance. : There is no significant association between the age of respondents and their willingness to pay for health insurance. : There is no significant association between the marital status of respondents and their willingness to pay for health insurance. : There is no significant association between the education level of respondents and their willingness to pay for health insurance. There is no significant association between the occupation of respondents and their willingness to pay for health insurance. There is no significant association between the income of respondents and their willingness to pay for health insurance. In order to find out the association between variables associated with the individuals having impact on their ability and willingness to join and pay for health insurance, the use of chi-square was made. The results of chi-square along with interpretation are shown in table

24 Table 8.18 Results of Chi-Square and Symmetric Measure Value df Sign. Significant/ Insignificant Accepted/ Rejected Pearson Chi-Square Significant Rejected Likelihood Ratio Linear-by-Linear Association Cramer V Contingency coefficient Pearson Chi-Square Significant Rejected Likelihood Ratio Linear-by-Linear Association Cramer V Contingency coefficient Pearson Chi-Square Insignificant Accepted Likelihood Ratio Linear-by-Linear Association Cramer V Contingency coefficient Pearson Chi-Square Significant Rejected Likelihood Ratio Linear-by-Linear Association Cramer V Contingency coefficient Pearson Chi-Square Significant Rejected Likelihood Ratio Linear-by-Linear Association Cramer V Contingency coefficient Pearson Chi-Square Significant Rejected Likelihood Ratio Linear-by-Linear Association Cramer V Contingency coefficient * Significant at the 0.05 level. 171

25 For the rejection of null hypothesis it is required that p value should be less than The table 8.18 shows that the value of p is which signifies that the results are insignificant at 5% level of significance. Moreover, the value of Pearson Chi-square which is more than the tabulated value of for 1 degree of freedom. This leads to the rejection of null hypothesis ) which state that there is no significant association between the gender of respondents and their willingness to pay for health insurance. In other words, willingness to pay for health insurance is associated with the gender of the individuals. Further the symmetric measure of association has also shown although there is association but it is not strong. The value of Chi-Square among willingness to pay and age of the respondents is which are more than the tabulated value of for 3 degree of freedom at 5% level of significance. This leads to the rejection of null hypothesis which state that there is no significant association between the age of respondents and their willingness to pay for health insurance. Thereby, the result of chi-square has provided us with the fact that association exist between these two. Besides this the result of symmetric measure has provided with the fact that although there is association yet it is not strong as the value of Cramer V and Contingency coefficient is and The value of Chi-Square among willingness to pay and marital status of the respondents is which is less than the tabulated value of for 1 degree of freedom at 5% level of significance. This leads to the acceptance of null hypothesis which state that there is no significant association between the marital status of respondents and their willingness to pay for health insurance. Thereby the result of chisquare has provided us with the fact that no association exist between willingness to pay and marital status of the respondents. The value of Chi-Square among willingness to pay and education level of the respondents is which are more than the tabulated value of for 8 degree of freedom at 5% level of significance. This leads to the rejection of null hypothesis which state that there is no significant association between the education level and their willingness to pay for health insurance. In other words significant association exists between these two. Besides this the result of symmetric measure has provided with the 172

26 fact that although there is association yet it is not strong as the value of Cramer V and Contingency coefficient is and The value of Chi-Square among willingness to pay and occupation of the respondents is , which is more than the tabulated value of for 7 degree of freedom at 5% level of significance. This leads to the rejection of null hypothesis which state there is no significant association between the occupation of respondents and their willingness to pay for health insurance. Thereby the result of chi-square has provided us with the fact that association exist between these two. Besides this the result of symmetric measure has provided with the fact that association is strong as the value of Cramer V and Contingency coefficient is and which is more than 0.5. The value of Chi-Square among willingness to pay and income of the respondents is which are more than the tabulated value for 4 degree of freedom at 5% level of significance. This leads to the rejection of null hypothesis which state that there is no significant association between the income of respondents and their willingness to pay for health insurance. Thereby the result of chi-square has provided us with the fact that association exist between these two. In other words association exists between the income of the respondents and their willingness to pay for health insurance. Besides this the result of symmetric measure has provided that although there is association yet it is not strong as the value of Cramer V and Contingency coefficient is and Conclusion In nutshell the followings are concluded from above analysis: A significant proportion of the sample was male members. Majority of the respondents belonged to the age groups of years and were married and living in nuclear families. Maximum respondents were graduate followed by higher education and post graduation and were employed. As far as level of income is concerned, a major percentage of the respondents fall in the annual income category of less than Rs and Rs Although, health insurance is not a new concept and the people are also getting aware about it, which mainly comes from TV followed by newspaper, agents, friends etc, but this awareness has not yet reached to the level of subscription. As 173

27 the results shown that just 19.4% are being covered by some form of health insurance and large chunk of the population is still financing health care expenditure without health insurance. While analyzing the reasons for having health insurance, it was found that most governing reason behind the subscription of health insurance was risk coverage against future illness as its weighted average score is The second main governing reason behind subscription of health insurance was to avail good quality medical treatment with weighted average score of 4.18, followed by employers contribution, travelling abroad, tax planning measures and existing illness as their respective weighted average scores are 3.75, 3.15, 2.92 and A significant portion of respondents with health insurance opted for public insurance company for the subscription of group health insurance policy and has himself seeked the insurance agent for the subscription of health insurance. Moreover, approximately, 38% of respondents with health insurance has so far logged claim with the insurance company. Alternatively, approximately 62% of respondents with health insurance policy have never logged claim with their respective insurers. The analysis of claim logged aspects provided that Hassle-free claim settlement and Hassle-free claim application process were mostly experienced by the respondents, while logging the health insurance claim with insurance company, as its weighted average scores were 4.38 and Whereas the least weighted average score is in the case of Claim settled with limited terms and conditions and Claim logged fully settled. The analysis of perceived level of satisfaction provided that approximately 62% of the health insurance policy holders were of the view that services provided are delivered effectively by the insurance companies; 48% of policy holders were having 100% chance of renewing the same and 66.1 % of the policyholders were even willing to pay more if additional services added with the existing policy. Overall, perceived level of satisfaction of the health insurance policyholders found to be satisfactory as approximately half or near half of health insurance 174

28 policyholders were agree with services provided delivered effectively; 100% chance of renewability; and even willing to pay more for additional services. The study provided with the fact that there are 7 key factors by clubbing the related variables namely, Ease of Services to Obtain; Minimum Consideration; Availability of Funds (whether in hand or from outside); Intermediaries Outreach and Capabilities; Multiplicity of Benefits with Extensive Promotional Activities; Goodwill and Linkage of the Company with Third Party Administrators (TPAs); and Operating with Customers Oriented Modern Technology are main factors, which are considered by an individual while selecting or buying health insurance. Similarly, it was observed that there are 7 key factors by clubbing the related variables under it which are acting as barriers and ultimately obstruct the subscription of health insurance. These are Lack of Funds to Meet Costly Affair; Lack of Awareness and Willingness to join; Lack of Intermediaries Outreach and Capabilities; Lack of Reliability and Comprehensive Coverage; Lack of Availability and Accessibility of Services; Narrow Policy Options; and Prefer Other Mode to Invest (followed by friends, relatives etc). Further, the analysis of non health insurance policyholders provided that those who are ready to buy shown preference for private insurance company, for group health insurance policy, with the possible age of insurance years followed by years. As far as premium payment is concerned, maximum number of respondents preferred for monthly premium payment. Alternatively, the results of analysis of willingness to join and pay for health insurance provided that very few percentage i.e. 11.9% are ready to buy health insurance without any conditions and 19.8% are willing to buy only if certain conditions will fulfill. Remaining is not ready to buy, still need some time or not provided with any response. As far as the ranking of conditions of buying are concerned, 1 rank is assigned to if comprehensive coverage provided with least cost as its weighted average score is 3.36 is more as compared with all other conditions. Whereas 2 rank is assigned to if some contribution will employer made, followed by If available with least formalities, If friends and relatives buy, If someone suggest about it. 175

29 Moreover, the association between the various variables linked with the respondents has been determined with their willingness to pay for health insurance and the results provided that on the one hand significant association exist between the gender; age; education; occupation; income of respondents with their willingness to pay for health insurance. On the other hand no significant association exists between the marital status of the respondents with their willingness to pay for health insurance. 176

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