A Reinsurance Fund for Micro Health Insurance in India



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RE:ViVE india A Reinsurance Fund for Micro Health Insurance in India $15,000,000 reinsurance fund Collateralized Insurance ObligaMon Target: Micro Health Insurance Providers (MHIPs) 10 Year Closed End Fund Geography: India CompeMMve Risk Adjusted Returns Ross School of Business, University of Michigan For further enquiry contact Colm Fay, MBA/MS 2012, colmfay@umich.edu Andrew Merrill, MBA 2011, akmer@umich.edu Laura Frey, MBA/MS 2011, ldfrey@umich.edu 1 Amrita Vijay Kumar, MBA/MS 2011, amritavk@umich.edu

The Indian healthcare market presents an opportunity to achieve social impact that benefits the most vulnerable 85% of Maternal Mortality is Preventable Many needless deaths due in part to low public healthcare spending and lack of access for the poorest 60,000 women per year 90% of Infant Mortality is Preventable 1.6 million children per year Public healthcare spending in India is less than 1% of GDP Ranks 171 out of 175 countries Results in high levels of out of pocket spending and potenmal for financial shock Willingness to pay for health insurance is esmmated at 1.38% of annual household income or INR600 Less than 1% of the BoP market has health insurance gap in the market + willingness to pay + growth potenmal = market opportunity 2

Greater penetramon of micro health insurance can provide support in healthcare emergencies and reduce associated financial shock Micro Health Insurance Providers (MHIPs) are exposed to small pool risk, and lack reinsurance solumons that would free up capital to enable growth Insolvency Risk Lack of Capital RE:ViVE india Fund will provide a reinsurance facility that will: Free up capital enabling insurers to scale MHIP Improve underwrimng, product design and pricing Risk of Small Pools Inability to Scale Dampen the impact of large claims and smooth income variamon among the poor Reduce insolvency risk 3

Reinsurance allows insurers to transfer risk thus limimng their loss exposure and freeing up capital to write more policies Reinsurance Insurance Agent Policy Holder $100 Reserve RE:ViVE Reinsurance Fund Premium Claims $100 Reserve Insurer $100 reinsurance policy Premium Claims $100 policy Policy Holder $100 policy Policy Holder Reinsurer s risk is highly diversified across a large pool with low claim variance Insurer has larger risk pool, lower exposure to large claims and beger underwrimng data Up to double the number of lives covered 4

Investment strategy diversifies underwrimng risk across large policy pool and manages porjolio composimon to limit exposure Aggregate 60% Combined RaMo 30 MHIPs 350,000 policies Maximum 15% exposure in each state Total Sums Assured $116,000,000 UnderwriMng criteria will be developed over Mme based on claims experience 5

Profile of target MHIP - Nidan Target Customer: Market Vendors LocaMon: Bihar Membership: 10,189 Loss RaMo: 43.5% Eligibility: 18-55 yrs, no pre- exismng condimons, no maternal coverage Two Products: Insurance Policy Plan A Plan B Premium per year INR170 INR350 Co- pay 20% 20% Sums Assured INR2,000 INR6,000 Source: Microinsurance: Innova0ons in Low- Cost Health Insurance, Dror et al., 2009 6

RE:Vive adds value through our ability to idenmfy the best MHIPs and apply rigorous underwrimng principles IdenMficaMon Screening Due Diligence ü Sourcing via referral from local partners ü On the ground presence ü 3 years of audited financial statements ü Minimum 2 years profitability ü Licensed by GOI ü Combined OperaMng RaMo (COR) less than 60% ü Strength of Management Team ü Financial strength, liquidity and solvency ü Corporate Governance ü UnderwriMng policies UnderwriMng Decision Monitoring ReporMng ü Commigee approves all re- insurance policies ü Decisions made via supermajority ü Members appointed based on actuarial and health sector expermse ü MHIP falls below minimum screening criteria over Mme ü Geographic exposure in any one area exceeds 20% of porjolio ü Aggregate COR less than 60% ü Quarterly and Annual Financial ReporMng ü Impact ReporMng based on IRIS standards ü Use of 3 rd party ramng agency 7

RE:ViVE INDiA is a $15,000,000 fund in 3 tranches that offers compemmve, risk adjusted returns to insmtumonal investors Tranches Size Return Priority Value ProposiMon PRI Investment 20% $3,000,000 3% Low risk social investment that preserves capital and generates small return InsFtuFonal Investment 70% $10,500,000 (INR denominated) 16% Emerging markets exposure with high yield income returns that have low correlamon to convenmonal securimes Philanthropic Grant Capital 10% $1,500,000 (INR denominated) 0% Mission driven grant dollars to improve health outcomes in India Financial goals Social goals 8

Benchmarking RE:VIVE india against a comparable asset class IdiosyncraMc nature of micro insurance risk makes it difficult to benchmark Catastrophe bond risk represents best proxy benchmark due to: Similar risk characterismcs Comparable low correlamons with standard asset classes Unsuitable benchmarks include: High Yield & Emerging Market indices: similar returns, but different risk profile Indian MFI: BoP focus but credit risk 20 18 16 14 12 10 8 6 4 2 Target Returns 13% 0 Swiss Re Global Cat Bond Total Return Index (2003-2011) 9

RE:ViVE india Fund Terms Philanthropic Junior Senior Size US $1,500,000 US $10,500,000 US $3,000,000 Currency INR INR USD Maturity 10 Year 10 Year 10 Year Rate 0% 16% 3% Coupon Freq N/A Annual Annual Loss Priority 1st 2nd 3rd Agachment 0% 10% 80% ExhausMon 10% 80% 100% Early RedempMon none none none Fee Per Annum 1% 1% 1% IncenMve Fee Excess reserves above 102.5% can be withdrawn as incenmve fee at manager s discremon - at maturity excess above 100% goes to manager as incenmve fee 10

Risk Management - OperaMng risks idenmfied and mimgamng factors Risks Losses exceed premiums leading to investor losses Catastrophic event causes large scale insured losses Currency exposure affects profitability MiFgaFng factors ConservaMve underwrimng and robust MHIP selecmon criteria ConservaMve solvency and reserve buffer pool Strict concentramon and diversificamon rules should limit large scale losses Robust due diligence and on the ground presence with local partners reduces poor selecmon of MHIPs Capacity building facility improves technical underwrimng capacity Currency hedges limit loss in conversion 11

Re:ViVE india measures its own financial performance and its external impact on MHIPs and Individuals RE:ViVE india Proving that insurance to Base of the Pyramid is a viable product INDICATORS: loss ramo, combined ramo, returns in excess of commitments MHIP Our objecmve is to pool MHIP risk so that they can provide more policies to BoP INDICATOR: New policies sold Individual Health insurance dampens health and financial shock INDICATORS: Lives covered, number of claims, number of policy holders falling below poverty line, gender equality among claimants, percentage of claims authorized Partnership with Local Technical Assistance OrganizaFon ü Specializes in MFI industry trends and social performance in India ü Emphasis on building relamonships, a great sourcing partner ü ExperMse in data collecmon and synthesis at the individual level 12

An experienced management team with depth of experience in insurance, invesmng and social impact INSURANCE HEALTHCARE INDIA FINANCE SOCIAL IMPACT Laura Frey MBA/MS 2011 Erb InsMtute Fellow ldfrey@umich.edu ü Acumen Fund assessed gaps, opportunimes, and returns for Healthcare Infra fund ü Community Credit Fund Founder ü FoundaMon serve on Investment Commigee ü GBF constructed impact metrics for porjolio company ü Brazil s first social fund Business Development Andrew Merrill MBA 2011 akmer@umich.edu ü Oppenheimer- built risk model to stress test and construct $1 billion catastrophe bond porjolio ü Oppenheimer assessed risk on $50 billion fixed income investments, $50 million on currency and int. rate risk, and built models to price NAV of porjolios Amrita Vijay Kumar MBA/MS 2011 Erb InsMtute Fellow amritavk@umich.edu ü PwC improved risk management for 5 South East Asian insurance co. ü NaMve Indian - understanding of cultural, linguismc, and relamonship building ü Early Stage V.C. deal sourcing, porjolio management, and due diligence ü E+ CO conducted industry analysis, due diligence, and capacity building for social fellows Colm Fay MBA/MS 2012 Erb InsMtute Fellow colmfay@umich.edu ü Accenture 6 yrs of developing pricing, channel, and underwrimng systems ü PATH market analysis for medical device that helps prevent maternal mortality ü Wello, COO, assessed social return on investment 13

Why should you invest in RE:ViVE india? Pioneering fund addressing a real gap in the growing Indian micro insurance market Unique fund structure draws together mission driven and tradimonal investors without compromising financial returns Deep domain knowledge and partnerships ensures effecmve deployment of capital to catalyze MHIP market $15 million can cover 350,000 lives and prevent unnecessary deaths from day one 14

THANK YOU RE:ViVE india 15