Dissatisfied Health Insurance Customers

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Published: 13th March 2009
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Health Insurance Policy is new in India and is definitely the fastest growing segment in insurance. Health insurance customers are the most dissatisfied ones in India. The loyalty levels are slowly declining as public sector players fail to meet customer expectations. Slow claim procedures and inefficient cash-less facilities are some of its drawbacks. In other countries rating of various products or companies based on consumer's voice is very common. But in India health insurance is a new concept. The Study has been able to show the dissatisfaction and has been able to open the eyes of the major players in the health sector which are described in the following paragraph.

Satisfaction levels not up to the mark
The study revealed that the satisfaction levels in health insurance plans was the least. Indicating that the health insurance segment needs to consolidate its services and bring down the dissatisfaction levels of consumers who use the service. TATA AIG was the top ranker whereas National Insurance cooled its heels at the bottom. TATA AIG's strength lies in its promptness in claim procedures. An alarm has been sounded for Public sector undertakings, as their consumers are switching to private sector players in the hope of better service.

Public sector undertakings can test your patience
Getting a claim processed from a pubic-sector insurance unit is like testing a consumer's patience. They are so slow and can never complete the process as per the time frame.
Have good hospital-network
The positive point is PSUs provide good network of hospitals, and in case of an emergency, you will not need to go hunting for a hospital.

TPAs
The single grievance that any dissatisfied health insurance consumer would have is that of slow settlement of claims, or that of disputed claims. In order to overcome the concept of Third Party Administrators was introduced which was essentially for outsourcing claim settlement. The cashless model of hospitalization also depends on the TPAs, where policy holders are allowed to avail medical treatment at any of the networked hospitals without having to pay cash upfront. However, TPAs are also a source of discontentment among consumers. The survey shows that their quality of service and infrastructure needed to improve, and that the service form hospitals was really not up to the mark.

Various parameters described below were taken into consideration while studying the health insurance companies in India.

o TPAs - On the basis of it quality and infrastructure, numbers of tie ups with different hospitals network, types of hospitals or health centre in terms of its infrastructural facilities.

o Tangibility - On the basis of promptness in terms of policy issue, on time home delivery of policy or health card, simple procedures for issuing policy, regarding agent's knowledge on different products; Customer service support facilities, Cashless transactions, etc.

o Responsiveness - With regards to quality of treatment provided on medical insurance card; immediate claim; effective cashless transaction facilities; degree of clarification on disease covered; hassle free reissuance of health card

o Problem Solving - In relation to Knowledge of customer service representative, Politeness and behavior of the customer service representative or TPA executive.

o Reliability - In regards to acceptance of insurance policy across the promised hospitals and medical institutions, financial strength of the company, branch network, promised service levels provided promptness in claim redressal; relaxed documentation norms and regulations.

o Assurance - Initiative to make the customer aware of product facilities and covers; regular updates and scope of the policy; appropriateness of the claim settlements, etc.

o Empathy - provision to provide personalized consulting or advisory provisions, effective customer loyalty programs; value-added services and feedback maintenance.

Such studies are important and are good to keep tab on the happenings in the insurance sector. These studies offer ideas about what is going on behind the scene. It is a good beginning and more often customers should respond to such studies where you get to express about the products and the service level of the Insurance Company.

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