Karuna Trust, Karnataka - ZEF
Karuna Trust, Karnataka - ZEF Karuna Trust, Karnataka - ZEF
Good and Bad Practices in MicroinsuranceKaruna Trust, India4. The ProductTable 4.1 Product DetailsProduct Features and PoliciesMicroinsurance Type Partner-agent health insurance productGroup or individual product Group policy for NIC, individualized by Karuna TrustTermOne yearEligibility requirements Targeted at people around poverty line, living in the areas of operationRenewal requirements Premium paymentRejection rateNo rejection reportedVoluntary or compulsory VoluntaryProduct coverage (benefits) • Rs. 50/day ($1.10) in case of hospitalisation as compensation ofincome loss; max for 30 days• Rs. 50/day ($1.10) in case of hospitalisation paid to special drug fundat the facility used; max. for 30 days• In case of surgery, Rs. 500 ($11) are paid for compensation of loss ofincome and Rs. 500 ($11) to drug fund; restricted to one surgery perperson and yearKey exclusionsNonePricing – premiums Rs. 22/year ($0.50)Pricing – other fees -4.1 PartnersWith the end of the pilot phase 2002-2004/05, Karuna Trust’s partners in providing theinsurance are National Insurance Company and the public health authorities.As a pubic insurer, developing products for the poor is part of NIC’s social responsibility andis requested by politicians. NIC bears the financial risk in this partner-agent arrangement andhas agreed to a claim ratio of up to 150%. Claims beyond this level are borne by KarunaTrust. NIC’s regional office is very positive about the health insurance pilot and interested inimproving its performance. For them, the scheme is not only a social obligation imposed byinsurance regulations, but a matter of heart. They are keen to learn how products for the poorcan work. The relationship between NIC and Karuna Trust seems to be very good.The public health facilities are the scheme’s only designated providers. The health authoritiesand some doctors participate in the (district/taluk level) coordination committees of thescheme. By participating in the coordination committee, the provider side is directly involvedin the scheme’s implementation. They are more than simply the supply side of health care.4.2 Distribution ChannelsKaruna Trust has implemented an effective distribution mechanism through offering clients avariety of alternative entry points, as illustrated in Figure 4.1.24
Good and Bad Practices in MicroinsuranceKaruna Trust, IndiaFigure 4.1 Distribution Channels• Most clients are members of Karuna Trust’s self-help groups. These groups disseminateinformation about the scheme and offer a platform for those willing to join. Duringsubscription time, SHG members can pay their premium directly to the local socialworker and receive a receipt (see Annex 4).• If non-SHG members want to join, they can ask an SHG member to forward theirrequest. It will be discussed during a group meeting and in case of a positive decision, thesocial worker will contact the concerned person. The SHGs check whether the applicantis a resident of the respective village and if the income is sufficiently low, since only BPLhouseholds are eligible to join. To confirm BPL status, SHG members are supposed tocheck the applicant’s ration card (see Box 4.2), but this is usually replaced by socialcontrol. By involving the SHGs, Karuna Trust makes use of the information availableamong the members; but as members are not bearing part of the risk, this mechanism isunlikely to create the desired effect.• Potential clients also approach the social workers in health facilities. In the lastsubscription period, about one third of the clients in T. Narsipur taluk joined at healthfacilities. A minority joined when they were admitted. As a social commitment, eventhese patients are immediately covered.• During the renewal period, many social workers go house-to-house to inform peopleabout the insurance. This mechanism is time consuming, but seems to be rather effective.• The programme coordinators serve as an additional distribution channels. In their dailywork, they inform people about insurance and prospective clients can approach them atthe field offices where they can become a member of the scheme.The distribution channels seem to be effective as Karuna Trust mainly builds on its existinginfrastructure. Using the same infrastructure has the advantage of leveraging the trust thatwas built up through other activities.The social workers at the health facilities are a particularly effective channel since theyapproach prospective clients (or are approached) when the client’s attention is focussed onhealth issues. They make use of the increased readiness of clients in these situations. Thevalue of the “right” situation when addressing a potential client is acknowledged in product25
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Good and Bad Practices in Microinsurance<strong>Karuna</strong> <strong>Trust</strong>, IndiaFigure 4.1 Distribution Channels• Most clients are members of <strong>Karuna</strong> <strong>Trust</strong>’s self-help groups. These groups disseminateinformation about the scheme and offer a platform for those willing to join. Duringsubscription time, SHG members can pay their premium directly to the local socialworker and receive a receipt (see Annex 4).• If non-SHG members want to join, they can ask an SHG member to forward theirrequest. It will be discussed during a group meeting and in case of a positive decision, thesocial worker will contact the concerned person. The SHGs check whether the applicantis a resident of the respective village and if the income is sufficiently low, since only BPLhouseholds are eligible to join. To confirm BPL status, SHG members are supposed tocheck the applicant’s ration card (see Box 4.2), but this is usually replaced by socialcontrol. By involving the SHGs, <strong>Karuna</strong> <strong>Trust</strong> makes use of the information availableamong the members; but as members are not bearing part of the risk, this mechanism isunlikely to create the desired effect.• Potential clients also approach the social workers in health facilities. In the lastsubscription period, about one third of the clients in T. Narsipur taluk joined at healthfacilities. A minority joined when they were admitted. As a social commitment, eventhese patients are immediately covered.• During the renewal period, many social workers go house-to-house to inform peopleabout the insurance. This mechanism is time consuming, but seems to be rather effective.• The programme coordinators serve as an additional distribution channels. In their dailywork, they inform people about insurance and prospective clients can approach them atthe field offices where they can become a member of the scheme.The distribution channels seem to be effective as <strong>Karuna</strong> <strong>Trust</strong> mainly builds on its existinginfrastructure. Using the same infrastructure has the advantage of leveraging the trust thatwas built up through other activities.The social workers at the health facilities are a particularly effective channel since theyapproach prospective clients (or are approached) when the client’s attention is focussed onhealth issues. They make use of the increased readiness of clients in these situations. Thevalue of the “right” situation when addressing a potential client is acknowledged in product25