SEWA

2. SEWA

5. Insurance Membership - 2005 Women – 83514 Men – 34306 Children – 18,587 Total Insured – 136,407

6. Current insurance packages offered

7. Two recent initiatives - Hospital tie-ups - Renewal Campaign

8. Hospital tie-ups ACTIVITIES OBJECTIVE Facilitate access to hospitalization by removing financial barriers 1. Encourage use of public and trust hospitals; 2. For members who use selected hospitals, pay 80% of claim within 48 to 72 hours of admission (balance at the time of discharge). Make it easier to claim and receive benefits under the scheme 1. Annual house-to-house visits to remind members about hospitalization insurance, and educate about “PR”; 2. Provide greater assistance in collecting and then submitting claims documentation. Direct members to Inpatient facilities of acceptable quality 1. Develop procedure for screening hospitals for inclusion; 2. Select hospitals; 3. Periodically re-evaluate hospitals based on performance.

9. System design Vimo SEWA Claims committee 4.Relays information, decision is made 6.Receipts & certificates Local Vimo Rep. 3.Collects Info. On Diagnosis, Length Of stay, cost 5.Payment for bed, Doc., medicines, lab tests 2.Phone call Insured 1.Goes to hospital Selected hospitals

10. Successes • SEWA insurance members received better quality care service from selected hospitals • 50% of claims came through cashless system • Increased use of public and trust hospitals as against private hospitals • Reduced the number of days of settlement of claim (80% in 48 hours)

11. Challenges • Availability of suitable public or trust hospitals • Educating the members about cashless system • Skilled human resource • Local representative

12. SEWA’sRenewal Campaign Objective • Continued protection to Vimo SEWA members • Achieve renewal rate – 70% - policy year 2006 • Policy year 2004: renewal rate – 30% (YP) • Policy year 2005: renewal rate – 42% (YP)

13. Reasons for non renewal From Research • Limited understanding of Insurance • Lack of money at time of enrollment • Limited contact between members and aagewans after enrollment

14. Reasons for non renewal • Not enough focus and monitoring on renewals during enrollment campaign

15. Renewal Strategy – P.Y. 2006 • Limited to Ahmedabad city (30,000 insureds) • Make individual contact with each member prior to enrollment campaign • Distribution of insurance and health education material • Visit each member during enrollment period for renewal

16. Implementation Process • Each aagewan was given user friendly member lists • Each aagewan was assigned manageable number of membership • Supportive supervision given to aagewans • Barcodes used for recording visits

17. Outcomes • Able to complete 82% of visits prior to enrollment period • Members felt good about the house-to-house visits • For the first time aagewans went systematically house-to-house to meet each insured member • There was increase in members’ understanding and information

18. Challenges • Obtaining accurate addresses • Labour and time intensive • Monitoring of visits

19. Lessons Learnt • Supportive supervision is critical • Adequate human resources required for satisfactory completion of visits • Aagewans • Supervisors • Individual house-to-house visits build trust

20. THANK YOU Contact details: rupal_jayswal@yahoo.com Upasana_joshi2000@yahoo.com