CARE India Microinsurance
Country of Operation
- Bajaj Allianz General Insurance CompanyFor-profit
SummaryThe health insurance scheme uses both a mutual model and a partner-agent model. Of the total premium, 65% will go to the pool, while 35% will go to Bajaj Allianz General Insurance Company.
Key program components
The premium is US$8.66 (Rs 390) to cover the policyholder between the ages of 18-69 and up to three other members of the family (as of March 2008). The pool will cover up to US$111 (Rs 5,000) for claims arising from critical illness, surgeries and hospitalisation. Any claim above US$111 (Rs 5,000) will be paid by Bajaj Allianz General Insurance Company.
The project partners have appointed a doctor to provide subsidised outpatient treatment to all members. The doctor also serves as a gatekeeper, recommending clients for hospitalization, to prevent misuse of funds by false referrals.