Center for Health Market Innovations (CHMI)

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CARE India Microinsurance

last updated Mar 26, 2013

Overview

Implementation Partner(s): 
Bajaj Allianz General Insurance Company
Legal Status: 
Private (not-for-profit)
Year Launched: 
2008
Stage: 
Existing/expansion stage

Funding

Primary Source of Funding: 
Membership/subscription fees
Summary: 

The 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.

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