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RSPN-Adamjee Health Microinsurance Model

Summary

The Adamjee-RSPN partnership, started in 2005, is the very first health microinsurance scheme in Pakistan, providing hospitalization and accident insurance coverage to low-income rural population across the country.

Key program components

The RSPN-Adamjee policy provides the following benefits package to its beneficiaries: Catastrophic health insurance package:

  • Annual premium is 250 Rs (US$3.50)
  • Insurance only takes effect if the patient is hospitalized for more than 24 hours
  • Patients can visit any hospital, public or private
  • Payment reimbursed (not cashless)
  • Transport to providers included

The policy has undergone a number of changes since implementation. Initially, it was designed to provide coverage for complications arising due to pregnancy - natural child birth was not covered. At present, however, the policy covers all associated procedures for expecting mother.

Furthermore, initially, the policy targeted only individuals 18-60 years of age, and the issuance of policy and renewal were carried out on quarterly basis and in batches because the lack of appropriate technology made handling individual cases difficult. However, with the acquisition of new technology, knowledge and expertise, the age limit has been removed and one can now purchase a 12-month policy on an individual basis.

The RSPN-Adamjee health microinsurance has also expanded to cover the cost of transportation to medical facilities. Within its first year in operation, the scheme was able to provide health insurance coverage to over 220,000 low-income individuals. In subsequent years, the RSPN-Adamjee model has been able to reach almost 800,000 clients through an already established network of Rural Support Programmes (RSPs). Adamjee is a commercial insurer based in Pakistan. RSPN is a network of ten Rural Support Programmes (RSPs). The RSPs involve poor, mainly rural communities, in improving management and delivery of basic services through a process of social mobilization.

RSPN-Adamjee had served 235,877 clients as of April 24, 2007.