Center for Health Market Innovations (CHMI)

Programs

Overview

Implementing organization: 
Shri Kshetra Dharamsthala Rural Development Project (SKDRDP), United India Assurance (UIA)
Legal Status: 
Year Launched: 
2004
Stage: 
Existing/expansion stage
Income Level of Target Population: 
Bottom 20%

Funding

Primary Source of Funding: 
Membership/subscription fees
Additional Source(s) of Funding: 
Donor

Scale

Personnel Employed: 
50-99
Number of Clients Served: 
16,60,185(per year, As of March 2013)
Number of Facilities Operated/Networked: 
Hospitals registered: 160
Other Measures of Scale: 
Insurance companies involved: 4 No. of trainings conducted 715 No. of Self Help groups covered: 111,537 No. of families enrolled: 420,302 No. of members enrolled: 1,660,185
Summary: 

Sampoorna Suraksha is a unique comprehensive insurance programme that aims to provide financial assistance to meet the medical expenses of the stakeholder and his family.

Key program components: 

Sampoorna Suraksha was developed by the Shri Kshetra Dharmasthala Rural Development Project (SKDRDP), a local NGO that has launched thousands of grassroots self-help groups in 1982.

An annual contribution of Rs 190 (US $3.40) covers up to Rs 5000 (US $90) in medical expenses. A family can enroll additional members for Rs. 115 (US $2) annually. The scheme is comprehensive in nature covering hospitalisation expenses, maternity care, life insurance, natural calamity and damages to property are also partly covered. Coverage is available from three months to eighty years. It follows the principle of zero rejection. 80 surgical procedures and treatments are packaged at reasonable costs, streamlining the hospitalisation expenses.

Target beneficiaries, 70% of whom are below the poverty line, are able to obtain cashless treatment in well-equipped hospitals with modern amenities, recognized by SKDRDP. Hospitals seek permission for admission with a preauthorisation request. After a treatment, patients are discharged and claims are sent to Sampoorna Suraksha for reimbursement of the authorised amount.

The programme also assists the stakeholder to obtain financial assistance from Pragathinidhi, a microfinance institution to meet any hospitalization expenses that exceed the sum insured. This scheme is open to members of SKDRDP promoted self-help groups (SHGs).

Additional Information
Additional enrollment and settlement details since inception can be found here

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