Annexure I

Questionnaire
Dear Respondent,
This survey is being conducted to know your awareness, perception and willingness to
pay for health insurance. The whole questionnaire is divided into three parts: Part A for
General Information, Part B for health insurance policy holders and Part C for non health
insurance policy holders. The information provided by you will be kept confidential and
will be used for academic purpose only.

Ruchita,
Research Scholar
Deptt. of Commerce and Business Management
Guru Nanak Dev University
Amritsar

Part- A. General information

1. Name:
2. Place:
3. Gender:

a. Male

b. Female

4. Age:
a. Less than 30 years

b. 30-40 years

c. 40-50 years

d. Above 50 years

5. Marital status:
a. Single

b. Married

6. Type of family:
a. Joint

b. Nuclear

7. Education:
a. Illiterate

b. Primary

c. Middle

d. Matric

e. Higher secondary

f. Graduation

g. Post graduation

h. Vocational

i. Other (specify)

Annexure

8. Occupation
a. Employed

b. Self employed

c. Labour

d. Housewife

e. Unemployed

f. Professional

g. Family owned business

h. Retired

9. Income per annum (in Rs.):

a. Less than 50000

b. 50000-100000

d. 150000-200000

e. Above 200000

c. 100000-150000

10. Do you have health insurance policy?

a. Yes

b. No

If yes, then provide the answer for Part-B and if No, then provide the answer for
Part-C
Part-B. For Health Insurance Policy Holder
11. Who is your insurer?
a. Public Company

b. Private company

c. Any other (specify) _

12. What type of Health Insurance Policy you have?
a. Individual Health Insurance

b. Group Health Insurance

c. Family Floater Health insurance

d. Other (specify)

13. What are the reasons for going in for health insurance policy? Rank from the
following in the order of priority assigning 1 to most important and 6 to the least
important?
a. Tax planning measure

b. Travelling abroad

c. Employers contribution

d. Existing illness

e. Avail good quality medical treatment

f. Risk coverage against future illness, old age etc
14. Who persuaded you to purchase the policy?
a. Insurance officials

b. Relatives

c. Friends

d. Advertisement

ii

e. Income Tax Advocate

f. Colleagues

g. yourself

h. Other (specify) _

15. What approach was adopted in seeking health insurance coverage?

a. Insurance agent seeked you out

b. You seeked out insurance agent

16. Do you agree that the services provided by the insurance companies are delivered
effectively?
a. Yes

b. No

c. Indifferent

17. What is the chance of renewing the service after the expiry of present insurance
policy?
a.100%

b. 50%

c. 25%

d. 0%

18. Are you willing to pay more for additional services, which can be included in your
health insurance package?
a. Yes

b. No

19. Do you think the promotional efforts being taken by insurance company are
sufficient?
a. Yes

b. No

20. How the awareness of health insurance can be increased? Rank the following by
assigning 1 to most effective way of enhancing awareness and 10 to least effective way
of enhancing awareness.
a. Newspapers
b. Conference and Seminars
c. Incentives to policy holders
d. Renewal notice by insurance companies
e. Advertisement
f. Sponsoring event by insurance companies
g. Internet (World Wide Web)
h. Road shows, fare & festivals
i Introducing saving linked insurance
j. Making health insurance mandatory

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33

21. Which of the following factors did you consider being the most important while
choosing your insurance policy? Please give the response for following statements on
five point Likerts Scale ranging from Strongly Agree to Strongly Disagree:
Note: - SA Strongly Agree, A Agree, I Indifferent, D Disagree, SD Strongly
Disagree.
Statements

a. Name and Reputation of the insurance company

b. Use of modern technology by insurance company
c. Courteousness of employees, brokers and corporate agents
d. Capability and knowledge of employees, brokers and
corporate agents
e. Services provided by the employees, brokers and corporate
agents
f. Availability of maximum consumable income
g. Use of extensive promotional activities
h. Maximum customers satisfaction
i. Prompt claim processing with least of formalities
j. Availability of loan facility to meet all associated cost of
health insurance
k. Minimum copayment involved
l. Minimum deductible applicable
m. Nominal premium charged
n. Wide policy options
o. Reliability of services offered
p. Employers contribution toward premium payment
q. Comprehensive coverage
r. Cash less facility
s. Easy accessibility of linked hospitals
t. Easy availability of services in hospitals
u. Flexibility of policy offered
v. Availability of tax benefits
w.Goodwill and Linkage of company with Third Party
Administrators (TPAs)

SA A

SD

22. How far do you agree with following points about Insurance providers?
Public Company
More safe

Private Company

Both

[ ]

Customer satisfaction provided [

[ ]

More Hidden Cost

[ ]

High Advertisement

[ ]

Fulfill Customer Expectation

[ ]

More Customized Products

[ ]

Better Services

[ ]

23. Have you ever logged claim with the insurance company?
a. Yes

b. No

24. If yes, how would you rate the following factors? Please give your response on five
point Likerts Scale ranging from Strongly Agree to Strongly Disagree:
Note: - SA Strongly Agree, A Agree, I Indifferent, D Disagree, SD Strongly
Disagree.
Statements

SA A

a. Hassle free claim application process

b. Hassle free claim settlement
c. Claim settlement within a limited period
d. Claim logged fully settled
e. Claim logged partially settled
f. Claim settled with limited terms and conditions
g. Cooperation and attitude of TPAs
h. Cooperation and attitude of surveyors
i. Cooperation and attitude of the insurance company
j. Time taken by TPAs
k. Time taken by surveyors

5
5

SD

25. Which of the following mode you have resorted in case of partial or no settlement of
health insurance claim?
a. Ombudsmen

b. Insurance Regulatory Development Authority cell

c. Consumer Court

d. Any other (specify)

26. What more you expect in terms of health services and benefits? Also give suggestion
for further improvement?

Part- C. For Non Health Insurance Policy Holders

27. Do you know about Health Insurance?
a. Yes

b. No

28. If yes, what are the sources of information?

a. TV

b. Newspaper

c. Agents

d. Family

e. Friends

f. Movies

g. Employees of Insurance Companies

h. Tax consultants and Doctors
i. Other (specify)
29. Why you have not taken Health insurance Policy? Please give your response for the
followings on the five point likerts Scale ranging strongly agree to strongly disagree:
Note: - SA Strongly Agree, A Agree, I Indifferent, D Disagree, SD Strongly
Disagree.
Statements

a. Low salary/non availability of funds

b. Dont like to buy
c. Dont feel the need for it
d. Prefer to invest money in some other areas
e. Unaware about it
f. No one suggested about it
g. Not taken by friends, relatives etc

SA

SD

Statements

SA

SD

h. Saving in some other areas to meet health care needs

i. Lack of comprehensive coverage
j. Lack of reliability and flexibility
k. Difficulty to approach insurance agents
l. Inadequacy of knowledge on the part of insurance agents
m. Behavior of insurance agents was not satisfactory
n. Linked hospitals are not easily accessible
o. Difficulty in availing services in hospitals
p. Narrow policy options
q. More copayment involved
r. More deductible applicable
s. More hidden cost involved
30. Are you willing to purchase Health Insurance Policy?
a. Ready to buy
b. Still need some time
c. Not ready to buy
d. No response
e. Buy only if certain conditions will fulfill
Rank the following conditions in the order of priority by assigning 1 to most prefer
and 5 to least preferred:
1. Someone suggest me
2. Friends & relatives purchase
3. Some contribution employer made
4. With some modification in policy options
5. Comprehensive coverage provided
31. Which insurance company you will prefer?
a. Public Company

b. Private company

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c. Any other (specify)

32. Which type of health insurance policy do you prefer more?

a. Individual Health Insurance

b. Family Health Insurance

c. Family Floater Health Insurance

d. Other (specify)

33. At what age would you ideally prefer to get selves and family insured?
a. 0-25

b. 25-35

c. 35-45

d. 45-55

e. 55-65

f. 65 & Above

34. How you would like to pay health insurance premium amount?
a. Half monthly

b. Monthly

d. Half yearly

e. Yearly

c. Quarterly

Thanks for providing valuable time and cooperation in this study.

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Annexure II

List of Organization Providing Community Health Insurance

Schemes and Included in Present Study

S.No

Abbreviation

Organization

Accord

Accord-Ashwini

AKHS

Aga Khan Health Services

AP-SPT

Andhra Pradesh State Police Trust

Antodaya

Antodaya

AAH

Aragonda Apollo Hospitals

ARY

Arogya Roksha Yojana Trust

AYT

Arogyashree Yojana Trust

ASM

Arthik Samata Mandal

AKS

Asha Kiran Society

10

ASSEFA

Association of Serva Sewa Farms

11

Awareness

Awareness

12

BAIF

Bhartiya Agro industries Foundation

13

BASIX

Bharatiya Samruddi Investments and Consultancy Services

14

BMCF

Bihar Milk Cooperatives Federation

15

BISWA

Bhartiya Integrated Social Welfare Agency

16

BUCCS

Buldana Urban Credit Cooperative Society

17

Chaitanya

Chaitanya

18

CAM

Charotar Arogya Mandal

19

CASP

Community Aid & Sponsorship Programme

20

CHAP

Community Health Assistance Project

21

COD

Centre for Overall Development

22

CYSD

Centre for Youth and Social Development

23

DHAN

Development of Humane Action Foundation

24

EHA-U

Emmanuel Hospital Association Uttarakhand

25

EHA-MP

Emmanuel Hospital Association Madhya Pradesh

9
9

S.No

Abbreviation

Organization

26

ESAF

Evangelical Social Action Forum

27

FF

Freedom Foundation

28

GSGSKK

Gandhi Smaraka Grama Seva Kendram Karadka

29

GK

Grameen Kota

30

GNK

Gram Niyojan Kendra

31

GMC

Gwalior Municipal Corporation Limited

32

HFF

Healing Fields Foundation

33

HALO

Health and Auto Learning Organization

34

IMC

Indore Municipal Corporation Limited

35

KKPKP

Kagad Kach Patra Kashtakari Panchayat

36

K-SPT

Karnataka State Police Trust (K-SPT)

37

Karuna Trust

Karuna Trust

38

Kas Foundation

Kas Foundation

39

Katsurba Hospital

Katsurba Hospital

40

Kodi Trust

Kodi Trust

41

LEAD

League for Education and Development

42

MT

Mahaseman Trust

43

MF

Mahashakti Foundation

44

MHC

Mallur Health Cooperative

45

MMS

Manndeshi Mahila Sahakari Bank

46

MAHE

Manipal Academy of Higher Education

47

MT

Mayapur Trust/Sri Mayapur Vikas Sangha

48

MoH&FW-MP

Ministry of Health Madhya Pradesh

49

MoLE-NSS

Ministry of Labour and Employment NSSS

50

MoLE-RSBY

Ministry of Labour and Employment RSBY

51

MSJ&E

Ministry of Social Justice and Empowerment

52

MT-Hand

Ministry of Textiles Handloom

53

MT-Art

Ministry of Textiles Artisans

54

MCHB

Mitra Christian Hospital Bissamcuttak

Annexure

S.No

Abbreviation

Organization

55

MARI

Modern Architects of Rural India

56

Myrada

Myrada

57

NF-HYD

Naandi Foundation Hyderabad

58

NF-UDA

Naandi Foundation Udaipur

59

NF-JOD

Naandi Foundation Jodhpur

60

New Life

New Life

61

Nidan

Nidan

62

OASIS

Organization for Awareness of Integrated Social Security

63

ODP

Organization for Development of People

64

PWDS

Palmyrah Workers Development Society

65

PREM

Peoples Rural Education Movement

66

PGB-CU

Pragathi Gramin Bank Chitradurga Unit

67

Pragati

Pragati

68

RAHA

Raigarh Ambikapur Health Association

69

RDCF

Rajasthan Dairy Cooperative Federation

70

RHT

Rinchi Hospital Trust

71

RUHSA

Rural Health & Social Advancement

72

SKAP

Sampoorna Kutumba Arogya Pathakam

73

Samskar

Samskar

74

SCHS

Seba Cooperative Health Society

75

SEWA

Self-Employed Womens Association

76

SHADE

Self Help Association for Development and Empowerment

77

SHEPHERD

Self Help Promotion for Health and Rural Development

78

SHGF-K

Self Help Groups Federation Kerala

79

SHGF-TN1

Self Help Groups Federation (1) Tamil Nadu

80

SHGF-TN2

Self Help Groups Federation (2) Tamil Nadu

81

Sevashram

Sevashram

82

Seva Mandir

Seva Mandir

83

Shanti Dhan

Shanti Dhan

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Annexure

S.No

Abbreviation

Organization

84

SKDRDP

Shree Kshetra Dharmasthala Rural Development Project

85

SPARC

Society for the Promotion of Area Resources

86

SCF

Solapur Cooperative Federation

87

SHH

Students Health Home

88

SCHCS

Symbiosis Centre for Health Care for Students

89

SKS

Swayam Krishi Sangam

90

TAI

Tamil Nadu AIDS Initiative

91

TNHIT

Tamil Nadu Health Insurance Trust

92

TF

Tribhuvandas Foundation

93

Uplift Health

Uplift Health

94

VHC

Vaatsalya Healthcare

95

VWS

Village Welfare Society

96

VHS

Voluntary Health Services

97

WSE

Welfare Service Ernakulam

98

WWF

Working Womens Forum

99

YES-T

Yeshasvini Trust

100

YFA

Youth for Action

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