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2. SEWA

5. Insurance Membership - 2005 Women – 83514 Men – 34306 Children– 18,587 Total Insured – 136,407

6. Current insurance packages offered Policy IScheme II WomenSpouseChildr en Famil y WomenSpouseChil dren Famil y Annual10070100250225175100480 Fix21001500 - -50004000 - - Natural Death 5000 - -20000 - - Mediclaim2000 -6000 2000 - Asset1000020000 Accidental Death 4000025000 6500050000 Accidental Death - Spouse 15000

7. - Hospital tie-ups - Renewal Campaign Two recent initiatives

8. OBJECTIVE ACTIVITIES Direct members to Inpatient facilities of acceptable quality Hospital tie-ups 1. Develop procedure for screening hospitals for inclusion; 2. Select hospitals; 3. Periodically re-evaluate hospitals based on performance. Facilitate access to hospitalization by removing financial barriers 1. Encourage use of public and trust hospitals; 2. For members who use selected hospitals, pay 80% of claim within 48 to 72 hours of admission (balance at the time of discharge). Make it easier to claim and receive benefits under the scheme 1. Annual house-to-house visits to remind members about hospitalization insurance, and educate about “PR”; 2. Provide greater assistance in collecting and then submitting claims documentation.

9. System design 1.Goes to hospital Insured Selected hospitals 2.Phone call 6.Receipts & certificates Local Vimo Rep. Vimo SEWA Claims committee 4.Relays information, decision is made 3.Collects Info. On Diagnosis, Length Of stay, cost 5.Payment for bed, Doc., medicines, lab tests

10. Successes SEWA insurance members received better quality care service from selected hospitals 50% of claims came through cashless system Increased use of public and trust hospitals as against private hospitals Reduced the number of days of settlement of claim (80% in 48 hours)

11. Availability of suitable public or trust hospitals Educating the members about cashless system Skilled human resource –Local representative Challenges

12. SEWA’s Renewal Campaign Objective Continued protection to Vimo SEWA members Achieve renewal rate – 70% - policy year 2006 –Policy year 2004: renewal rate – 30% (YP) –Policy year 2005: renewal rate – 42% (YP)

13. Reasons for non renewal From Research Limited understanding of Insurance Lack of money at time of enrollment Limited contact between members and aagewans after enrollment

14. Reasons for non renewal Not enough focus and monitoring on renewals during enrollment campaign

15. Renewal Strategy – P.Y. 2006 Limited to Ahmedabad city (30,000 insureds) Make individual contact with each member prior to enrollment campaign Distribution of insurance and health education material Visit each member during enrollment period for renewal

16. Implementation Process 1.Each aagewan was given user friendly member lists 2.Each aagewan was assigned manageable number of membership 3.Supportive supervision given to aagewans 4.Barcodes used for recording visits

17. Outcomes 1.Able to complete 82% of visits prior to enrollment period 2.Members felt good about the house-to- house visits 3.For the first time aagewans went systematically house-to-house to meet each insured member 4.There was increase in members’ understanding and information

18. Challenges Obtaining accurate addresses Labour and time intensive Monitoring of visits

19. Lessons Learnt 1.Supportive supervision is critical 2.Adequate human resources required for satisfactory completion of visits –Aagewans –Supervisors 3.Individual house-to-house visits build trust

20. THANK YOU Contact details: rupal_jayswal@yahoo.com rupal_jayswal@yahoo.com Upasana_joshi2000@yahoo.com