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Marketing of Health Insurance in Rural Area: A Study
With Reference to Dakshina Kannada and Udupi Districts of Karnataka
Name
Mr. Santhosha
Guide Name
Dr. M.G. Krishnamurthy
Research Centre
Department of Management Studies, Jawaharlal Nehru
National College of Engineering, Shivmoga
Year of
Registration
May 2009
Marketing of Health Insurance in Rural Area: A Study
With Reference to Dakshina Kannada and Udupi Districts of Karnataka
1. Introduction to Study
1.1 Overview of Rural Markets
In India ever since independence, because of some obvious reasons, marketing acquired a
largely urban bias. Hence, there was no attempt on the part of marketers to know the rural
consumer and satisfy their needs. The indifferent attitude also due to the assumption that the
rural people were poor and had no purchasing power to buy expensive branded products.
Besides such, lack of transportation and communication links and limited reach of mass
media were also responsible for neglect of the rural consumer by the business firms.
The green Revolution in the seventies provided a much needed boost to the agriculture-based
rural economy in the country. This made India as a self- sufficient economy in food
production and also contributed towards overall economic growth of the rural sector.
Subsequently, other allied activities such as dairying, poultry and horticulture gained
momentum to supplement the land owner’s income from crop farming. Infrastructural
facilities in the form of road links, electricity and communication networks also improved
largely during the seventies and eighties. These positive developments led many firms to take
interest in the rural markets and extend their penetration and reach to smaller towns and
villages.
The Indian rural market with its vast size and large demand base definitely offers huge
opportunities to marketers. Rural marketing has gained prominence in the last decade. The
nineties saw widespread changes in the Indian business environment. Urban markets for
many consumer goods either got saturated or were badly hit by recession. A fear of
competition in urban markets and huge opportunities in rural markets forced all marketing
strategist to enter the rural markets.
Rural Marketing in India has gained importance in recent years due to the newer
understanding of the concept of rural market. Vast nations such as China and India, which
account for one third of population, have 70% of their population living in rural areas.
Marketers have started giving importance to the neglected rural markets because of the
saturated urban markets and improved incomes and spending power of the rural consumers.
1.2 Financial Services in Rural Markets
Financial services are a form of services that provide solution to the financial needs of
consumers. They are of various types like banking, insurance, mutual funds, securities
financial transaction service etc. Provision of quality access to financial solutions is vital for
development of people in rural areas. Low –income households and micro enterprises can be
extremely benefited from bank credit, savings, securities, mutual funds and insurance
services. Investing in securities generates regular cash flow and also gives capital
appreciation. Banking services enable people to take advantage of profitable business
opportunities and increase their earnings potential. Insurance services can help all the stake
holders to manage the associated risk with life, business and agriculture.
Attitude of rural people towards use of money and saving has changed after nineties. The
age-old practice of keeping the savings in the form of cash or gold has given way to
preference for bank accounts, mutual funds, securities and insurance. Recently self-help
group concept has got tremendous success in rural areas. This study concentrates on rural
insurance.
1.3 Insurance in Indian Rural Markets
The insurance market in India, liberalized in 2000 with the advent of private insurance
companies in November 2000 has not expanded in real terms beyond the urban domain.
There exists a vast potential in the rural areas where more than 70% of our population lives.
But it is common perception and belief amongst the insurance companies that it is expensive
to do business in rural areas. Most companies are focusing only on meeting regulatory
requirements from rural areas and don’t see them as commercially viable rural business
opportunities, waiting to be exploited.
When the insurance sectors opened up to private player in the year 2000, the insurance
Regulatory and Development Authority(IRDA) had made it mandatory for the private
insurance players to sell a percentage of new polices written in the rural sector. The initial
guidelines had stipulated that 5 percent of total polices sold by private sector insurance
players had to be in the rural areas. Currently, life insurance companies are required to sell 7
per cent, 9 per cent, 12 per cent, 14 per cent and 16 per cent of their policies in rural areas in
the first, second, third, fourth and fifth financial years, respectively. It also defined rural area
as one with a total population of less than 5,000, with a population density of less than 400
per square kilometer, and more than 25% of the male working population is engaged in
agricultural pursuits.
India as country is under –insured in the urban as well as the rural areas. Only 35 percent of
the 250 million insurable population is insured. In India there about 30 insurance in life
insurance business and non-life sector. To increase the penetration levels insurance
companies will need to look at newer segments especially the relatively untapped rural
market rather than fighting for a share in the same pie in the urban markets.
1.4. Health Insurance in India
The greatest resource India has is its human resource and with it come the health issues. Size
is a corollary for potential. Thus India obviously has a huge market for health care and health
insurance is an integral part of it. The concept of medical insurance started catching up in
India only during the mid 1980’s. Initially, only the basic version of hospitalization cover was
offered. With the opening up of the industry and the resultant competition, more innovative
products have been introduced in the market. But still the health insurance sector has not
made much headway in India. Overall, only a small percentage of (less than nine) of the
population is covered by some form of health insurance. Health insurance in the Indian
market has made considerable progress in the post-liberalization era. However, considering
the vast potential that is available in the country, it is still far from where it should be. Health
insurance constitutes a paltry 10% the total industry revenue and has not kept pace the
expansion of the healthcare industry on the whole. Unlike non-life insurance, health
insurance is still in nascent stage in India and will probably take some time to settle down.
1.5 Health Insurance in Rural India
Though India has made rapid strikes in the health sector since independence, the cost of
healthcare is burdensome for most families in rural India. Around 70 per cent of India’s
population lives in villages. Of these, less than 2 per cent are insured. Though the rural health
insurance market is huge, it has so far remained untapped. Recently, IRDA has constituted a
committee to chalk out a plan for spreading health insurance in rural areas.
Today, the health insurance providers face lot of hurdles and challenges in reaching the rural
population due to various factors such as lack of healthcare facility, belief in non-medical
means, problem of accessibility to institutional healthcare, improper agent service and the
problem of affordability.
Today significant portion of the rural population which is engaged in pure agriculture is
slowly withdrawing from it. A lot of people belonging to the second generation are getting
white-collar jobs. Thus insurance companies have lot of opportunities to penetrate in the rural
India. Extension of health insurance coverage to rural population may seem to be
intimidating now, but in the long run it will enhance the quality of healthcare and hygiene in
the rural
1.6 An Overview of Dakshina Kannada District
Dakshina Kannada is a coastal district of Karnataka. The Dakshina Kannada district is in fore
front in education. Mangalore is the head-quarter and chief city of the district. The Dakshina
Kannada district has an area 4560 square kilometer. Density of human population is 416
persons per square kilometer. There are 354 villages in the district. Three national bank out
of 19 nationalized banks are established in Dakshina Kannada namely, Vijaya bank, Canara
bank, Corporation bank. Red clay tile (Mangalore tiles), Cashew processing factories and
Beedi industries are flourished in this district. Agriculture has taken back seat because of
influx of money from natives settled in other areas. Significant people from this district work
in gulf countries and other states of India. Tables 1.1 and 1.2 give the some statistics of
Dakshina Kannada.
Table 1.1 Data of Dakshina Kannada-Population
Particulars Statistics
Total population 18,97,730
Males 9,38,434
Females 9,59,296
Rural Population 11,68,428
Total literacy rate 83.35%
Male literacy rate 89.70
Female literacy rate 77.21
Source: Census of India 2001
Table 1.2 Data of Dakshina Kannada-Villages
Sl. No Name of the Taluk No of Villages as per
census 2001
1 Bantwal 79
2 Belthangadi 80
3 Mangalore 88
4 Puttur 67
5 Sulya 40
Total 354
1.7 An Overview of Udupi District
Udupi District was created in August 1997. There were eight districts in undivided Dakshina
Kannada and the three northern taluks, such as udupi, Kundapura, and Karkal were separated
from Dakshina Kannada district. The administrative headquarters of Udupi district is Udupi.
The district has mostly small scale industries. There is not any noteworthy industry at present.
There are some red clay tile, cashew, coconut oil industries providing employment to
hundreds. Syndicate bank was established in this district. Tables 1.3 and 1.4 give the some
statistics of Udupi.
Table 1.3 Data of Udupi-Population
Particulars Statistics
Total population 11,12,243
Males 5,22,231
Females 5,90,012
Rural Population 9,05,890
Total literacy rate 81.25%
Male literacy rate 88.23%
Female literacy rate 75.19%
Source: Census of India 2001
Table 1.4 Data of Udupi -Villages
Sl. No Name of the Taluk No of Villages as per
census 2001
1 Karkal 50
2 Kundapura 99
3 Udupi 99
Total 248
Above table show that nearly 63 percent of population lives in rural Dakshina Kannada and
nearly 82 percent of population lives in rural Udupi. These districts have high literacy rate
compared to other districts of Karnataka. According the observation penetration of private
companies in the area of health insurance in these districts is low. Some governmental plans
like “Yahshasvini” is playing important role in rural health care. Yashashvini plan is having
its own limitations.
1.8 Literature Review
The old and related literatures are reviewed to get the in-depth understanding of the research
topic. Following are the some of the reviewed studies:
Chakravarthi (2006) reported that health insurance schemes are more complex and because
of various demand and supply side imperfections there are inherent problems in the health
insurance market. He also says that most of the perspective population is unaware of the pros
and cons of the different schemes of health insurance.
Ratna and Sarkar (2007) reported that rural population treat health as an important aspect
and are interested in a health insurance scheme. They reported that High costs of
hospitalization and surgery is not posing financial risks for poor households. They also
reported that Poor rural people are able to take judicious decisions regarding the composition
of a health insurance benefit packages.
Naveen and Veerashekhrappa (2009) reported that Micro-insurance is entirely a new
financial product for the rural poor in the study villages. All respondents heard about the
micro health insurance for the first time through the SHGs and the NGO staff. They say that
large numbers of the SHG members cover their health insurance through micro-health
insurance program. They also reported that the accessibility of micro health insurance is more
skewed towards the income group of very poor and moderately poor households.
Vinod and Saharan (2007) reported those general publics are slowly becoming aware about
the benefits of the health insurance and its importance in today’s world. They say that the
premium level and index of growth of health insurance business is continuously rising up in
India. They also reported that public sector players are declining with their market share in
health portfolio whereas the private sector players are on the rise in their contribution level.
Pradip and Parthi (2007) reported that Competition is yet to reach the pricing arena in
health insurance. The oligopoly nature of market has turned to restrict the free play of market
forces through product differentials. They also reported that health insurance has positioned
itself today as one of the throbbing classes of insurance in non-life insurance sector in India.
Charkravarti (2006) reported that below poverty line population are not capable of paying
health insurance premium and the insurance agents are not properly informed about the
policy. He says that general publics take financial help from the neighbours/community to
bear the financial burden of medical expenses. He reports that a large section of the rural poor
in West Bengal simply avoid health implications due their poverty; as they are unable to bear
the cost of treatment.
2. Need for the Present Study
As stated above India as a country is under –insured in the urban as well as the rural areas.
Only 35 percent of the 250 million insurable population is insured. In India there about 30
insurance in life insurance business and non-life sector. To increase the penetration levels
insurance companies will need to look at newer segments especially the relatively untapped
rural market rather than fighting for a share in the same pie in the urban markets. In
healthcare insurance in urban market is penetrated by private and public sector companies. In
rural areas due lack of awareness in the minds of rural customers companies have not
concentrated on this segment. There is a need of health insurance in rural India to finance the
medical expenses. This study concentrates on the marketing strategies followed by private
and public sector to penetrate the rural market. This study also discovers the attitude,
awareness level, of rural customers towards health insurance in Udupi and Dakshina Kannada
Districts of Karnataka. In these areas there is no such study conducted by the any other
researchers, or any other research organizations in specific. This study helps private and
public health insurance companies to adopt effective marketing strategies to penetrate these
markets.
3. Objectives of the Study
The main objective of the study is to understand the marketing of health insurance in rural
areas of Udupi and Dakshina Kannada Districts of Karnataka. Other sub specific objectives
are:
a) To determine current knowledge, attitudes and practices regarding health insurance of
Dakshina Kannada and Udupi rural customers’
b) Identify the factors which are prohibiting the purchase of health insurance policies.
c) Compare the risk factor and other factors of purchasing health insurance policies.
d) Determine the potential rural customer’s perceived need for acceptance of and
willingness to purchase health insurance policies.
e) Determine the Knowledge of the rural consumers regarding private health insurance
companies and their products
f) Know the rural health insurance in India
g) Know the present marketing strategies adopted by private and public sector companies in
these two districts.
h) Know the performance of General insurance companies and other private insurance
companies in India
i) Role of IRDA in regulating health insurance sector in India
j) Know the reasons behind low penetration of health insurance schemes in India and
specifically in Udupi and Dakshina Kannada districts.
4. Scope of the Study
The scope of the study is restricted to surveying of rural consumers in Udupi and Dakshina
Kannada districts of Karnataka. It attempts to throw lights on health insurance services in
financial services industries. Surveys are restricted to the villages of these two districts. Study
also attempts throe lights on present marketing strategies followed by public and private
insurance payers in Dakshina Kannada
5. Methodology
5.1 Statement of the Problem
Marketing of health insurance in rural area: a study with reference to Dakshina Kannada and
Udupi districts of Karnataka
5.2 Research Approach
A survey approach is considered as the best method to find out the marketing of health
Insurance in rural areas of udupi and Dakshina Kannada Districts.
5.3 Design of the Study
The study design adopted is descriptive research design.
The study will be conducted at Dakshina Kannada and Udupi District of Karnataka State. The
study will be conducted in the selected villages of Dakshina Kannada and Udupi District.
5.4 Sampling Design
5.4.1 Population
All policy holders of different health insurance and non policy holders of health insurance in
Udupi and Dakshina Kannada villages are population for this study. The non policy holders
will also be considered to find out whether they will be potential customers and have any idea
about health insurance policy schemes for the rural sector by the insurance companies.
5.4.2 Sampling Frame
Information of data about selected districts in Karnataka state is obtained form Census 2001.
Data of selected villages from selected two districts will be collected from respective village
pachayaths to ascertain whom the researcher will consider as the sample respondents for the
study.
5.4.3 Sampling Units
Target respondents are policy holders of health insurance of respective villages. In order to
know the awareness about various insurance schemes for the rural people, even non policy
holders will be considered. The proposed sample size for the present study is 1,200 out of
which 600 each will be policy holders and non policy holders of health insurance.
5.4.4 Sampling Method
Target respondents for the present study are people living in rural areas of D.K and Udupi
districts. The samples will be selected using multi stage random sampling.
Out of the 5 taluks of D.K district, it is randomly proposed to select 3 taluks, from each taluks
so selected, it is proposed to select 10 villages by simple random sampling. Out of the
selected villages, it is proposed to select 20 sample respondents out of which 10 each will be
concentrated on policy holders and non policy holders of the health insurance.
Out of the 3 taluks of Udupi district it is proposed to select 10 villages by simple random
sampling. Out of the selected villages, it is proposed to select 20 sample respondents out of
which 10 each will be concentrated on policy holders and non policy holders of the health
insurance.
5.5 Sources of Data Collection:
5.5.1 Primary Data
The sources of the primary data for the present study are collected through the personal
interviews using research instrument as questionnaire. Data will be obtained from different
health insurance policy holders and non policy holders of Udupi and Dskshina Kannada
districts through structured interview schedule.
5.5.2 Secondary Data
The secondary data includes data collected from periodicals such as magazines, business
news papers, and from subject related books. Dakshina Kannada and udupi districts
information will be collected from the respective district office and respective panchayath
offices.
Industry and company profile will be collected from different insurance companies by their
company records and through personal interview.
5.5.3 Content Validity
To ensure content validity, the interview schedule will be submitted to experts in the field.
The experts will consist of researchers and Insurance executives who have made a mark in
the field. To refine the research study pilot test will be conducted.
5.5.4 Data Collection Procedure
The research study will be preceded by visiting the selected villages in the taluks through
administering the interview schedule to the respondents personally. It is proposed to develop
the interview schedule in both English in Kannada. The English version will then be
translated into Kannada for better comprehension of the respondents.
5.5.5 Plan for Data Analysis
The data analysis for the present study will include both descriptive and inferential statistical
measures where the analysis will be done using latest version of SPSS (Version 16.0)
6. Probable Chapter Scheme
The entire study is broadly divided into 5 chapters
Chapter-1- Introduction: The Introduction gives an understanding about the topic selected
and the significance of the study, importance of the study, and objectives of the study.
Chapter-2- Review of Literature: Gives an insight about Indian health insurance industry,
rural health insurance, structure of the industry, profile of the different health insurance
companies, their market share industry emerging trends, IRDA regulations, literature review
etc
Chapter-3-Methodology: Gives insight into the research approach, design sampling, data
collection,
Chapter-4-Data Analysis: Gives detailed analysis of survey conducted in the area of Udupi
and Dakshina Kannada districts villages.
Chapter -5-Summary of the Findings: Gives key findings of the study
Chapter-6-Suggestions and Conclusion: Gives suggestions for health insurance players
based the findings of the study. Second part of this chapter concludes the study and gives the
limitations of the study
(SANTHOSHA) (DR. M. G. KRISHNAMURTHY)
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