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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

Department of Management Studies, Jawaharlal Nehru


Research Centre
National College of Engineering, Shivmoga

Year of
May 2009
Registration
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)


Research Scholar Research Guide
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