Indian Journal of Forensic Medicine & Toxicology
Vol. 14 No. 4 (2020): Indian Journal of Forensic Medicine & Toxicology

Assessment of Satisfaction Levels of Health Insurance Policy Holders with Claims Settlement Process in Pune, Maharashtra

Neha Ahire1, Parag Rishipathak2 (Unknown)



Article Info

Publish Date
29 Oct 2020

Abstract

Introduction: Customer satisfaction is an important determinant of health insurance penetration. It isnot only indicative of customer loyalty but is also helpful in identifying the needs of the customer andfurther necessity of product innovation. As compared to other verticals of insurance, health insurance ismore complex as for the administration and implementation of the policy various stakeholders are involved.Theses take holders are namely hospitals, Third Party Administrators and health insurance agents andadvisors. Equally important is the satisfaction with the claim settlement process, which significantly impactoverall satisfaction with health insurance policies.Aim and Objectives: To assess of customer satisfaction levels with the claim settlement process amongsthealth insurance policyholders in Pune, Maharashtra. Further, the study is aimed to identify the potentialareas of dissatisfaction and weaknesses in the claim management system.Materials and Method: The study design is and exploratory and descriptive. Sequential random samplingused to select participants from the data of health insurance policyholders who have availed the benefit ofhealth insurance through hospitalisation. 5-point Likert scale was used to assess the responses on claimsettlement process.Results: Health insurance claims administration involves coordinated efforts of stakeholders viz insurancecompanies, TPA services, Hospitals and agents and advisors. The study shows scope of improvement inthe claims settlement process. The policyholders experience depends on the coordination, timeliness andtransparency in the process.

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