Publication database

“Can health microinsurance (HMI) schemes achieve sustainability?” As with many seemingly simple questions, there is no simple answer. The answer to this question is of interest to a variety of parties. Insurance providers seek to understand if there is a viable business case for offering an HMI product. Health-care providers and pharmaceutical companies are interested in whether or not HMI can be a means for broadening coverage. Donors and other funding organizations want to know if HMI is a viable investment as a means to improve health-care access, health outcomes and financial protection for the low-income population. Governments consider how to use HMI schemes as a step towards universal health coverage.

Briefing Note 35 presents results from a review of the financial performance of five schemes in India, Pakistan and Bangladesh.

“Can health microinsurance (HMI) schemes achieve sustainability?” As with many seemingly simple questions, there is no simple answer. The answer to this question is of interest to a variety of parties. Insurance providers seek to understand if there is a viable business case for offering an HMI product. Health-care providers and pharmaceutical companies are interested in whether or not HMI can be a means for broadening coverage. Donors and other funding organizations want to know if HMI is a viable investment as a means to improve health-care access, health outcomes and financial protection for the low-income population. Governments consider how to use HMI schemes as a step towards universal health coverage.

This paper seeks to answer this simple yet crucial question based on the experiences of five schemes in South Asia.

Most providers of health microinsurance (HMI) can do more to understand the illness and claims patterns of insured clients. The objective of this study is to demonstrate that analysing claims data equips HMI practitioners with valuable insights to improve the client value and viability of HMI programmes. This brief summarizes a study that performs a comparative analysis of three South Asian HMI programmes – run by VimoSEWA, Uplift Mutuals and Naya Jeevan. These providers share a common geographic region and offer broadly similar insurance for hospitalization services to low-income households.

The Evangelical Social Action Forum (ESAF), through its Microfinance and Investments (P) Ltd (EMFIL) of India participated in the ILO’s Microfinance for Decent Work (MF4DW): Action Research project from 2008-2012. As part of this experimental research, ESAF launched and tested business development services and awareness raising activities on the benefits of formalisation for their members entrepreneurs in order to see if there was a positive impact of formalisation on the economic and social performances of clients and their enterprises, using a target versus control group methodology.

National Rural Support Programme (NRSP) of Pakistan participated in the ILO’s Microfinance for Decent Work (MF4DW) action research programme from 2008-2012. As part of this experimental research, NRSP launched and tested an extended microinsurance product (health and accidental death) covering extra-nuclear family members of the same household in order to see if there was a positive impact on the reduction of child labour among 2,097 client households, using a target versus control group methodology.

Most providers of health microinsurance (HMI) can do more to understand the illness and claims patterns of insured clients. The objective of this study is to demonstrate that analysing claims data equips HMI practitioners with valuable insights to improve the client value and viability of HMI programmes. The study performs a comparative analysis of three South Asian HMI programmes – run by VimoSEWA, Uplift Mutuals and Naya Jeevan. These providers share a common geographic region and offer broadly similar insurance for hospitalization services to low-income households.