Case study

Can Health Microinsurance Protect the Poor?

Studying a client-managed health insurance model in Pune, India
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This study by Microfinance Opportunities (MFO) contributes to the debate on whether microinsuarnce is a good deal for the poor. It examines a client-managed health insurance model implemented by Uplift India Association (Uplift). The study focuses on one specific component of client value, namely, financial value. It examines whether and how Uplift provides financial value to its members.

The study includes a case study comparing specific experiences of insured and uninsured households when faced with malaria. It supplements case study findings with an analysis of Uplift’s claims and financial data. The MFO report takes the definition of financial value as articulated by Magnoni & Zimmerman (2010) as its starting point, that financial value is the value that policyholders obtain when claims are made. Conclusions include:

  • Uplift provides substantial value to its health microinsurance clients;
  • This value is obtained through claims reimbursements and also for some through lower costs of care due to price concessions negotiated by Uplift at participating hospitals;

MFO recommends an expanded definition for financial value based on its findings, which is that financial value of health insurance is the degree to which membership in a health microinsurance program lowers the overall costs incurred due to ill health.