QUESTIONNAIRE 1. From which company have you purchased your current health insurance policy?

Public Sector Company (National, Oriental, New India, United) Private Sector Company 2. Which of the following was the most prominent reason for which you to bought a health insurance? Anticipation of need Out of the compulsion of Job Hardcore telesales Because of poor health / recent poor health of Self / Family member 3. While comparing health insurance policies of different companies, you gave importance to the aspects related to Health Insurance Policy Health Insurance Company Third Party Administrator (TPA) All of the above 4. What do you think is the role of TPA in health insurance? To facilitate cashless treatment among a network of hospital covering wider area. To provide reimbursement of the costs paid to acquire health care. An intermediary between customer and the insurer to facilitate easy settlement process. To keep record of customers health, facilities availed and costs paid. 5. Did you know about the procedure of cashless treatment / reimbursement through your health insurance policy? Yes No 6. Did you face any problem while availing the cashless treatment? Yes No 7. In which of the following area related to cashless settlement did you face the problem Planned cashless treatment Reimbursement of treatment expenditure Emergency cashless treatment Reimbursement of pre/post treatment expenditure 8. What was the problem you faced? Delay in response of TPA Reimbursement Overcharging Any Other (Please Specify)__________.

9. How long it took your TPA in approving the pre-authorization form? Less than 4 hours (Very Efficient) 4 to 8 hours (Efficient) 8 to 12 hours (Average) Less than a day (Poor) More than a day (Very Poor) 10. Was there any difference between the estimate provided to you as an individual and estimate provided for cashless treatment, if Yes, Kindly tell us the most appropriate range which measures the difference: No Difference Less than 50 % More than 50% More than 100% 11. Do you think that existence of TPA has improved the overall system of health care through health insurance? Yes No 12. Do you think that existence of TPA has increased the cost of health care and health insurance? If yes, kindly answer next question, otherwise skip next. Yes No
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13. What do you think is the most prominent reason for increased cost of health care through health insurance at hospitals? Additional costs on part of hospitals Additional costs on part of TPA Additional costs on part of both hospital and TPA Margin for error and additional cost is kept at the time estimate for pre-authorization Connivance of both hospital and TPA to charge more 14. Did your TPA provide you with the literature or instructions on settlement process and other aspects? Yes No 15. Please indicate the extent to which you are satisfied or dissatisfied with the overall service provided by the current health insurance policy. (Kindly tick () the proper box). Very Satisfied Satisfied Indifferent Dissatisfied Very Dissatisfied 16. Please indicate the extent to which you are satisfied or dissatisfied with the overall service provided by the TPA through your health insurance policy. (Kindly tick () the proper box). Very Satisfied Satisfied Indifferent Dissatisfied Very Dissatisfied 17. Are you so happy with the services of your TPA/company that you will renew your policy with the same insurer? Yes Probably yes May or may not be Probably no No 18. Please indicate the quality of service provided to you by TPA on the basis of following parameters on a scale of 1-5. 5 - Extremely good 4 Good 3 - Neither Good nor Bad 2 Bad 1 - Extremely Bad Sl.No. i. ii. iii. iv. v. vi. vii. viii. ix. x. xi. xii. xiii. xiv. Factors Sensitiveness Promptness Helpful Paper formalities Processing of pre-authorization Admission of patient Accessibility Increasing cost Convenient operating hours 24x7 Customer care Settlement of bills Complaint redressal Trained Staff Accuracy in keeping records Score

1 1 1 1 1 1 1 1 1 1 1 1 1 1

2 2 2 2 2 2 2 2 2 2 2 2 2 2

3 3 3 3 3 3 3 3 3 3 3 3 3 3

4 4 4 4 4 4 4 4 4 4 4 4 4 4

5 5 5 5 5 5 5 5 5 5 5 5 5 5

19. If your friend wishes to buy a health insurance policy, would you be willing to recommend the same policy considering the services of TPA? Definitely yes Probably yes May or may not Probably not Definitely not

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20. Please indicate the extent to which you agree or disagree with the following statements. (Kindly tick () the proper box). Strongly Agree Helpdesks(Point of Interaction) My TPA was easily accessible at the help desk of hospital. TPAs Helpdesks are efficient and prompt and ease the process of coverage / admission / Discharge. Information given by TPA Helpdesk for various purposes was clearly understandable. There should be a system of immediate feedback on service of a TPA at Helpdesk. I felt that getting serviced through a TPA is a complex process. No grievance redressal mechanism is there in place at helpdesk for health insurance customers. Helplines of TPAs/insurance companies are mere an eyewash Information Information given by TPAs through its leaflets / consumer guide is clearly understandable. I faced difficulty in getting information about the process of admission, discharge and settlement I was unable to understand the terms and conditions of my health insurance policy My TPA was helpful in providing information to me regarding my health insurance policy Service TPA was prompt in replying on preauthorisation while I got my patient / myself admitted in hospital TPAs refused the coverage partially / fully. Agents / telesales / helplines are more keen in selling their insurance than understanding my needs and helping or providing information Overall Health insurance would have been simple without TPAs. Cost of treatment would have been substantially less than what I paid through TPA based health insurance. Government needs to introduce stricter norms to control TPAs. I would like request the company to change my TPA. TPAs should be removed from the business of health insurance.
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Agree

Indifferent

Disagree

Strongly Disagree

21. Please indicate the quality of service provided to you by TPA Employee on the basis of following parameters on a scale of 1-5. 5 - Extremely good 4 Good 3 - Neither Good nor Bad 2 Bad 1 - Extremely Bad Sl.No. i. ii. iii. iv. v. vi. vii. viii. ix. x. xi. xii. xiii. xiv. xv. Factors Understanding of your need Personal/individual attention Knowledge and answering of queries Ease of contact Politeness Trustworthiness Availability Willingness Problem solving Sincerity Correctness of information Correctness of service Waiting time Maintenance of office Maintenance of equipments Score

1 1 1 1 1 1 1 1 1 1 1 1 1 1 1

2 2 2 2 2 2 2 2 2 2 2 2 2 2 2

3 3 3 3 3 3 3 3 3 3 3 3 3 3 3

4 4 4 4 4 4 4 4 4 4 4 4 4 4 4

5 5 5 5 5 5 5 5 5 5 5 5 5 5 5

22. Please tell us about yourself Age group (years) Less than 18 Education Level Occupation Monthly Income Under graduate Service (Govt.) 20,000

18 25 Graduate Service (Pvt.) 20,000-40,000

26 45 Postgraduate Professional/Business 40,000-60,000

45 Others Others 60,000

Name, Add., & Ph.No.

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