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At ICICI Lombard, investing in rural markets is a part of our social responsibility. The protection provided to the rural class is specific and customised according to their requirements. Through a multiple channel system, we not only provide protection for agricultural assets but also health, motor and other covers.
Rashtriya Swasthya Bima Yojna (RSBY) has been launched by the Ministry of Labour and Employment, Government of India to provide health insurance coverage for Below Poverty Line (BPL) families.
Provide protection to BPL households from financial liabilities arising out of health shocks that involve hospitalisation.
RSBY provides the participating BPL household with the freedom of choice between public and private hospitals and makes him a potential client worth attracting on account of the significant revenues that hospitals stand to earn through the scheme.
Business Model for all Stakeholders
The scheme has been designed as a business model for a social sector scheme with incentives built for each stakeholder.
The insurer receives a premium for each household enrolled under RSBY.
A hospital has the incentive to provide treatment to a large number of beneficiaries as it is paid per beneficiary treated. Even public hospitals have the incentive to treat beneficiaries under RSBY, as the money from the insurer will flow directly to the concerned public hospital, which they can use for their own purposes.
Intermediaries such as NGOs and MFIs have a greater stake in assisting BPL households. The intermediaries will be paid for the services they render in reaching out to the beneficiaries.
By paying only a maximum sum up to `750 per family per year, the government is able to provide access to quality healthcare to the BPL population.
An electronic list of eligible BPL households is provided to the insurer using a pre-specified data format.
An enrolment schedule for each village, along with dates, is prepared with the help of the district level officials.
As per the schedule, the BPL list is posted in each village at the enrolment station and prominent places prior to the enrolment and the date and location of the enrolment in the village is publicised in advance.
Mobile enrolment stations are set up at local centres (e.g., public schools) at each village. These stations are equipped with the hardware required to collect biometric information (fingerprints) and photographs of the members of the household covered, and a printer to print smart cards with photo.
The smart card, along with an information pamphlet describing the scheme and the list of hospitals, is provided on the spot once the beneficiary has paid the registration fee. The process normally takes less than ten minutes. The cards are handed over in a plastic cover.
A government officer – Field Key Officer (FKO) needs to be present and must insert his/her own, government-issued smart card to verify the legitimacy of the enrolment. (In this way, each enrolee can be tracked to a particular state government official).
In addition to the FKO, an insurance company representative / smart card agency representative must be present. At the end of the each day of enrolment, the list of households that have been issued smart cards is sent to the state nodal agency. This list of enrolled households is maintained centrally and is the basis for financial transfers from the Government of India to the state governments.
This list of enrolled households is maintained centrally and is the basis for financial transfers from the Government of India to the state governments.
RSBY has a provision whereby an insurer has to hire intermediaries (e.g. NGOs, MFIs, etc.) to provide grassroots outreach and assist members in utilising the services after enrolment.
For more information, kindly visit Rashtriya Swasthya Bima Yojana website
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