A

PROJECT REPORT
ON

“COMPARATIVE ANALYSIS BETWEEN CIGNA TTK

& STAR HEALTH AND ALLIED INSURANCE Co.
Ltd.”

CIGNA TTK HEALTH INSURANCE COMPANY

A Summer Internship Project (SIP) done in
“FINANCE”
Submitted in partial fulfillment of the requirement for the award of degree of
Master of Management Studies (MMS) under the university of Mumbai
Submitted by
POOJA PRAKASH SAWANT
ROLL NO: 40
BATCH: 2017-2019
Under the guidance of
Dr. Uma Durgude
Bharati Vidyapeeth’s
Institute of Management Studies & Research
Navi Mumbai

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 (i)

ACKNOWLEDGEMENT

The project has been prepared as a part of an internship required during the completion of
MMS from Bharati Vidyapeeth Institute of Management Studies & Research.

I acknowledge with thanks to my work place and my colleagues for the team work that
have helped me to learn the work effectively. I am very thankful to the Cigna TTK
Health Insurance Co. of my company who provided me opportunity to work in his place.

I am thankful to my industry guides Mr. Kamal Ahuja, who provided me suggestions,

ideas and advices for this project to get it completed effectively. My guide was very
helpful to me in discussions.

I would like to express my deep sense of respect & sincere gratitude to Dr. Anjali Kalse I
/c director of Bharati Vidyapeeth Institute of Management Studies & Research.

I am thankful to my project guide Prof. Dr. Uma Durgude (Mentor) as without his
continuous guidance and enthusiasm the project would have never been materialized in
the present form.

Finally I would also like to thanks to those who helped me directly or indirectly for the
completion of this project report.

Signature of the student

POOJA SAWANT
Roll No. 40
MMS- Finance

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 (ii)

PLEASE PASTE HERE THE CERTIFICATE FROM THE COMPANY

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 (iii)

CERTIFICATE

This is to certify that the Summer Project titled “Comparative analysis between Cigna
TTK health insurance co. & Star health And Allied insurance co.” is successfully
done by Ms. Pooja Sawant, a student of Bharati Vidyapeeth’s Institute of Management
Studies and Research, submitted in partial fulfillment of Master of Management
Studies under the University of Mumbai during the academic year 2017-2019 from 2nd
May to 30th June 2018 at Cigna TTK Health Insurance Co. ltd.

Date :___________

_____________________ _________________

Prof._____________ Dr. Anjali Kalse

Project Guide I /c Director

BVIMSR BVIMSR

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 (iv)

EXECUTIVE SUMMARY

The report has been prepared from leanings received in internship program working
under one of the Standalone Health Insurance Company, Cigna TTK Health Insurance
under the guidance of Mr. Kamal Ahuja, Business Consultant and Mr. Deepak
Chaudhary, Zonal Head. The broad objective is to study what factors influence adequate
health insurance in India. The main focus is to analyze the how aware people are about
the need of health insurance. This study focuses on the factors that influence the buying
decisions of customers. Information used to prepare this report has been collected from
both primary and secondary sources. Primary information was collected from the direct
interactions with the potential clients using the profiling method provided by the
company. The secondary data was collected from various reports on psychographic
segmentation and behavioral segmentation. Various journals and books were also
referred to understand what is profiling and elements to be included. Different websites
were also used for information on the Insurance Industry. The Insurance Industry has
collected Rs.3.78 trillion gross domestic premiums of which the Health Insurance has
contributed Rs. 378.97 billion in gross domestic premiums. The Insurance sector is
growing at a compounded annual growth rate of 24.3%. Cigna TTK is one of the 5
Standalone Health Insurance Companies that work only in the health insurance only.
Cigna TTK is a joint venture of the global Health Insurance Company Cigna Corporation
and Indian conglomerate TTK Group which has expertise in the Indian Pharmaceuticals
and Indian Market. Indian market is a vast market for Insurance. The penetration of
Health Insurance in India is less than 4% making it one of the most attractive market for
Insurance in India. Cigna TTK was incorporated in the year 2014. It has now completed 4
years in the Indian market and currently operates in only 14 cities and is planning to
expand in other cities as well. The project includes the level of awareness of health
insurance among the people. It also states that how important do people consider having a
health insurance. The ratios of two companies are compared and the analysis is shown. It
also shows the interpretation of secondary data collected for the purpose of the project.

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 (v)

TABLE OF CONTENTS

Chapter
Particulars Page No.
No.
(i) Acknowledgement 2

Certifications
(ii) Certificate from the company. 3
(iii) Certificate

(iv) Executive Summary 5

(v) Table Of Content 6

1. Introduction of the Project 9

1.1 Concept of the study. 8

1.2 Need for the study 10

1.3 Objectives of the study 10

1.4 Scope of the study 11

1.5 Introduction of the topic 12

(a) Meaning 11

(b) Why do you need health insurance? 13

(c)How Does Health Insurance Work? 14

(d) Types 15

(e) Advantages 16

1.6 Literature review on company . 18

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 1.7 Regulatory or Legal aspects related to the topic 20

2. Introduction to the Industry 22

(a) Introduction of insurance industry. 22

(b) Introduction of health industry. 23

2.1 Industry Overview. 26

2.2 Major players in Industry. 27

2.3 Current Scenario 29

2.4 Comparative Analysis 31

2.5 Future Trends. 33

3. Introduction to the company 35

(i) CignaTTK Health Insurance Company Limited 35

3.1. Organization Profile 35

3.2 Organizational Structure 36

3.3 Product 38

(ii) Star Health and Allied Insurance Co Ltd 41

3.1 Organization profile. 41

3.2 Organizational Structure 42

3.3 Product 43

(iii) SWOT Analysis of Cigna TTK Co. 45

4. Research Methodology 46

5. Data analysis & Interpretation 48

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 5.1 Ratios 48

(a) Meaning of Ratio 48

(b) Ratio Analysis 48

(c) Advantage of Ratio Analysis 48

(d) Limitations of Ratio Analysis 49

49
(e) Classification of ratios
(f) Annual Statements (includes Profit & Loss A/C, Revenue
50
Statement, Balance Sheet)

(g) Calculation of Ratios & Interpretation 56

5.2 Data Analysis 61

6. Conclusion & Suggestions 69

7. Learning experience from SIP 71

8. Bibliography 75

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Chapter 1: Introduction of the Project
1.1Concept of the study.

Health insurance is insurance that covers the whole or a part of the risk of a person
incurring medical expenses, spreading the risk over a large number of persons. By
estimating the overall risk of health care and health system expenses over the risk pool,
an insurer can develop a routine finance structure, such as a monthly premium or payroll
tax, to provide the money to pay for the health care benefits specified in the insurance
agreement. The benefit is administered by a central organization such as a government
agency, private business, or not-for-profit entity. According to the Health Insurance
Association of America, health insurance is defined as "coverage that provides for the
payments of benefits as a result of sickness or injury. It includes insurance for losses from
accident, medical expense, disability, or accidental death and dismemberment" Health
Insurance Health Insurance is an insurance policy that ensures that you get cashless
treatment or expense reimbursement, in case you fall ill. A health insurance policy
reimburses the insured for medical and surgical expenses arising from an illness or injury
that leads to hospitalization. The insurance company provides the insured with the facility
of cashless hospitalization at a network hospital or provides a reimbursement for the
incurred expenses. Furthermore, health insurance cost is subsidized to the insured in the
form of tax exemption under section 80D of Income Tax Act, 1961. Individual Plans
Cashless Hospitalization: Medical expenses are sky-rocketing! Get health insurance
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IRDAI, Policy Bazaar helps you compare and find the best health plan. Individual Health
Insurance Plan from Top Insurers Lowest Premium On Medical Insurance Compare
Policies Instantly Importance of Health Insurance in India Health insurance in India is
one of the fastest growing industries. However, this wide scope for growth indicates the
limited penetration of health insurance among the Indian populace. As per the latest
report released by National Sample Survey Organization (NSSO) titled “Key Indicators
of Social Consumption in India: Health”, only 20 percent of the Indian population had
health insurance coverage. Additionally, only 18 percent of the total population residing
in urban areas and 14 percent of the total population residing in rural areas had any form
9
of health insurance coverage. Thus, there is no debating the importance of having
insurance in a country like India where medical expenses are sky-rocketing. Everyone
must buy a good health insurance policy that includes medical costs, hospitalization
costs, medication and laboratory test costs, including critical illness. Don’t get confused
with questions like – Which health policy to buy? Does it cover every eventuality? What
illnesses are excluded from this cover? Policy Bazaar is here to resolve all such
confusions. Compare Health Insurance Quotes & Save Big It is vital that you compare
health insurance online before purchasing any plan in order to choose the best plan for
your healthcare needs.

1.2 Need for the study

 The need for this study is to understand both the company's performance also
which factors are responsible for the performance of the companies and which
company provides more benefits and facilities to the customers and investors.
 To analyze the best offers and plan provided by each company. It is also assumed
that the observations, evaluations and conclusion made from the study will be
useful for comparison.

1.3 Objective of the study.

1. To study the factors affecting the customer buying decision and awareness of
health insurance.
2. To study the customer satisfaction level for health insurance.
3. To analyze two companies in different aspects such as premium, benefits and
facilities provided by both the companies.
4. Comparative study of Cigna TTK and Star Health & Allied Insurance Co. ltd. in
terms of their performance in profitability and productivity in the Health
Insurance industry.
5. To study profit and loss a/c and balance sheet through ratio.

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1.4 Scope of study.

 The research will help to know the level of awareness about health insurance
among people.
 The result of research would help to know how important do people consider
having a health insurance.
 The ratio analysis will help the investor to compare the products in terms of
premium and benefits & will also help the investor to know in which company he
should invest.
 This research will help to know what encourages the investors to buy health
insurance.

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1.5 Introduction of the topic.

(a) Meaning:

Health insurance in a narrow sense would be an individual or group purchasing health

care coverage in advance by paying a fee called premium. In its broader sense, it would
be any arrangement that helps to defer, delay, reduce or altogether avoid payment for
health care incurred by individuals and households. Given the appropriateness of this
definition in the Indian context, this is the definition, we would adopt. The health
insurance market in India is very limited covering about 10% of the total population
Health insurance guarantees payments to a person in the event of sickness or injury and
works as protection scheme. Health insurance is protection, scheme to take care of health
of a person and works it works by buying a policy from a company or an insurance agent.
Depending on the premium paid the health insurance policy will pay specified amounts
for the medical expenses incurred to overcome the health problem. Currently the trend of
some of the reputable companies seems to be to build in a health insurance policy as a
benefit to an employee. Some countries offer free health insurance to their citizen. In
India certain sectors like railways, army and the employees working with the central
government are covered in a health scheme provided cover to almost 20million people in
different part of country. Health like education should be essential and should be freely
available to all the citizens of a country. Some developed countries realizing the
importance of the health of the nation spend as much as 6% to 8% of their GDP on it and
32 have advanced facilities in their government run hospitals. Some examples include the
United Kingdom where the National Health Services hospitals provide all the health
requirements to majority of their citizens. Sweden and Norway follow similar
government run health schemes. As per the census of USA in the year 2004, it was noted
that 245.3 million people had health insurance coverage; however 45.8 million lived
without an insurance cover. In response to some of these stats Senator John Kerry said.
"Great physicians and nurses, skilled, caring and unparalleled in their training, intervened
in my life and probably saved it. I was lucky but other Americans are not. It is time to
speak again and stand again for the ideal that in the richest nation ever on this planet, it is
wrong for 41 million Americans, most of them in working families, to worry at night and
wake up in the morning without the basic protection of health insurance." Developing

12
countries like India have priority of spending in other sectors like the army and the
infrastructure development and barely 2% of the GDP is spent on the health and results in
the government hospitals lack in facilities especially for any advanced procedure such as
heart surgery or hip placement. Health insurance schemes are particularly important for
individuals from the lower income group to provide them and their family members with
adequate cover in event of any mishap or illness. The escalating medical costs are due to
the advanced diagnostic and therapeutic procedures that have become the hallmark of
modern medical care. An insurance scheme will guarantee that no compromises are made
in your treatment for wants of funds.

“Health insurance aims that one can access to the best health care without fearing the
financial strain, it help people to have peace in mind rather than to have fear”.

(b) Why do you need health insurance?

As medical care advances and treatments increase, health care costs also increase. The
purpose of health insurance is to help you pay for care. It protects you and your family
financially in the event of an unexpected serious illness or injury that could be very
expensive. In addition, you are more likely to get routine and preventive care if you have
health insurance.

You need health insurance because you cannot predict what your medical bills will be. In
some years, your costs may be low. In other years, you may have very high medical
expenses. If you have health insurance, you will have peace of mind in knowing that you
are protected from most of these costs. You should not wait until you or a family member
becomes seriously ill to try to purchase health insurance.

We also know that there is a link between having health insurance and getting better
health care. Research shows that people with health insurance are more likely to have a
regular doctor and to get care when they need it.

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(c) How Does Health Insurance Work?

When you become a member of a health plan, you’re joining a group of people who have
also chosen that plan. Insurers call it a risk pool because they measure the amount of risk
associated with those people.

Some people are high risk because they are not in good health and likely to use a lot of
medical services. Others are lower risk because they are healthy. And let’s not forget
unexpected illnesses or injuries that can happen to anyone.

The health insurer does lots of calculations to estimate how much money it will cost to
cover the collective medical expenses for everyone in your plan. Each member of the
plan pays a monthly rate, or premium.

When you need health care, you and your health insurer share the covered medical costs.
Your plan outlines your out-of-pocket costs for each service — whether it’s a co-
pay, deductible, or coinsurance.

Some years you may require lots of medical services, other years you may need less, but
the whole point of having it is so you can avoid paying the full cost of medical services
on your own. If medical costs are exceptionally high, your health insurer may have to
adjust rates from time to time.

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(d) Types:

Health Management Organizations (HMOs) :

HMOs can be the most affordable health plans, but that affordability comes at the price of
choice. HMOs are comprised of a group of doctors, specialists, and facilities that all work
together, so going outside of the HMO for care is not possible. Additionally, a referral is
often required from your primary care physician before seeing a specialist. Still, it can be
preferable. Generally, wait times and paperwork is much reduced and members can often
see multiple doctors in a single day.

Preferred Provider Organization (PPO) :

PPOs are some of the most common employer-sponsored health insurance plans in the
country. PPOs give you freedom over the specific doctors you see and you don’t need a
referral from your primary care physician to go see a specialist. However, they tend to be
more expensive, particularly if you go see a doctor that does not participate in your health
insurer's network. Be sure to check if the doctor is in your network before you see them.

As you can see, PPO plans tend to offer a bit more freedom, but you’ll have to pay for it.
There are also three other plans that are less common.

Exclusive Provider Organization (EPO) :

An EPO is similar to a PPO, in that you can see any doctor but do not pay for any out of
network doctors visits or procedures. They tend to be less expensive than the PPO but
more expensive than an HMO and are good options for first-time professionals.

Point-of-Service Plan (POS) :

A blend of the HMO and PPO, POS insurance plans give you some choice but are
generally less expensive because your primary care refers you to any other physician.

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(e) Advantages:

1. Tax benefits

Apart from providing you with the health security and safety in future, a medical
insurance plan can help you to save your taxes under Section 80D of the Income Tax Act.
According to the Income Tax Laws of 2015-2016, the premiums paid for the health
policies of your parents are also admissible to reduce your tax liability. However, the
amount of deduction depends on the age of the member who is medically insured and his
policy premium being taken into account. The range of tax deduction that can be availed
ranges from Rs. 25,000 to Rs. 60,000 per annum depending on the age of the person
whose policy premium is being taken into account. The deduction in case of senior
citizen above 60 years is certainly on the higher side of this range.

2. Health Check Benefit

Your individual health plan provides for a free health check once every four years the
process of application may vary from one insurer to another, but one thing remains the
same, and that it, the test results do not impact your current policy premiums. The new
results will only be considered if you want to increase your sum assured or purchase a
new health plan.

3. No-claims Bonus

It is not every year that you need to avail the benefits of your health cover, until and
unless you suffer from certain major diseases like cancer. In such a case, a no-claims
bonus can be availed leading to annual advantages. No-claims bonus refers to the benefits
you can avail while the renewal of the policy if you have not made a claim in the
previous year. Based on this, most insurers will assure to increase the total sum assured
of your health plan or offer discount in the Renewal premium costs.

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4. Top-ups and Super Top-ups

Top Up Insurance works alongside your current health policies and enhances it to provide
you a larger coverage at a much lower premium. For example, if you have an individual
health insurance plan of Rs 10 lakhs and a top-up policy of Rs 20 lakhs with a deductible
of Rs 10 lakhs. If you run up a medical bill of Rs 15 lakhs; you can use your individual
health insurance policy to pay Rs 10 lakhs and then your top-up policy to pay the
remaining Rs 5 lakhs. Many insurance companies provide this benefit to people who live
in the metro cities, thus increasing the cost of health facilities automatically for them.

5. Restore or Regain Benefit

Restore Benefit is offered in case you end up exhausting the whole of the sum insured. In
such a case, your sum insured will be restored in case the claim is made for a different
illness during the same policy year. It is similar to a super top-up plan, but it can only be
availed for a separate disease and within the same policy year. For example, if you end up
having a stomach tumor problem due to which you end up exhausting all the sum insured,
say Rs. 15,00,000 and then after a couple of months in the same policy year, if
unfortunately, you are diagnosed with some heart illness, the insurance company will
refill the sum insured of Rs. 15,00,000.

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1.6 Literature review on company .

Koradala Venkateshwarlu in his research paper- Health Care Insurance in India:

The New Paradigm pointed out that people require health insurance to decrease the out of
pocket expenses for unforeseen medical emergencies. He also pointed out the barriers of
health insurance industry is the income, unsuitable policy, no much priority of
government and awareness. Income is the major constraint which cannot be avoided in
India. Therefore koradala in his paper suggested to adopt triangular model of universal
health insurance.

Hima Gupta in the research paper pointed out that health insurance in India has
little development but competition between the health insurance providers will cause the
market to grow and offer the customer with new plans and policies along with different
price. Also the infrastructure of hospitals in rural area is poor than urban areas. Hima
Gupta suggested that healthcare sector needs to be regulated and reformed to reduce
health care risk.

Pooja Kansra in her paper pointed out, in the past two decades the health care
cost has drastically increased, this has made many families to control their spending and
invest in health care. Health insurance is still at the preliminary stage even after
awareness and penetration of health insurance in Indian Market. The health insurance
awareness should be increased in India. Once the penetration increases in Indian market,
the catastrophic out of pocket health expenditure will decrease immensely which is
necessary for quality life.

Indrani Gupta and Mayur Trivedi in their paper pointed out that it is unjust for
not including HIV positive patients in health insurance and suggested health insurance
company to include them also in the policies so that there is growth in health insurance
sector in India.

18
 Tina Murarka in her paper point out that now insurance industry is in nascent stage. In
a very short time private companies have acquired 13 percent market share. She said that
the insurance products will grow in the coming years because of increasing working class
people and saving pattern. Some of the drivers are growth of financial industry,
promoting innovations and removing inefficiencies and the role of IT sector. Till now
insurance sold by agents were as an investment and tax benefit product. However
penetration still remains low in insurance.

Chitra Rachel in her article in Economics times point out that some health insurance
companies like Bajaj Allianz General Insurance, Cigna TTK and Star health insurance
covers the critical illness like diabetes, cancer, hypertension etc in their pro health policy.
They also provide health coach for individuals with pre-existing diseases. They have tied
up with gymnasiums, doctors, dietitians and fitness consultants for their insurance
holders to maintain their fitness. They have tied up with these gyms, spas and salons to
give discounts to the insurance holders. Some companies even run their wellness
programs for customer's fitness.

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1.7 Regulatory or Legal aspects related to the topic

Regulation plays a major role in the health care industry and health care insurance
coverage. The various regulatory bodies protect the public from a number of health risks
and provide numerous programs for public health and welfare. Together, these regulatory
agencies protect and regulate public health at every level. Health care regulations are
developed and implemented not only by all levels of government (federal, state and local)
but by private organizations as well.

IRDA - Insurance Regulatory Development and Authority is the statutory, independent

and apex body that governs and supervise the Insurance Industry in India.

It was constituted by Parliament of India Act called Insurance Regulatory and

Development Authority of India (IRDA of India) after the formal declaration of
Insurance Laws (Amendment) Ordinance 2014, by then President of India Pranab
Mukherjee on December 26, 2014.

Establishment:

 IRDA Act was passed upon the recommendations of Malhotra Committee report
(7 Jan, 1994), headed by Mr. R.N. Malhotra (Retired Governor, RBI).
 Main Recommendations - Entrance of Private Sector Companies and Foreign
promoters & an independent regulatory authority for Insurance Sector in India.
 In April, 2000, it was set up as statutory body, with its headquarters at New Delhi.
 The headquarters of the agency were shifted to Hyderabad, Telangana in 2001.

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Objectives of IRDA:

 To promote the interest and rights of policy holders.

 To promote and ensure the growth of Insurance Industry.
 To ensure speedy settlement of genuine claims and to prevent frauds and
malpractices.
 To bring transparency and orderly conduct of in financial markets dealing with
insurance.

Organizational Setup of IRDA:

 IRDA is a ten member body consists of One Chairman (For 5 Years & Maximum
Age - 60 years )
 Five whole-time Members (For 5 Years and Maximum Age- 62 years)
 Four part-time Members (Not more than 5 years)
 The chairman and members of IRDAI are appointed by Government of
India.
 The present Chairman of IRDAI is Mr T.S Vijayan.

Functions and Duties of IRDA:

Section 14 of IRDA Act, 1999 lays down the duties and functions of IRDA:
 It issues the registration certificates to insurance companies and regulates them.
 It protects the interest of policy holders.
 It provides license to insurance intermediaries such as agents and brokers after
specifying the required qualifications and set norms/code of conduct for them.
 It promotes and regulates the professional organizations related with insurance
business to promote efficiency in insurance sector.
 It regulates and supervise the premium rates and terms of insurance covers.
 It specifies the conditions and manners, according to which the insurance
companies and other intermediaries have to make their financial reports.
 It regulates the investment of policyholder's funds by insurance companies.

21
Chapter 2: Introduction to Industry

(a) Introduction of insurance industry.

The Insurance Regulatory Authority of India (IRDA) has come to the forefront in
tackling these service standard issues recently. Speaking at the first meeting of the India
Health Insurance Forum in Hyderabad last Thursday, IRDA chairman J Harinarayan said
the industry must now work to improve communication with its customers, particularly
with regard to health insurance policy documentation, as a third of all consumer
complaints this year have been directed towards health insurers. According to IRDA data,
of the 92,898 complaints levied at the non-life sector so far in 2012, 38,891, or 37.5
percent have been focused on health insurance issues. ―If one-third of complaints are
from the health side, I will conclude that the nature of communication on health
insurance policies and the understanding of the policy by the consumer are areas of
concern. Probably, the lack of clarity is reflected in the increasing number of complaints,‖
IRDA chairman J Harinarayan said, adding that ―good communication is the
responsibility of the insurance company and not of the policy holder. An insurance
policy, as a contingent contract, has to be specific and unambiguous.‖ With a reach of just
about 2% of the country‘s 1.2 billion population, India offers a huge potential in health
insurance market. There are over 30 health insurance products in the category offered by
both life and non-life insurers. While ICICI Lombard, Bajaj Allianz and Reliance General
are some of the prominent general insurers in the health insurance space, Apollo DKV,
Star Health & Allied Insurance are the standalone players. Health insurance‘s annual
premium collections are over Rs 6,000 crores. Despite the high growth, 15 the business is
a huge challenge for insurers because of the high losses over soaring medical expenses

22
(b) Introduction of health industry.

How many accident you need to realize that you need Health Cover? It takes just one
visit to a hospital to make us realize how vulnerable we are, every passing second. For
the rich as well as poor, male as well as female and young as well as old, being diagnosed
with an illness and having the need to be hospitalized can be a tough ordeal. Heart
problems, diabetes, stroke, renal failure, cancer – the list of lifestyle diseases just seem to
get longer and more common these days. Thankfully there are more speciality hospitals
and specialist doctors – but all that comes at a cost. The super rich can afford such costs,
but what about an average middle class person. For an illness that requires
hospitalization/ surgery, costs can easily run into five digit bills. A Health insurance
policy can cover such expenses to a large extent. Read why Health Insurance is more
important these days compared to Old days Health is a human right, which has also been
accepted in the constitution. Its accessibility and affordability has to be insured. While
the well-to-do segment of the population both in rural & urban areas have acceptability
and affordability towards medical care, at the same time cannot be said about the people
who belong to poor segment of the society.

It is well known that more than 75% of the population utilizes private sectors for medical
care unfortunately medical care becoming costlier day by day and it has become almost
out of reach of the poor people. Today there is need for injection of substantial resources
in the health sectors to ensure affordability of medical care to all. Health insurance is 9 an
important option, which needs to be considered by the policy makers and planners. As
mentioned earlier, the cost of Health Insurance depends on the sum assured, age, current
health condition and your previous medical history. Higher the sum assured, higher the
premium. So what is the ideal health insurance cover requirement? There is no standard
answer or thumb rule for this. If we agree that health insurance is important, one has to
look at his/ her own lifestyle, health condition, age/ life stage, family history of illnesses
and affordability. Keep in mind that most insurance companies limit the sum assured to a
maximum of 5lakhs. Also note that many health insurance policies provide additional
benefits‖ such as daily allowance, ambulance charges, etc. for hospitalization. Not only
are such ―benefits‖ superfluous, they tend to drive the premiums higher.

23
The concept of health insurance was proposed in 1694 by Hugh the Elder Chamberlen
from the Peter Chamberlen family. In the late 19th century, "accident insurance" began to
be available, which operated much like modern 10 disability insurance. This payment
model continued until the start of the 20th century in some jurisdictions (like California),
where all laws regulating health insurance actually referred to disability insurance.
Patients were expected to pay all other health care costs out of their own pockets, under
what is known as the fee-for-service business model. During the middle to late 20th
century, traditional disability insurance evolved into modern health insurance programs.
Today, most comprehensive private health insurance programs cover the cost of routine,
preventive, and emergency health care procedures, and also most prescription drugs, but
this was not always the case. Insurance may be described as a social device to reduce or
eliminate risk of life and property. Under the plan of insurance, a large number of people
associate themselves by sharing risk, attached to individual insurance plan that
exclusively covers healthcare costs and is called Health Insurance.

Some major health insurance companies in India include National Insurance Company,
New India Assurance, United India Insurance, ICICI Lombard, Tata 11 AIG, Royal
Sundaram, Star Allied Health Insurance, HDFC standard life, Bajaj Allianz, Apollo
Munich health insurance company , AG Health Insurance Company, Cigna TTK health
insurance company, Max Buppa insurance company among others.

The best time to avail a health insurance plan is when the insured is still in a good
physical condition. The normal logic among young people is that since they are rarely
afflicted by physical ailments they do not need such a plan. In reality people can fall prey
to a disease or other physical problem at any time - nobody can be absolutely sure of a
life fully free of such issues. Normally as someone gets older the problems increase and
the possibilities of some major disease are always there. A problem with trying to get a
medical insurance during old age is that since there are more chances of a medical
condition the premium is often high or the insurer is not ready to cover the individual in
question.

24
2.1 Industry Overview.

Health Insurance was introduced in 1912 in India after India got its independence in 1947
the Government sponsored Health Insurance in India. Life Insurance was the antecedent
of Health Insurance. In 1948 the government brought a new scheme for private sectors
workers that is Employees State Insurance Scheme (ESIS). In 1954 the government
brought another scheme for employees of Central Government the scheme was named as
Central Government Health Scheme CGHS. In 1986 the mediclaim was began by
government insurance company and in 1999 the health insurance in India began a new
era where the IRDA (Insurance regulatory and Development Authority) allowed the
participation of private and foreign companies.

The insurance industry consists of 57 insurance companies out of these 24 are in

life insurance sector and 33 are in non-life insurance sector. Among the 33 insurance
companies, 5 are private sector insurers who provides health, accidental, personal and
travel insurance. They are Star Health and Allied Insurance, Max Buppa Health
Insurance, Apollo Munich Health Insurance, Religare Health Insurance and Cigna TTK
Health Insurance. Health insurance industry has increased growth by 24242 Cr. to 29633
Cr. from the year 2017 to Jan 2018, so making an increase by 22% in the year 2018.
Health insurance industry is gaining importance day by day. Among the BRICS nations
India pays second highest the out of expenses for health care. In India 31% and 47% of
hospital admissions in urban and rural respectively are either financed by loans or
through sale of assets. 70% of Indians fall under the poverty line owing to high medical
bills. Rising cost health care expenses is where we need health insurance in India.

A person who has health insurance need not worry about quality treatment because
quality treatment comes with a price. Insured person's all hospitalization or surgery
charges are taken care of by Health Insurance Company. Now-a-days technology is
playing an important role in India; Health Insurance Company provides cashless
facilities. Even the treatments done by ayurvedic and homeopath are covered by health

25
insurance which people are not much aware of. The health insurance companies give top-
up and deductible facility to customers who want additional health cover.

As there is an increasing awareness of health insurance in our country the chances of

the growth of the industry is more. Earlier people used to consider health insurance as
additional expense which is not required but today as increasing knowledge people are
realizing the importance and necessity of health insurance. The health insurance
companies are bringing lot of benefits and facilities as per customer's need which is also
increasing factor of growth of the industry. Technological innovations are another factor
helping the growth of health insurance industry. Availing different policies and plans for
all types of people is another reason for growth. In India 20-30% of young populations
who are below the age of 40 are suffering from heart diseases. Now the government
health care centers facilities are decreasing due to the lack of funds and people neglect
and are uncomfortable to take treatment from government hospitals unless they have no
money. This leads a common man to have health insurance now-a-days. Each and every
day the importance and growth of health insurance is increasing among the young people
in India.

26
2.2 Major players in Industry.

A quiet revolution has swept through India’s health care sector in the past five years- best
evidenced in the fact that now nearly 27% of the nation’s population is insured. The
Indian healthcare sector is projected to continue its rapid expansion, with a market value
of $280 billion by 2020. There are lots of options as far as insurance companies are
concerned as both public as well as private health insurance operators are offering health
insurance coverage. Let’s know in detail about Health Insurance Companies operating in
India.

1. Apollo Munich Health Insurance Company Limited

It is a joint venture between Asia’s largest integrated healthcare provider Apollo hospitals
Group and Germany based Munich Health. The company works upon the thought of
“Let’s Uncomplicated’ and offers tailor-made mediclaim policies to individuals, family,
senior citizen and corporate.

2. Star Health and Allied insurance Co Ltd

It is India’s first stand-alone health insurance company, dealing in personal accident,

mediclaim and travel insurance Due to its hassle-free and customer-friendly direct claim
settlement, the company was bestowed with "Claims Service Company of the year 2014”
award among 28 General Insurance Companies who were also competing for the same
title.

3. Bajaj Allianz General Insurance Co Ltd

Bajaj Allianz General Insurance Company Limited is a joint venture between Bajaj
Finserv Limited (recently demerged from Bajaj Auto Limited) and Allianz SE. Bajaj
Finserv Limited holds 74% and the remaining 26% is held by Allianz, SE.

27
4. Cigna TTK

Cigna TTK is established as a joint venture between Cigna, a global insurance company
and TTK Group, an Indian conglomerate. Incepted in 2012, Cigna TTK offers health
insurance plans to meet both individual and family health insurance needs.

5. The New India Assurance Co Ltd

Headquartered in Mumbai, The New India Assurance Co. Ltd. is a nationalized general
insurance company operating in 22 nations. Founded in 1919, Indian operations of the
country today span across all Indian territories through 2097 offices..

6. Bharti AXA General Insurance Co Ltd

It is a joint venture between Bharti Enterprises of India, a pivotal Indian business group
and AXA group of Europe, a world leader in financial protection. Started its operations in
2008, the company currently has 59 branch offices throughout the country. Moreover, it
is the first general insurance company to get dual certifications of ISO 9001:2008 and
ISO 27001:2005 within first year of its operations in 2009.

7. MAX Bupa Health Insurance Company Ltd

MAX Bupa Health Insurance Company is formed after a joint venture between Max
India Limited and UK based Bupa Finance PLC, UK. The perfect combination of both
global expertise and local knowledge in healthcare and insurance makes MAX Bupa the
right choice when it comes to safeguarding the health of your family.

28
2.3 Current Scenario

India’s life insurance industry is poised for higher growth in 2018 aided by low
penetration and rising share of financial assets in household savings. The savings habits
of Indian households is evolving structurally amid a low-interest rate scenario, thereby
bringing to fore the need for life insurance both as a life risk mitigation tool as well as a
lucrative investment avenue for the common man. Over the years, life insurance has
become a more customer-friendly product helped by pragmatic regulations and
guidelines. The broad focus on agency expansion, bancassurance, digitalization and
government policies are expected to support the industry in 2018.The year began on an
exciting note, as the effect of demonetization ensured that private sector individual
annual premium equivalent (APE) grew stronger on the back of higher financial savings.
Year-to-date (up to November 30), the first-year premium of life insurers has grown by
16% y-o-y to `1.81 lakh crores, while the number of policies served has crossed 1.5
crore-mark vs. 1.37 crore a year ago. On the regulatory front, norms on revised
commission/remuneration structure and introduction of reward system, guidelines on
insurance e-commerce and electronic issuance, guidelines related to information and
cyber security given the global trends, thought leadership on risk-based capital regime,
life insurance portability and investment norms have enriched the industry. With
insurance regulator Irdai mandating PAN/Form 60 and Aadhaar linkage compulsory for
existing and new insurance policies, a slew of benefits for customers and stakeholders are
waiting to be reaped in the days to come. The linkage of Aadhaar with insurance plans
will prove to be beneficial, especially during claims settlement for establishing the unique
identity of the claimant. This will also weed out fraudulent claims and boost the speed of
settlement, therefore offering a better customer experience.

As 2018 unfolds, the life insurance industry is expected to forge a deeper

connection with customers and scale new highs in terms of customer engagement and
servicing. Technology will play a massive role in this, as life insurers’ dive deeper into
product and operating process innovation. Customization of the exact need-based product
offering will be the guiding principle under broader goal-based financial planning,
instead of the one-size-fits-all approach. Chatbots, e-insurance, artificial intelligence and

29
analytics-driven products will become mainstream, as the ongoing digitalization drive
picks up more pace. The 2018-19 Budget will be important for the life insurance industry.
Life insurance should be given a separate tax exemption limit as in many Asian countries,
and not lumped with others in Section 80C to ensure more customer incentive for
committing to long-term savings, Health insurance already has a separate slab to its credit
and having a dedicated one for life insurance would facilitate long-term protection for
every Indian.

30
 2.4 Comparative Analysis

Insurance Sum
S.No Plan name Entry age Features
Provider assured

For
Variant 1 1
Lakh, -10
 Refill Benefit
Lakhs
 Animal Bite
Minimum - Vaccination
For
90 days  Direct Claim
Health Variant 2 5
Settlement
Lakh -
1. Max Bupa companion Maximum -  Long-Term Policy
12.5 Lakh.
individual Age no bar Benefit
 Hospital Cash
For
Benefit
Variant 3
15 Lakhs -
1 Crore

 Cancer
Hospitalization
Booster
 Any room upgrade
 Sum Insured
Reload Benefit
 Pre-
Aditya
2. Diamond Hospitalization
Birla and Post-
Hospitalization
Coverage
 Unlimited sum
Insured Reload

 Automatic
Minimum- 91 Recharge of Sum
days Insured
NCB super
3. Religare Maximum-  Lifelong
premium Renewability
No age bar as
such  No Claim Bonus
Super
 Everyday Care

31
 Benefit
 Domestic Air
Ambulance Cover

 Enhanced Sum
Insured
 Restoration
Minimum- 91 Rs. 4.5 Benefit
days lakhs, Rs.  Health
5.5 lakhs, Maintenance
Pro health Maximum-
4. Cigna TTK Rs. 7.5 Benefit
Plus No limit as
lakhs and  Critical Illness
such
Rs. 10 Expert Opinion
 Maternity
lakhs
Expenses

 Restore Benefit
 Stay Active
Minimum- Benefit
91st day  Multiplier Benefit
Apollo Optima
5.  E-opinion
Munich Restore Maximum-65  Additional Cover
years for Critical Illness

 Auto Recharge
Benefit
 Compassionate
Minimum- 16 Travel
Family  Repatriation of
Day 2lakhs - 15 Mortal Remains
6. Star Health Health
lakhs  Road Traffic
Optima Maximum -
Accident Cover
65 yrs  Restoration of
Amount Insured

32
2.5 Future Trends.

Every pillar of the “health” umbrella is now acknowledging the importance of

innovation, and more than ever we are seeing the prioritization of streamlined processes
through digital platforms. Startups are expected to bring innovation while refurbish the
sector by combining technologies. This is based on Indian market position, thereby
providing services to some of the rapidly growing companies in the healthcare industry.
Here are some of the emerging trends that talks about how digitization and transparency
are important for healthcare ecosystem.

1. Digital Health Interventions:

This is one of the broader categories within digital health .The idea of using digital
interventions to monitor and improve everything from sleep patterns to patient treatment.
The goal with digital interventions is to improve patient outcomes and empower people
to fix problems that are either chronic or acute. Insurance companies, in particular, are
realizing that there is value here because they can improve success rates for treatments
and reduce the amount of patient readmissions. The venture arms of insurers such as
Humana and Kaiser Permanente have made significant investments in this arena.
However, since this is also a fairly broad category, it should be noted that the results of
the studies related to digital interventions tend to be somewhat inflated.

2. Benefits of Electronic Health Record:

Our healthcare providers should pay attention to Electronic Health Record (EHR) to offer
reliable access to patient's complete healthcare information to diagnose the problem at an
early stage. These electronic health records give information such as new medication and
notify healthcare providers about any life-threatening or upcoming disease. With this, the
providers can make changes in the treatment as per the disease to avoid any serious
consequences for patients and provide better results in the treatment. It also helps to
quickly access and looks into the problem areas and correct operational problems.

33
3. Wearable devices:

The other technology that has come up is wearable medical devices that collect data
anytime and anywhere. They are sensor based accessories that are designed to help
people become active, eat well, sleep better, etc. These fitness or wearable devices are
available in several forms like watches, footwear, chest straps and sensible glasses, area
expected to grow within the coming years. It will manage patient's heart rate, blood
pressure and blood sugar levels to name a few. It will also prevent and maintain their life
as well as reduce trips to the doctor and save money.

4. The Need for Transparency in Healthcare:

The need for transparency has become the most vital component in the healthcare
industry. Patients must avail their rights to the prescribed treatment, medical records and
history. Transparency in healthcare will drive positive patient outcomes and greater
satisfaction. The patients can provide their identifications like Aadhaar number to check
information online such as prescribed medicines, tests and doctor's information all at one
place from anywhere.

5. Artificial Intelligence and Cloud:

The adoption of artificial intelligence is on the rise, making the healthcare ecosystem
more organized. AI will help in solving many problems of the patients, doctors, hospitals
as well as the overall healthcare industry. Earlier, patients didn't have appropriate
information about the right doctor, hospital or the treatment. Now, with the help of AI-
based applications, people can directly talk to doctors, physician, and expertise for the
best treatment. Moreover, patients accustomed their medical record files every time,
however, with the introduction of electronic medical records system they can access data
anytime. The medical billing system, on the other hand, will help in making data
streamlined and structured. It is expected that by 2020, around 20 percent of healthcare
and 40 percent of science organizations will achieve productivity through the adoptions
of AI technology between 15 percent and 20 percent.

34
Chapter 3: Introdcution to the Company

(i) CignaTTK Health Insurance Company Limited

3.1 Organization profile.

Cigna TTK is joint venture Company between Cigna and TTK group. Cigna TTK
provides health insurance service in India. It is one of the standalone companies among
health insurance companies in India. Cigna is a US based global healthcare service
provider; they provide medical, dental, life, disability and accident insurance while TTK
group is a Indian conglomerate. Cigna has Rs. 110 million customers worldwide and is
ranked as 78 in fortune 500 in the year 2017. David Cordani is the CEO of the company.
Cigna has more than 200 years of experience in the health service industry. TTK has 74%
of the joint venture as per Indian Regulations. TTK group has Rs 22 billion Indian
business groups. Prestige Cookware is one of the famous brands of TTK. It has 86 years
of experience in Indian market. TTK has more than 6 lakhs customers.
Cigna TTK is growing at the rate of 54.24% as compared to its competitors in
the last 3 years. Cigna TTK grew at 59% in sales for the FY 2017-18. The bench mark for
claim settlement ratio of standalone health insurance Company is 78-82%.The CEO of
Cigna TTK is Mr. Sandeep Patil. Cigna TTK provides the claim settlement ratio of 88%
in the year 2016-2017 which is above the bench mark. Cigna TTK has offices in different
places such as Ahmedabad, Banglore, Chandigarh, Chennai, Cochin, Coimbatore, Delhi,
Hyderabad, Kolkatta, Mumbai and Pune. Cigna TTK was awarded by economic times for
best promising brand in India. Pro health is the major product of the company. They also
have products such as critical care and accident care for individuals and family. Cigna
TTK also introduced a special product that is Cigna global health product for the
employees who travel to different countries. They have lot of products in health insurance
service and it is designed to meet the customer needs. The insurance covers all the
charges of hospitalization. Their family plan covers up to 7 members in a family which
consist of 2 adults and 5 children. Cigna TTK provides lots of benefits, features and
facilities like the additional feature of top-up and deductible facility, health check-up
between every 3 years for insurance holders. It also provides plans for individuals who
have pre-existing diseases. Cigna TTK has a network of more than 4000 hospitals.

35
3.2 Organizational Structure

Prasun Sikdar (MD & CEO)

Prasun brings more than 22 years of leadership experience in financial services and deep
insurance knowledge to Cigna TTK. Before joining Cigna TTK, Prasun was Group
President and Global Head at Yes Bank, where he
managed and grew key bancassurance and mutual fund
alliances and partnerships. Prior to this he was a
founding member and Senior General Manager – Chief
Sales & Distribution at ICICI Prudential Life Insurance.
During his 17 years with ICICI Prudential Life
Insurance, he worked across several portfolios including
Operations & Underwriting, Bancassurance, Agency,
Alternate Distribution, Health Business and Sales Strategy. Before ICICI Prudential Life,
he has been associated with GE Capital (SBI Cards) and Citicorp.

Manoj Naik(Chief Finance Officer)

Manoj brings to Cigna TTK over 25+ years of experience
primarily in Financial Services serving GE Capital &
Fullerton Securities across India, Europe and Taiwan – of
this, 13+ years have been as a CFO. His diverse Treasury &
Retail Finance exposure brings international best practices
to Cigna TTK. Manoj will spearhead Finance & Treasury
functions at Cigna TTK. Manoj is a postgraduate in
Management from the Indian Institute of Management,
Bangalore. He has also completed his Accredited Coach
Training Program (ACTP) with International Coach Federation (ICF).

36
JYOTI PUNJA (Chief Customer Officer)
Jyoti Punja is Chief Customer Officer at Cigna TTK
Health Insurance. She’s been associated with reputed
insurance companies for almost two decades and knows
the nuances that come in the field. She brings with her
experience and in depth knowledge of the insurance
industry from her previous senior leadership positions in
companies like LIC of India, Birla Sun Life Insurance
and Bharti AXA. To add to her knowledge, she holds a
dual Bachelor’s degrees in both Science and Law from Mumbai University.

REENA TYAGI (Head - Human Resources)

Cigna TTK Health Insurance is in the hands of a strong Human
Resources leader. Reena Tyagi, the Head of Human Resources
department in Cigna TTK Health Insurance has been a front-
runner in the field of Human Resources since 1993. She is
capable of shaping and grooming acquired talent and existing
employees into future leaders due to her experience with top
notch companies. Having completed her MBA from University
of Indore, she has since acquired ample work experience and
understanding of the field by working for high profile companies such as NIIT, Tata
Teleservices Ltd, ABN AMBRO and Bharti Airtel Ltd. As Cigna TTK Health
Insurance’s Head of Human Resources, you can expect only the best from her!

37
3.3 Product

Pro Health Accumulate Plan.

What is the Plan all About?

This plan aims at securing your health today and grow your reserves for tomorrow to
combat rising medical costs. Pro Health Accumulate Plan provides a higher insurance
coverage upto 25 lacs offering a bundle benefits ranging from in-hospital to home care.
This plan also caters to your smaller expenses towards consultation, diagnostic tests,
pharmacy charges and other outpatient expenses through Health Maintenance Benefit.

Key Features :

1. Avail a “Personal Health Wallet” that grows every year, even if you claim

2. Up to 10% discount on renewal for staying healthy

3. Of benefits with Protective Healing and Proactive Living

4. Covers non allopathic treatment as well

Policy Benefits :

1. The plan will offer the coverage for ambulance expenses up to Rs 2000 in case of
hospitalization.

2. Health check-up once every 3 years for all insured above 18 years.

3. No Claim Bonus offered, which increase the sum insured by 5% for each claim free
year up to a maximum of 100%.

4. This plan offers reward points equal to 1% of premium paid each year. In addition, you
can accumulate points by opting for our online wellness programs maximum up to 10%
of premium paid in the policy.

38
5. Critical Illness benefit and cumulative bonus booster can be opted as an add on to the
policy.

6. Avail tax benefits u/s 80D as per IT Act, 1961 for premium paid for this plan.

Sub Limits :

1. The hospital room sublimit is limited to a single private room under this plan.

2. Mandatory 10% or 20% Co Payunder this plan, if the insured is 65 years and above.

Waiting Period Clause :

1. Initial Waiting Period: 30 days waiting period is applicable from the policy inception
date apart from claims due to accidental hospitalization.

2. Specific Waiting Period: Two Years Waiting Period will be applicable for specific
illnesses.

3. Pre existing Disease Waiting Period: Any pre-existing ailment/injury that was
diagnosed /acquired within 4 years from the issuance of the first policy.

4. Critical Illness Add on Waiting Period: A waiting period of 90 days starting from
inception and 30 day survival period will also apply to get a claim under this add on.

Who Can Buy The Plan ?

Factor Minimum Maximum

Age (as
on last Adult - 18 Years, Child - 91 Days No Limit
birthday)

39
 Sum
5.5 Lacs 25 Lacs
Assured

Cover
Individual/Family Floater -
Type

Policy
1 Years 3 Years
Tenure

Grace
30 Days -
Period

Free
Look 15 Days -
Period

Riders Critical Illness -

Exclusions :

1. Expenses attributable to self inflicted injury

2. Medical treatment expenses for treating AIDS

3. Childbirth related expenses

4. Convalescence/Recuperating Benefits

5. Genetic disorders, etc.

40
(ii) Star Health and Allied Insurance Co Ltd

3.1 Organization profile.

Overview

Star Health and Allied Insurance Co Ltd commenced its operations in 2006 with the
business interests in Health Insurance, Overseas Mediclaim Policy and Personal
Accident. With no other insurance category to focus and divide our attention, we use our
resources to focus on service excellence, design products and use core competency of
innovation to deliver the best to our customers.

At Star Health Insurance, the company offers a wide range of health insurance
products at affordable prices to make health insurance every human being’s right. And as
a company, single-mindedly dedicated to health insurance.

We have built a promising path for our future with a capital base of Rs.1050
crores. We have emerged as India’s first stand-alone Health Insurance Company, dealing
in personal accident, medi-claim and overseas travel insurance.

Our Vision:

 To become the largest and most preferred health Insurance Company in India.
 To provide financial security for health care management.

Our Mission:

 To offer wide range of innovative Products / Services.

 To provide prompt, courteous and quality service to customers.
 To leverage State of Art Technology for customer satisfaction.
 To adopt best management practices in business operations.

41
Our Commitment :

 Make available insurance coverage to every segment of population.

 Expand product lines and services on continuing basis.
 Build and maintain enduring relationships with customers.
 Conduct business operations with customer as focal point.
 Create insurance awareness as part of corporate social responsibility.

3.2 Organizational Structure

V. Jagannathan (Chairman, Chief Executive Officer and Managing Director)

Mr. V. Jagannathan serves as the Chairman, Managing Director and Chief Executive
Officer of Star Health and Allied Insurance Company Limited. Mr. Jagannathan is a
doyen of the Insurance industry with over 40 years of experience in Insurance.

N. Jayaraman (Chief Investment Officer and General Manager, Star Health

and Allied Insurance Company Limited)
Mr. N. Jayaraman serves as Chief Investment Officer and General Manager at Star
Health and Allied Insurance Company Limited and served as its Deputy General
Manager.

S. Ramaswamy (Chief Financial Officer, Star Health and Allied Insurance

Company Limited)
Mr. S. Ramaswamy serves as the Chief Financial Officer of Star Health and Allied
Insurance Company Limited. Mr. Ramaswamy is a Senior Chartered Accountant with
over 27 years of work experience in Insurance.
K.C.Kumar (Executive Director Human Resource)

Mr. K.C. Kumar is heading the Human Resource and Administration department. He is
an MBA in Human Resource with more than 25 years of experience in banking in various
senior level positions including 4 years of overseas experience.

42
3.3 Product

Star Comprehensive Insurance Policy

Features
 No cap on room rent and treatment cost.
 Covers medical expenses incurred on Bariatric surgical procedures and its
complications.
 Air ambulance assistance, Second medical opinion are covered.
 Cost of health check up for every block of 3 claim free years.
 Cover for maternity (normal and caesarean delivery) and New born baby.
 Automatic restoration of entire Sum insured by 100%.
 Dental / ophthalmic cover on OPD basis.
 Hospital cash benefit.
 Cover for over 400 day care procedures.
 Personal accident cover against Death and Permanent total disablement (equal to
the Health Insurance cover) at no additional cost.
 100% Increase in Sum Insured upon a claim free renewal.

Eligibility

 Persons between 18 years and 65 years of age at the time of entry can take this
Insurance. Dependent children can be covered from 3 months and up to 25years
of age. There is no upper age limit for continuous renewals.
 This policy is both on Individual basis and on Family Floater basis. Family for the
purpose of this policy means self, spouse and dependent children.

43
Star Advantage

 No third Party Administrator, direct in-house claim settlement.

 Faster & hassle-free claim settlement.
 Cashless hospitalization wherever possible.
 Network of more than 8400+ hospitals across India.
 24x7 Toll Free Helpline.
 Information on health through free health magazine.
 Facility for maintaining personal health records in electronic format.

44
(iii) SWOT ANALYSIS OF CIGNA TTK CO.

STRENGHTHS WEAKNESS

 Quality over quantity  Lack of

products. Awareness of
 Special plans and company.
products with  No branding
extraordinary features. and marketing.
 Competitive Prices  Low
 Business Growth Investments
 Rise in Per Capita  Not an
Income experienced
player in the
market.

OPPORTUNITIES THREATS

 Huge market potential  Rising

 Clean Brand name. unemployment.
 Good claim settlement  New Insurance
ratio firms coming up.
 Government support  Existing Insurance
 Strong future growth giants.
 Can leverage  The legal
international markets to framework,
create new market. bureaucracy and
financial
infrastructure
worsen the
insurance business
environment.

45
Chapter 4 : Research Methodology

This study is based on comparative analysis between Cigna TTK Health Insurance Co. &
Star Health & Allied Insurance Co. The study is also been carried out to know the level
of awareness of health insurance among the people. The data has been compiled in the
following ways. They are:

(a) Primary data: Primary research involves the collection of original primary data. It is
often undertaken after researchers have gained some insight into an issue by
reviewing secondary research or by analyzing previously collected primary data. It can be
accomplished through various methods including questionnaires market research,
or experiments.

(b) Secondary data: It is secondary in nature i.e. already collected information. this can
be collected through company's Annual Report & interpretation of

1. Balance Sheet
2. Profit & Loss A/C
3. Annual reports.

(i) Research design

A Research design is purely and simply the framework of plan for a study that guides the
collection and analysis of data. The study is intended to find the level of awareness of
health insurance among the people and to analyze the ratios and comparison of different
companies. The study design is descriptive in nature.

46
(ii) Type Of Research
Descriptive Research:
As per the Objective defines that this Research will map the comparison of two
companies. Also it analyses the awareness among the customers & analysis financial
position of Cigna TTK health insurance co. Thus, this research can be termed as a
Descriptive type of research. It is the simplest type of research and is more specific.
(iii) Data Collection tools: Questionnaires

(a) Sampling unit

Sampling may be defined as the selection of some part of an aggregate or totality on the
basis of which a judgment or inference is made about the aggregate or totality. It is the
process of obtaining information about an entire population by examining a part of it.

(b) Sample Size:

The size of the sample for the study is 50.

(c) Sampling Method:

There are essentially two types of sampling design.
a) Profitability sampling

b) Non-profitability sampling

For the purpose of the study, Non probability method of sampling is used in which
samples are obtained with the help of Convenience Sampling.
It is a Sampling technique where the samples are gathered in a process that does not give
all the individuals in the population equal chances of getting selected.

(d) Data analysis technique :

The data collected are analyzed with the help of the statistical tools like percentage
analysis and graphical analysis.

47
Chapter 5 : Data analysis & interpretation:-

5.1 Ratios:

(a) Meaning of Ratio : A ratio is simple arithmetical expression of the relationship of

one number to another. It may be defined as the indicated quotient of two mathematical
expressions.
According to Accountant’s Handbook by Wixom, Kell and Bedford, “a ratio is an
expression of the quantitative relationship between two numbers”.

(b) Ratio Analysis : Ratio analysis is the process of determining and presenting the
relationship of items and group of items in the statements. According to Batty J.
Management Accounting “Ratio can assist management in its basic functions of
forecasting, planning coordination, control and communication”.
It is helpful to know about the liquidity, solvency, capital structure and profitability of an
organization. It is helpful tool to aid in applying judgement, otherwise complex
situations.

(c) Advantage of Ratio Analysis :

1. Helpful in analysis of Financial Statements.

2. Helpful in comparative Study.

3. Helpful in locating the weak spots of the business.

4. Helpful in Forecasting.

5. Estimate about the trend of the business.

6. Fixation of ideal Standards.

7. Effective Control.

8. Study of Financial Soundness.

48
(d) Limitations of Ratio Analysis :

1. Comparison not possible if different firms adopt different accounting policies.

2. Ratio analysis becomes less effective due to price level changes.

3. Ratio may be misleading in the absence of absolute data.

4. Limited use of a single data.

5. Lack of proper standards.

6. False accounting data gives false ratio.

7. Ratios alone are not adequate for proper conclusions.

8. Effect of personal ability and bias of the analyst.

(e) Classification of ratios:

Ratio may be classified into the four categories as follows:

(A.) Liquidity Ratio

a. Current Ratio

b. Quick Ratio or Acid Test Ratio

(B.) Leverage or Capital Structure Ratio

a. Debt Equity Ratio

b. Proprietary Ratio

(C.) Activity Ratio or Turnover Ratio

a. Fixed Assets Turnover Ratio

49
b. Working Capital Turnover Ratio

(D.) Profitability Ratio or Income Ratio

a. Gross Profit Ratio

b. Net Profit Ratio

c. Operating Ratio

(f) Annual Statements (includes Profit & Loss A/C, Revenue Statement, Balance
Sheet)

(i) Of Cigna TTK Co.

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51
52
(ii) Of Star Health Co.

53
54
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(g) Calculation of Ratios :

Sr. No.: Cigna TTK Health Insurance Co. Star Health Insurance.

2016 - 2017 2016 - 2017

2017 - 2018 2017 - 2018
1. Net Working
= 516,568 - = 1,08,54,934 = 7003294 -
Capital = = 854,633 -
899,172 - 5374931 2781623
Current Assets 1,202,008
- Current = - 347375 = - 382604 = 5480003 = 4221671
Liabilities
2. Current
= 516,568 / = 1,08,54,934 = 7003294 /
Ratio = = 854,633 /
899,172 / 5374931 2781623
Current Assets 1,202,008
/ Current = 0.71 : 1 = 0.57 : 1 = 2.01 : 1 = 2.51 : 1
Liabilities
3. Quick Ratio = = 729649 / = 363475 / = 5019968 / = 3311056 /
Quick Assets / 1,202,008 899,172 5374931 2781623
Current = 0.60 : 1 = 0.40 : 1 = 0.93 : 1 = 1.19 : 1
Liabilities
4. Asset turnover = 26,61,391 / = 18,17,686 / = 27396000 / = 19114548 /
ratio = Net 37,85,731 28,85,578 33471698 22126140
sales/ Average = 0.70 = 0.63 = 0.81 = 0.86
Total Asset
5. Proprietary = 36,47,258 / = 25,13,651 / = 4555761 / = 4555761 /
Ratio = 42,78,225 * 32,93,236 33471698 * 22126140
Shareholder's 100 *100 100 *100
Funds / Total = 85.25 = 76.32 = 13.61 = 20.59
Assets * 100
6. Fixed Assets = 2,661,391 / = 1,817,686 / = 27396000 / = 19114548 /
Turnover Ratio 68,101 16,616 969609 838073
= Sales / Fixed = 39.08 = 109.39 = 28.25 = 22.80
Assets
7. Debt to asset = = 28,61,245 / = 19,60,384 / = 213775792 / = 14231781 /
Total Liability / 42,78,225 32,93,236 33471698 22126140
Total Asset = 0.67 = 0.59 = 6.38 = 0.64

= 1,350,537 / = 1712035 / = 1179437 /

8. Return on
= (1,049,476) / 32,93,236
Investment = 33471698 22126140
4278225 = - 0.41
Gross Profit / = 0.05 = 0.05
= - 0.24
Total Assets

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 = (1,049,476) / = (1,350,537) = 1712035 / = 1179437 /
9. Gross Profit
2,661,391 * / 1,817,686 27396000 * 19114548*
Margin =
Gross Profit / 100 *100 100 100
Sales*100 = - 40.48 = - 75.41 = 6.24 = 6.17

10. Operating = (1,310,166) = 1384076 / = 965035 /

= (10,65,896) /
Profit Margin / 1,817,686 27396000 * 19114548*
2,661,391 *
= Operating *100 100 100
100
Profit / = - 72.07 = 5.05 = 5.04
Sales*100 = – 40.05

11. Net Profit = (1,049,476) / = (1,350,537) = 1701548 / = 1179437 /

Margin = Net 2,661,391 * / 1,817,686 27396000 * 19114548*
Profit After 100 *100 100 100
Tax / = - 39.43 = -74.29 = 6.21 = 6.17
Sales*100
12. Return on = (1,049,476)/ = (1,350,537) = 1701548 / = 1179437 /
Equity = Net 36,47,258 * / 25,13,651 4555761 * 4555761*
Income / total 100 *100 100 100
shareholder’s = - 28.77 = - 53.72 = 37.34 = 25.88
Equity

57
Interpretation:-

About Cigna TTK Co. :

Current ratio :

In 2017 the firm's ability to cover its current liabilities with its current assets was 0.57. in
2018 the ratio goes up to 0.71, which means that the company has the ability to pay its
liabilities, as the definition says that higher the ratio, greater the liability of the firm to
pay its bills. This tells that Cigna TTK is improving their liquidity & efficiency, because
their current ratio is improving.

Quick Ratio :

According to the definition of asset ratio, the co. should have the ability to pay its
liabilities through its most liquid asset. The table shows that in 2017, the firm has the
0.40. then we observe the slight improvement of 0.20 percent in 2018.

Debt Ratio :

The ratio shows the company’s ability to cover its debt through its total assets. The ratio
was 59 % in 2017, the goes up in 2018. The ratio has to be low. So we can interpret that
in the year 2018, the risk of the firm is getting higher as the ratio goes up to 67 %.

Gross profit margin :

The ratio should be high according to the definition, because higher the ratio, higher will
be the firm's ability to produce goods & services at low cost with high sales. Here in this
table there is small difference between the ratios in 2 years, but still high, which means it
is favorable.

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Operating profit margin :

Cigna TTK’s operating profit margin has increased in 2018 then the margin in 2017 by
approximately 32%. This increase in operating profit margin is mainly due to growth f
net revenue, good cost control & strong productivity in company in 2018. This higher
margin reflect that the Cigna TTK has more efficient cost control management or the
more profitable business.

Net profit margin :

According to the definition, higher the ratio, higher will be the firm's ability to pay its tax
in the year 2017, the margin was little low but in 2018 the margin increased for the
company. Cigna TTK is more efficient at converting sales into actual profit and its cost
control is good.

About Star Health & Allied Insurance Co. :

Current ratio :

In 2017 the firm's ability to cover its current liabilities with its current assets was 2.51. in
2018 the ratio goes up to 2.01, which means that the company does not have the ability to
pay its liabilities, as the definition says that higher the ratio, greater the liability of the
firm to pay its bills.

Quick Ratio :

According to the definition of asset ratio, the co. should have the ability to pay its
liabilities through its most liquid asset. The table shows that that is a minute fall in the
ratio which is not profitable in long run.

Debt Ratio :

The ratio shows the company’s ability to cover its debt through its total assets. The ratio
was 64% in 2017, the goes down in 2018 to 63%. The ratio has to be low. So we can
interpret that in the year 2018, the risk of the firm is getting lower which is a good sign.

59
Gross profit margin :

The ratio should be high according to the definition, because higher the ratio, higher will
be the firm's ability to produce goods & services at low cost with high sales. Here in this
table there is small difference between the ratios in 2 years, but still high, which means it
is favorable.

Operating profit margin :

Star health & Allied insurance company's operating profit margin has increased in 2018
then the margin in 2017. This increase in operating profit margin is mainly due to growth
net revenue, good cost control & strong productivity in company in 2018. This higher
margin reflect that the Star health & Allied insurance co. has more efficient cost control
management or the more profitable business.

Net profit margin :

According to the definition, higher the ratio, higher will be the firm's ability to pay its tax
in the year 2017, the margin was little low but in 2018 the margin increased for the
company. Star health & Allied insurance co. is more efficient at converting sales into
actual profit and its cost control is good.

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5.2 Data Analysis

Graphs :

gender male female

20 30

gender
male
female

Interpretation : Data shows that maximum females have contributed for the research
purpose.

age group
(years)
0 - 17 2
18 - 30 36
31 - 50 12
51 - 65 0
65 - 75 0
75 & above 0

age group (years)

0 - 17
18 - 30
31 - 50
51 - 65
65 - 75
75 & above

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Interpretation : The data has been collected more from the people in the age group of
18 - 30.

Occupation
Student 20
Service 18
Business/ 12
Profession
Retired 0

Occupation
Student
Service
Business/ Profession
Retired

Interpretation : According to the data maximum number of students have health

insurance which is a good sign.

Do you have a health yes no

insurance?
36 14

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 Do you have a
health insurance ?
yes

no

Interpretation : The above pie chart shows that maximum number of people have health
insurance.

How important do you consider health insurance

to be ?
Extremely Important 30
Somewhat Important 10
Neutral 6
Not Important 4

How important do you

consider health
insurance to be ?
Extremely Important

Somewhat Important

Neutral

Interpretation : the above graph shows that maximum people consider health insurance
very important and is considered as a necessary investment.

If yes, which plan do you have ?

Individual Policy 10
Family Floater 16
Corporate Plan 3
Any Two 8

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 If yes, which plan
do you have ?
Individual Policy

Family Floater

Corporate Plan

Any Two

Interpretation : People prefer having a family floater so that they can secure their entire
family.

Which company's policy do you have ?

New India Assurance Co. 14
Apollo Munich Health Insurance 2
Religare Health Insurance 0
Cigna TTK Health Insurance 0
Birla Sun Life Insurance 1
Other 27

Which company's
policy do you have ?
New India Assurance
Co.
Apollo Munich Health
Insurance
Religare Health
Insurance
Cigna TTK Health
Insurance
Birla Sun Life
Insurance

Interpretation : People have health insurance of various companies. People buys insurance of
those companies who gives better services and also product with best features.

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How much does your premium cost annually? (in
rupees)
0 - 10000 16
10001 - 25000 20
25001 - 50000 6
50001 & Above 2

How much does your

premium cost
annually? (in rupees)
0 - 10000

10001 - 25000

25001 - 50000

50001 & Above

Interpretation : Maximum amount of premium is paid in the range of Rs.10000 to Rs.

25000. This is the range in which the people of a developing country like India would
like to invest.

What influenced you to buy a health insurance

policy ?
To Cover Medical Emergencies 31
Tax Benefits 2
Parents Purchased it for You 8
Other 3

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 What influenced you
to buy a health
insurance policy ?
To Cover Medical
Emergencies

Tax Benefits

Parents Purchased it
for You

Other

Interpretation : Maximum number of people buys health insurance to prevent medical

emergencies. Medical emergencies are occur at any point of time hence it is very
important to have a health insurance.

If you don't have a health insurance policy then

what is the reason for you not buying ?
Not Interested 4
Lack Of Knowledge About Health Insurance 5
Not Earning Yet 8
Lack of Trust on Co. 8

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 If you don't have a
health insurance policy
then what is the reason
for you not buying ?
Not Interested

Lack Of Knowledge
About Health Insurance

Not Earning Yet

Lack of Trust on Co.

Interpretation : The main reason behind not having a health insurance is lack of trust on
the companies. Some times the claim is not settled due to which people loose hope from
the insurance companies.

Are you satisfied with your company's features & benefits of your health
insurance policy ?
Yes 28
No 0
Not Aware About the Features & Benefits 16

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 Are you satisfied with
your company's
features & benefits of
your health insurance
policy ?
Yes

Findings :

From the research we can say that maximum people are having a health insurance which
means that the people are getting more concerned about their health which is a very good
indication. People usually prefer buying a family floater policy rather that an individual
policy so that they can secure their whole family at a very nominal amount of premium.
Health insurance of different companies are purchased which is depended on the peoples
mindset, trust factor, company image, etc.

68
Chapter 6 : Conclusion and suggestions

Conclusion :

 People must be made aware about health insurance as it has become a need in
today's world.
 Government should come up with some special policies which would help the
poor people to buy an insurance.
 People should be made aware that insurance is not just an investment but is very
important as it can occur anytime to anyone.
 The amount of spending or expenses behind one disease can drain off the lifetime
savings of the family, hence it should be necessarily bought.
 In India 95% of the population is uninsured and that creates a huge market for
health insurance. While providing health insurance it becomes essential to provide
adequate insurance to people so that they can use in case of an health emergency.

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Suggestions

1. I would like to suggest that the company to make a lot of advertisement and arrange an
awareness campaign so that many people come to know about the insurance and buy it.

2. The company should advertise because people will know about the company and start
trusting it and it would be less difficult in the part of the agent or the employee to make
the people understand the creditability of the company.

3. The company should invite more and more agents and advisors to join hands with the
company and make the best possible use of the policy and make them understand that
each and every feature should be explained to the customers.

4. The company should keep a track record of the agents who sells the policy and keep a
regular update on it.

5. The company should call their customers and ask them on regular basis whether they
have any issue regarding the policy or any point which is not resolved by the agent and
should solve the doubt.

6. This type of practice will make a good customer relation with the company and the
customers will be loyal towards the company as no company wants that the client should
not come to them again, every company thinks that instead of selling a product and
earning money they will provide and retain the customers each year which will lead to
business every year and the goodwill of the company is maintained.

70
Chapter 7: Learning Experience from the project.

Project Experience

I learned many things while doing my project that includes

 Importance of a salesman in an organization
 How to analyze the consumer buying behavior for product.
 Comparing the company's ratios with the help of revenue a/c, profit & loss
statement and balance sheet.
 Making people aware about the health insurance and product offered by Cigna
TTK.
 Convincing the people and making them realize how important it is to buy the
health insurance..
 Conducting a survey and the interpretations of survey.
 How to behave in a business place.
 Importance of maintaining relationship with the customers.
 Importance of customer satisfaction.
 How to keep patience while selling product.
 Lastly, Nothing is simple, we need to work hard.

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(i) Annexure (Questionnaire)
1. Name

2. Gender

Female

Male

3. Age Group

0 - 17 years

18 - 30 years

31 - 55 years

56 - 65 years

66 - 75 years

75 & above

4. Occupation

Student

Service

Business/ profession

Retired

5. Do you have a health insurance?

Yes

No

6. How important do you consider health insurance to be?

Extremely important

Somewhat important

Neutral

Not important

72
7. If yes, which plan do you have?

Individual policy

Family floater

Corporate plan

8. Which company's policy do you have?

New India Assurance Co.

Cigna TTK Health Insurance

Birla Sun Life Insurance

Apollo Munich Health Insurance

Religare Health Insurance

Other

9. How much does your premium cost annually? (in rupees)

0 - 10000

10001 - 25000

25001 - 50000

50001 & above

10. What influenced you to buy a health insurance policy

To cover medical emergencies

Tax benefits

Parents purchased for you

Other

11. If you don't have a health insurance policy then what is the reason for you not buying?

Not interested

Lack of knowledge about health insurance

Not earning yet

Lack of trust on company

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12. Are you satisfied with your company's features & benefits of your health insurance
policy?

Yes

No

Not aware about the features and benefits

74
Chapter 8: BIBILOGRAPHY

1. https://www.businesstoday.in/opinion/columns/trends-healthcare-industry-healthcare-
sectors-artificial-intelligence/story/267321.html

2. https://www.forbes.com/sites/quora/2017/09/29/4-trends-in-digital-health-to-keep-an-
eye-on-in-2018/#6423e7e064ac

3. https://www.ibef.org/industry/insurance-sector-india.aspx

4. https://www.policybazaar.com/health-insurance/individual-health-
insurance/articles/best-health-insurance-plans-in-india/

5. https://www.financialexpress.com/industry/life-insurance-in-2018-this-is-what-will-
support-the-industry-in-new-year/997975/

6. https://www.cignattkonline.in/buy-health-insurance/

7. https://www.starhealth.in/

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