connect insurance brief final e version 29 january 2011

8/7/2019 Connect Insurance Brief Final E Version 29 January 2011

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Engaging Insurance Sector

in India forMainstreaming HIV and AIDSProgramme Brief: Insurance, Project Connect

Population Services International

Supported By: Technical PartnersConnect Partner


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Engaging insurance sector in India for mainstreaming HIV and AIDS

India is home to an estimated 2.4 million People Living with HIV (PLHIV). Out of pocket expenses for accessing quality healthcareservices have been a challenge for PLHIV in India who also bear the brunt of stigma and discrimination from healthcare providers.Countries such as South Africa with high adult HIV prevalence of over 15 per cent have taken measures to mainstream HIVthrough commercial insurance cover. However, with a low prevalence of 0.31 per cent in the country, the insurance sector inIndia is yet to take major steps. The National AIDS Control Programme envisages mobilising private sector insurance companiesto dene their role and contribution in the programme. Project Connect, led by Population Services International (PSI) aims tobuild value added models of public private partnerships to mitigate HIV and AIDS in India. Connect is funded by the United States

Agency for International Development (USAID) under the Presidents Emergency Plan for AIDS Relief (PEPFAR). One of the keystrategies of Connect is to engage the insurance sector in India for insurance solutions sensitive to PLHIV. The project has beenadvocating the mainstreaming of HIV in insurance since 2007.

Facilitating Indias rst group health insurance product for PLHIV

Leveraging PSIs expertise in social marketing, Connect partnered with KarnatakaNetwork for People Living with HIV (KNP+) to provide technical assistance toStar Health and Allied Insurance, India, in rening an existing health insuranceproduct which the company had launched in 2007. This product however hadlittle or no demand. Based on the health requirements of PLHIV, appropriatechanges were made in the product. The premium for the product was reducedby nearly half the earlier price and in-patient treatment cover was introduced aspart of the policy benets. Further and as part of an eort to create demand forthe product and to increase uptake of the policy, insurance literacy campaignswere organized across Karnataka. This revised product was launched in March2008 with a pilot group of 258 PLHIV from Karnataka enrolling under the policy.

Advocating insurance among PLHIV

Connect partnered with Indian Network for People Living with HIV/AIDS (INP+) to strengthen the systems of the network andthe state aliates in Karnataka, Andhra Pradesh, Tamil Nadu and Maharashtra. The Kerala aliate of INP+ was also providedtechnical support. These eorts resulted in insurance becoming a part of the national agenda of INP+. Subsequently, INP+ heldmultiple meetings with its state level aliate networks and organized a national consultation on insurance for PLHIV in June2009 to discuss the need for insurance and healthcare nancing for PLHIV. Consensus emerged from this consultation that

advocacy eorts need to be taken up with insurance companies for more products sensitive to the needs of PLHIV. It was alsofelt that for the below poverty line (BPL) PLHIV, there is a need to explore premium payment options such as subsidy throughmobilising resources, promoting savings in PLHIV groups and appropriate mechanisms that would allow PLHIV to pay premiumin instalments with a view to reduce the economic burden on aected households.

Expanding coverage in high HIV prevalent States in India

Various partnerships such as those mentioned subsequently in thisdocument coupled with sustained demand creation eorts helped ininsuring many more PLHIV across various states. Currently more than 6500PLHIV are covered under Star Netplus, the group health insurance policyexclusively for PLHIV. Four out of every ve people who were insured in2009-2010 renewed their policy in April 2010 for another year.

Partnerships for Scaling up Insurance

Karnataka Network for People Living with HIV (KNP+)

KNP+ has been a key partner to Connect in facilitating Indias rst group health insurance policy for PLHIV. The network leads theinsurance advocacy and mobilisation eorts in Karnataka and nearly 1500 PLHIV were insured in Karnataka as of October 2010.Connect provides technical assistance to build capacity of KNP+ and aliated district level Networks to mobilise, manage andmonitor health insurance for PLHIV. As a result of this technical assistance and capacity building eorts, KNP+ now mobilizes

PLHIV for insurance independently. It manages most of the operations suchas claims management, cashless hospitalization, hospital empanelment andreimbursements. The network also actively inputs in periodically rening theproduct benets. To inculcate the habit of savings so as to take care of premium

for renewals, KNP+ has formed nearly 50 Self-help groups (SHG) among theinsured PLHIV. To support children and widows who are not in a position to paythe annual premium, KNP+ is mobilising resources from local donors. The networkalso plays an active role in advocacy with insurance companies for additionalinsurance products for PLHIV.


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Greater Visakhapatnam Municipal Corporation, Andhra Pradesh

In 2009, Greater Visakhapatnam Municipal Corporation (GVMC) came forward to becomethe proposer of the rst insured group in Andhra Pradesh by paying 50 per cent of thepremium amount for 200 PLHIV. This group policy, which was the rst in Andhra Pradesh,was launched with support from Visakhapatnam AIDS Control Society (VACS) and AndhraPradesh State AIDS Control Society (APSACS) in June 2009. GVMC continues to remain theproposer of the group in 2010 as well. Subsequently Plan India, an organisation working forchild rights also came forward to cover over 600 PLHIV in Andhra Pradesh.

Petraalthaan Pillai-ya? Tamil Nadu

Connect, in partnership with renowned actor Padmashri Dr. Kamal Haasan and Radio Hello FM, Tamil Nadusleading and largest radio network launched Petraalthaan Pillai-ya?, a campaign in Tamil Nadu to coverchildren living with HIV (CLHIV) in the state. This campaign, launched on World AIDS Day 2009, succeededin raising enough resources to provide health insurance cover to more than 2500 children in Tamil Nadu.A sizable number of these children are orphan or with single parent. The second phase of the campaignhas been launched in November 2010 with more celebrities like Madhavan and Trisha lending their voicefor the cause. To build sustainability and ensure continued support for CLHIV in Tamil Nadu, the campaignwill now be run by Tamil Nadu State AIDS Control Society (TANSACS) which is mobilising resources fororphan and vulnerable children (OVC) in the state under The Tamil Nadu Trust for Children Aected by HIV/AIDS(TNTCAA) instituted by the Government of Tamil Nadu.

Network of Maharashtra by People Living with HIV/AIDS (NMP+)

Connect initiated the partnership with the Network of Maharashtra by People Living withHIV/AIDS (NMP+) in 2008. Since then, more than 1300 PLHIV were insured till October 2010in the state by NMP+. With sustained capacity building eorts initiated by Connect, thenetwork completely manages the insurance operations. NMP+ has also been working withexperts from National AIDS Research Institute (NARI) for advocating insurance for PLHIV. Thenetwork is also leading the eorts for a tax waiver on the insurance policy for PLHIV with thenance ministry, Government of India.

Consultation with Insurance Sector, India

In the absence of sucient evidence on the viability of insurance products for PLHIV,insurance companies perceive HIV to be beyond the scope of insurance and continue toretain the condition as an exclusion in generic insurance products. In order to understandthe concerns of the sector and to explore opportunities for mainstreaming HIV ininsurance, Connect, in association with Federation of Indian Chambers of Commerce andIndustry (FICCI) organised a national consultation with private and public sector insurancecompanies in December 2009. The consultation revealed that insurance companiesperceive that HIV is a non-insurable risk and that there is a need to disseminate moreevidence on morbidity and mortality due to HIV. This is required in order to demonstratethat HIV, like Cancer or Diabetes, is a manageable chronic condition.

Technical Support to Insurance Companies in India

The Connect team is actively engaged in providing strategic support to various insurance companies in India in designing productscovering HIV. ICICI Lombard, Bharti AXA, Bajaj Allianz, National Insurance Company, Oriental Insurance Company, etc are some of theinsurance companies in India who have shown interest in covering PLHIV. Connect has been closely working with these insurancecompanies and is providing inputs on product design, evidence on scope for mainstreaming HIV and facilitating consultations withexperts.

Piloting Mainstreamed Insurance Model

Connect in partnership with DHAN Foundation is piloting a mainstreamed insurance

model in the high HIV prevalent Salem district in Tamil Nadu. Under this model, life and

health risk of more than 70,000 individuals in Salem district will be covered irrespective

of their HIV status. There is no exclusion of any condition in this product and HIV has

been mainstreamed in consultation with senior micro-nance and actuarial experts in

the country.


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Gathering Strategic Evidence for Advocacy

Under the guidance of experts from renowned academic institutions such as Institute of Economic Growth (IEG), National Instituteof Mental Health and Neurosciences (NIMHANS), National AIDS Research Institute (NARI) and Y.R. Gaitonde Centre for AIDS Researchand Education (YRG CARE) the project is exploring strategic evidence in the Indian context to mainstream HIV in insurance. Atestimonial documentary My New Immunity, a policy brief titled Towards Mainstreaming HIV and AIDS: Role of Insurance Sector inIndia, a booklet documenting life stories of some of the beneciaries of PLHIV insurance titled The Positive Story, and a pamphletdesigned to create awareness about the insurance product Indias First Group Health Insurance for People Living with HIV: A SocialMarketing Innovation, etc are some of the Connect s contributions for advocating PLHIV insurance.

International Conference on Mainstreaming HIV and AIDS: Role of Insurance Sector

Connect has partnered with Health Systems 20/20, another USAID funded project which works in over 30 countries worldwide,to address health systems weaknesses. Under this partnership and in order to gather and disseminate global experience onmainstreaming PLHIV insurance, an international conference is being organised under the aegis of National AIDS Control Organisationin February 2011. This conference will also serve to facilitate informed deliberations on mainstreaming HIV in insurance in India.

For further information, contact:

Atul Kapoor, Program Director Email: [email protected]

Population Services International

52/2, First Floor, 8th Main, 16th Cross, Malleswaram, Bangalore-560 055. INDIA Tel: +91 80 40855600 www.psi.org.in/connect Email: [email protected]

Population Services International (PSI) is a global not for prot organisation working in partnership within the public and private sectors, and harnessing

the power of the markets. PSI has partnered with Y.R. Gaitonde Centre for AIDS Research and Education (YRG CARE) for implementing project Connect.

International Labour Organization and Revised National Tuberculosis Control Programme (RNTCP) are technical partners to Connect.

connect insurance brief final e version 29 january 2011

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