PGDHIM SEM 1 ASSIGNMENT 2

 

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Post Graduate Diploma in Health Insurance Management (PGDHIM)

 

 2^nd SET OF ASSIGNMENTS

Student Name:____________

PRN No. _________________

 

 

Answer the following questions:

 

Course 1: Health Insurance, Its Models & Financials

 

Question. What is community health insurance? What are the advantages and dis-advantages

of community health insurance?  (5 Marks)

 

Answer: Community-based health insurance (CBHI) is a form of micro health insurance, which is an overarching term for health insurance targeted to low-income people. The specific feature of CBHIs is the community involvement in driving its setup and in its management.

 

Small, voluntary CBHI schemes are

 

 

 

 

 

 

Course 2: Public Health Insurance

 

Question. What is ECHS?      (5 Marks)

 

Answer: ECHS was authorised by Government of India on 30 Dec 2002, and has been introduced from 01 April 2003. It is a publicly funded medicare scheme for those who are ex-servicemen and pensioners & their eligible dependants. It provides medical care through outpatient treatment at around 427 Polyclinics

 

                                                                                                             

Question.  Describe the Claim Reimbursement process under CGHS scheme?   (5 Marks)

 

Answer: Apply within 90 days of discharge / completion of treatment procedure, to CMO I/c of the Wellness Centre, where your CGHS card is registered, along with the following documents:

 

1) Medical Reimbursement Claim (MRC) forms duly filled in

2) Check list

3) Copy of Discharge

 

 

 

Course 3: Health Insurance Products & Underwriting

 

Question. How do you evaluate the market performance of a new insurance product?         (5 Marks)

 

Answer: Past success doesn’t guarantee ongoing success, particularly when it comes to insurance product portfolios. Today’s evolving insurance landscape has made new product development vital to insurers’ financial strength and business growth. At a time of changing customer demand, regulatory standards, and market pressures, how do insurers bring successful new products to market?

 

 

Question.  Short note on Top-Up Products                                                                                    (5 Marks)

Answer: Top-up health plans are a stepney to your health reimbursement policy after you exhaust the sum insured limit.

 

A regular policy reimburses hospital bills up to the sum insured while a top-up plan covers costs after a certain threshold is reached.

 

 

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