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6 Health Insurance - A New Dimension in Health Care Services in Bangladesh: A Study of It's Perspectives, Problems and Prospects Inflated Bills The benefit schedule of GHI excludes any pre-hospitalization expenditure. However, in several claims it was found that, some of the pre-hospitalization expenditures such as transport charges for bring the patient into the Clinics/Hospitals, charges of diagnostic pathological test etc., are included under the ceiling of ancillary services of the benefit schedule. False Claims To Utilize The Maximum Ceiling While in some claims it was found that the bills of medicine and drugs are inflated in order to exhaust the maximum ceiling of Medicine & Drugs. For instance, it was found that either the quantities of medicine claimed during hospitalization do not tally with the total dosage used or medicines which are being prescribed for post-hospitalization stages are included in the claim. Overstay In few claim the marketer observed that the number of days of confinement seems to be very high with the nature of the case of treatment. It is assumed that the member's have influenced the physicians to allow them to stay more than required, so as to utilize the maximum coverage allowed under the plan. Complete False Claim In few claim the marketer observed that some of the dishonest members made a complete false claim without being hospitalized. Upon through investigation it was found that the claim made was baseless. Re-Insurance Of GHI Due to the statutory requirement of The Bangladesh Bank regarding transfer of foreign currencies, the marketer could not arrange re-insurance for GHI with foreign re-insurers for global coverage of its services. Political Unrest The political environment of Bangladesh since launching of Health Insurance products, (since 1995) experienced a tremendous unrest. Frequent hartals, strikes and continuous blockade programs resulting to overall detoriation of law and order situation and stagnation of the national economy characterized this period. So, during this period due to political turmoil, GHI could not penetrate into its target market as forecasted. Suggestions The following suggestions might help the marketer to accelerate the growth and also to prevent various fraudulent attempts to a certain limit. (a) Personal Supervision Personal Supervision will have a multi-dimensional effect, which are detailed below
Journal of Business Research, Vol. 2, 1999 7 Ensure Quality Personal supervision will help the marketer to ensure the quality of service rendered to the members during hospitalization by the authorized Hospitals/Clinics. Though it will be costly in respect of time and money, but it will ensure quality and customer satisfaction. Ensure Smooth Settlement Of Claim Personal Supervision will further help the marketer to ensure the geneuinity of the various benefits enjoyed. This will ensure smooth settlement of the claim. Increase Loyalty And Customer Satisfaction Personal Supervision during confinement of the member will also help the marketer to meet with the member physically. The member will feel happy with this courtesy call. Thus, it will both increase the loyalty towards the company and will also ensure customer satisfaction. Thus, by ensuring quality, smooth settlement of claims, increase loyalty and customer satisfaction, personal supervision will be very effective and increase the possibility of renewal of the GHI for the coming years. Market Promotion Since the existing marketer is enjoying the monopolistic environment, less efforts has been provided towards product promotion. As stated earlier, since GHI is at its Introduction Stage initially it will need heavy promotional campaign at its target market. Thus by intensifying promotional measures, the marketer will be able to communicate with i) those prospect who are totally unaware to make them aware about GHI. ii) those prospects who are aware to develop their interest about GHI, help them to evaluate with proper information and finally to induce them to make a trail. iii) those prospects that are at the trail stage to induce them to finally adopt GHI. * 10 (c) Original Documents The marketer should communicate clearly to both the members and Hospitals/Clinics regarding submission of original bills for smooth settlement of claims. No duplicate or fictitious bill is to be accepted. This will prevent fraudulent attempt to a certain extent. Conclusion Since the service of Government Health Care Facilities are below the international standard and the Private Health Care services are beyond the affordability of the fixed income group, thus Health Insurance is an important and valuable means of getting Health Care Services for them. So Health Insurance is rapidly becoming popular practice not only in the developed countries like USA, UK, Japan and the like but also in the countries like Singapore, Malaysia, Philippines, Thailand, India, Indonesia, Pakistan and Bangladesh..
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