By design itself, a Mutual tries to avoid asymmetries of information , if trust and ownership have to be built properly.
The onus on the Mutuals is that:
Members should understand the product, its benefits and is able to use it well (not underuse or overuse)
Members should be able to give feedback, suggest changes in the delivery or product design
There should be a system which can take this feedback at design level
That members get correct and timely information
That we explain discuss high claims, rejected claims
That we provide processes and means that help members manage their health
That we provide data in understandable format so that they can make informed decisions at all levels (claim to policy)
Though indispensable it takes time and perseverance to develop test and deploy such systems with communities especially with those who are not well versed in reading or writing.
Uplift deploys a three pronged strategy of Informing,Educating and Communicating with its members on a regular basis and with tools that are designed and developed in house tested with Members and deployed through training of the field staff.
INFORMATION: Informing the members about the product and process is central to the success of Mutual.
Pre Sales: Promotion/ Orientation (charts-posters-verbal)
Post Sales:Monthly Virtual Fund Info (details)
24X7 HelplineInformation on Health care providers and how to access them,
Exclusions, SMS to Members
Claim papers in Claim Meetings
EDUCATION: Making members understand the model the values and the roles and responsibilities
Pre Sales: SMART SHRIMATI (Role play) / Sharing Risks (role play)
Post Sales: Welcome Meetings at the time of I card Distribution
Client Education Series on Health Insurance (Monthly),
Health Talks (Monthly),
Health CampaignGuidance Centre for Medical Advice
Claims Meeting/Disbursement (Monthly)
COMMUNICATION: A two way process where the goal is to understand member experience and learn from them as to what is needed
Pre Sales: Product Survey
Post Sales: Monthly Interviews from Members on Mutual Experience
Annual Product review
Empanelment of Health Care Providers
Rejected Claims Visit (pre-post claim decision)