Factors Influencing the Policyholders Satisfaction Towards Mediclaim Policy

Abstract

Insurance plays a vital role in healthcare management, with mediclaim policies being particularly crucial for managing medical expenses. This research examines the key factors influencing policyholder satisfaction in mediclaim insurance through a comprehensive mixed-method study of 500 policyholders across urban and semi-urban areas. Using the SERVQUAL model and Customer Satisfaction Index methodology, the study identifies five primary factors affecting satisfaction: claim settlement efficiency (correlation coefficient: 0.82), customer service quality (0.76), premium affordability (0.71), policy coverage breadth (0.69), and transparency in terms (0.65). The research employs stratified random sampling and utilizes both quantitative surveys and qualitative interviews conducted over six months. Findings indicate that prompt claim settlement and clear communication significantly impact satisfaction levels, while digital accessibility and personalized service emerge as growing priorities. The study reveals a notable correlation between premium affordability and perceived value, with comprehensive coverage options enhancing satisfaction. Based on these findings, the research proposes specific recommendations for insurance providers and policymakers, including the implementation of automated claim processing systems, development of transparent communication channels, and establishment of standardized settlement timelines. This study contributes to the understanding of consumer behavior in health insurance and provides actionable insights for industry stakeholders.