Outbidding The Quacks

Yes, the toughest job was explaining how insurance works to low-income communities—the fact that if they don't fall ill, the money won't come back to them. "Most of them were willing to set aside some money, provided there is an intermediary," says Mukti Bosco, founder secretary-general of HFF, which focuses on malaria, typhoid, unknown fever, pregnancy and fractures.

Here's how it works: members pay NGOs working with HFF an annual premium of Rs 353. The NGOs, in turn, purchase insurance cover from HDFC Chubb, which acts as an underwriter for about 50 common illnesses. The premium covers a family of five and provides health insurance of Rs 20,000 as well as personal accident insurance of Rs 25,000 in case of death of the primary earning member. "We network with hospitals in the area after a rating; the amount to be paid to hospital is pre-negotiated. It's scientific and transparent," points out Bosco.

The poor don't understand documentation, so there are many grey areas. This is when the HFF's facilitator steps in. He or she not only simplifies medical jargon but also briefs about the likely payment. Mostly, 80 per cent of the cost is borne by Healing Fields. The facilitator also helps the patient in securing admission, getting his claims documentation and wage compensation. On next are health schemes for migrant labour and those who are barely above the poverty line, since they don't get state benefits.