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«Protecting the poor A microinsurance compendium Edited by Craig Churchill Protecting the poor A microinsurance compendium Protecting the poor A ...»

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Bienestar Magisterial (BM) Health microinsurance: A comparison of four publicly-run schemes, Latin America Jens Holst, November 2005, Case Study No. 18 Bienestar Magisterial is a mandatory health insurance scheme in El Salvador for full-time teachers on the payroll of the Ministry of Education and their families. Created in 1969, it covered around 75,000 persons by 2003. The benefit package includes primary healthcare, specialized outpatient care, inpatient care through referral and emergency care. Healthcare is provided primary through around 100 family doctors who guide members through the system if more specialized care is needed. Physicians and facilities are contracted by the programme to provide care. Provider compensation is based on a variety of different systems such as a fee-for-diagnosis-related-group and fee-per-diem. Financing of the scheme is from direct income contributions. There are no co-payments.

CARD Mutual Benefit Association (MBA) CARD MBA, the Philippines Michael J. McCord and Grzegorz Buczkowski, December 2004, Case Study No. 4 CARD MBA is an insurance institution that started its operations in 1999. It operates in three regions of the country and offers life insurance and integrated credit life and disability insurance, along with a provident fund for longterm savings that does not have a risk-pooling element. In 2003, around 580,000 lives were insured in the scheme. CARD MBA is one of three sister organizations the aim of which is to improve the quality of life of poor women, particularly those residing in rural areas. It provides insurance for people borrowing from the CARD Bank, for whom cover is compulsory.

Sales delivery, premium collection and claims payments are outsourced to the sister organizations for a fee.

Description of microinsurance providers 607 Christian Enterprise Trust Zambia (CETZAM)1 Technical assistance for the promotion of microinsurance: The experience of Opportunity International Richard Leftley, June 2005, Case Study No. 11 CETZAM is a microfinance NGO founded in 1995 to fight poverty through microenterprise development. It initially offered a credit life product and now also offers funeral and property insurance as well. There were around 5,000 subscribers to its microinsurance products in 2004. CETZAM acts as an agent of a private sector insurance company. The credit life and funeral insurance products are compulsory for people borrowing from the organization.

Columna Columna, Guatemala Carlos Herrera and Bernardo Miranda, December 2004, Case Study No. 5 Columna, an insurance company created in Guatemala in 1993, operates primarily through the country’s credit unions and cooperatives to serve the selfemployed in the informal economy. Its predecessor was the Guatemalan National Federation of Credits Unions’ life insurance scheme, which had started in 1970. The majority of Columna’s clients are from its affiliated credit unions and cooperatives, but some clients join individually or through partner NGOs. Though Columna had over 500,000 clients in 2003, and offers a range of products from motor insurance to insurance against assault, only some products can be considered microinsurance. These are: credit life and life savings plans which are mandatory for people borrowing from any of Columna’s partner credit unions/cooperatives, and a voluntary life insurance product that offers benefits in the event of death or disability.

Coordination régionale de mutuelles de santé de Thiès (CRMST) Mutual health insurance, CRMST, Senegal Klaus Fischer, Ibrahima Hathie, Issa Sissouma, September 2006, Case Study No. 24 Coordination de Thiès is an association of 39 mutual health organizations, with about 75,000 beneficiaries at the end of 2005 (up from about 70,000 the previous year), covering all pathologies offered to individuals in public health institutions. In the late 1980s, Thiès was the birthplace of the now rapidly growing movement of MHOs in West Africa that now includes 1 CETZAM is also discussed in Madison Insurance, Zambia, Case Study Nor. 10 by Lemmy Manje.

608 Appendix I hundreds of schemes. The MHOs are independent risk-carrying entities, with the majority based on rural areas. The Coordination plays an important role in providing support to the MHOs, acting as intermediary between MHOs and other stakeholders, helping with the development of new MHOs and contracting health service providers. It falls under the law of associations that recognizes the form of “union régionale”, which corresponds to Coordination’s structure.

Delta Life Delta Life, Bangladesh Michael J. McCord and Craig Churchill, February 2005, Case Study No. 7 Delta Life is an insurance company founded in 1986. It started offering insurance products for high- and middle-income groups and then, taking inspiration from the Grameen Bank, it launched a voluntary microinsurance product targeted at low-income persons in the informal economy in 1988. It currently offers a range of endowment products, and had 859,000 lowincome policyholders in 2002. The products offered are perceived by clients and staff more as long-term savings products than insurance. Certain occupational groups are excluded from purchase of certain products and most of its microinsurance clients live in rural areas.

La Equidad Seguros La Equidad Seguros, Colombia Gloria Almeyda and Francisco de Paula Jaramillo, September 2005, Case Study No. 12 La Equidad Seguros, established in Colombia in 1970, offers a variety of insurance products both for institutional and individual needs; it also targets low-income groups. It has partnered and is primarily owned by cooperatives throughout the country. Among its many products, two group products can be considered microinsurance. Both of these cover death and disability and are distributed through La Equidad Seguros’ partner organizations. One of these products is only available to clients of a microfinance institution, Women’s World Foundation (WWF). WWF acts as an agent, responsible for marketing, premium collection and claims processing. The other product is a similar one targeting La Equidad’s partner cooperatives. There were around 30,000 microinsurance policyholders in 2004, most of whom either own informal microenterprises or are low-wage workers.

Description of microinsurance providers 609 FINCA Uganda AIG Uganda: A member of the American International Group of companies Michael J. McCord, Felipe Botero and Janet S. McCord, April 2005, Case Study No. 9 The attention surrounding the initial partnership between FINCA Uganda, formerly a microfinance NGO (now a regulated financial institution), and AIG Uganda served to launch the partner-agent model as an effective and potentially profitable way to deliver insurance to the low-income market.

Although in 2003, 26 MFIs had group policies with AIG Uganda covering 1.6 lives, FINCA was the initial driver of the product design and enhancements.

Grameen Kalyan (GK) Health microinsurance: A comparative study of three examples in Bangladesh Mosleh U Ahmed, Syed Khairul Islam, Md. Abul Quashem and Nabil Ahmed, September 2005, Case Study No. 13 Grameen Kalyan’s health insurance scheme was started in 1996. Around 58,000 families, the majority of whom were members of the Grameen Bank, purchased insurance in 2004. The scheme offers an annual product covering preventative and curative health services. Healthcare is provided through the programme’s 28 clinics and community health workers in eight districts.

Each clinic has a staff of around 10 employees. There are co-payments for all services except for preventative, family-planning and health education services, which are provided through community health workers.

International Cooperative and Mutual Insurance Federation (ICMIF) Lessons learnt the hard way International Cooperative and Mutual Insurance Federation (ICMIF), January 2005, Case Study No. 6 ICMIF is an international association of insurers operating on the principles of the cooperative movement and democratic mutuality. Founded in 1922, it now has 141 members in 67 countries, comprising more than 300 insurance companies. The principal member services provided by ICMIF are reinsurance, development, market intelligence, investment, the biennial global conference and training. This case study considers the experiences of nine unnamed members (or former members) that experienced serious problems over the years. By analysing their experiences, the study creates a framework for an insurer’s vulnerabilities. Although the companies cannot strictly 610 Appendix I speaking be called microinsurers, the lessons they learned are applicable to the extension of insurance to low-income markets.

Karuna Trust Karuna Trust, Karnataka, India Ralf Radermacher, Olga van Putten-Rademaker, Verena Müller, Natasha Wig and David Dror, November 2005, Case Study No. 19 Founded in 1987, Karuna Trust is a multipurpose NGO dedicated to rural development and rural health in the Indian state of Karnataka. It launched a health insurance pilot programme in 2002 to complement the public health system. Its integrated health insurance product offers benefits for transportation to a health facility, inpatient drugs and income during hospitalisation and post-surgery recovery. More than 61,000 persons were covered in 2004, although the organization experienced a significant drop the following year.

The premium for the product was initially completely subsidized (by UNDP), but many of the clients were less inclined to purchase the insurance when they actually had to pay for it. The product is offered in partnership with a state-owned insurance company.

Madison InsuranceMadison Insurance, ZambiaLemmy Manje, May 2005, Case Study No. 10

Madison Insurance started offering microinsurance products in 2000 in partnership with microfinance institutions. In 2003, there were over 30,000 subscribers to its group credit life and group funeral insurance products. The purchase of insurance policies is mandatory for people who borrow from these partner financial institutions.


MAFUCECTO, Togo Catherine Tremblay, Marisol Quirion, Suzanne Langlois and Frank Klutsé, October 2006, Case Study No. 25 Although initially set up in 1989 by the credit union network (FUCEC) to provide personalized life insurance products through the cooperatives in the network, MAFUCECTO initially encountered problems because the credit unions found the cover too expensive. In 2003, a desire to improve services and partner satisfaction led the network to completely reorganize MAFUCECTO and introduce new procedures and products, with funding Description of microinsurance providers 611 and technical assistance from international entities. The project goal was to set up an insurance company for the sub-region to provide common insurance products for the six credit union networks. For the moment, however, only loan-linked life insurance is offered through one network.

Malawi Union of Savings and Credit Cooperatives (MUSCCO) MUSCCO, Malawi Union of Savings and Credit Cooperatives Sven Enarsson and Kjell Wirén, March 2005, Case Study No. 8 Founded in 1980, MUSCCO is a federation that serves the needs of its member savings and credit cooperatives. At its peak in 2000, MUSCCO worked with 111 cooperatives with 66,000 members. It offers credit life and life savings microinsurance products and had 56,000 insureds in 2003. MUSCCO’s credit unions target low-income groups, small farmers and government employees. Its products are exclusively for its cooperative partners’ members and are also compulsory for them. Some of the insurance operations are carried out by the partner cooperatives but risks are managed in-house by the federation.

Opportunity International (OI) Technical assistance for the promotion of microinsurance: The experience of Opportunity International Richard Leftley, June 2005, Case Study No. 11 Opportunity International, an international NGO created in 1971, serves over 800,000 borrowers worldwide. Its mission is to provide opportunities for people in chronic poverty to transform their lives through creating jobs, encouraging small business and strengthening communities. It works with banks and MFI NGOs in 30 countries. As a result of demand from clients, the organization has provided technical assistance since 2002 to develop microinsurance products. While OI commenced its microinsurance activities in Africa, it has now spread to other parts of the world. In 2005, Opportunity’s partners covered approximately 2,700,000 low-income persons. Recently, it established the “Micro Insurance Agency” as an insurance broker serving the poor.

612 Appendix I

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