An Empirical Study on Critical Success Factors Influencing Health Insurance Purchase Decisions

Abstract

Health insurance has become one of the essential tools of financial protection against health shocks, especially in developing economies with high out-of-pocket medical expenditure. The study aims to investigate the critical success factors of health insurance purchasing decisions by individual consumers. Using primary data obtained through a structured questionnaire, the survey was conducted for 185 respondents. It is carried out for Nashik city. The study evaluates the relationship of the constructs perceived risk (because there are some who perceive further or realized risk in these products, and also the possibility that these products are risk-prone), awareness and knowledge (as several who may be unaware or knowledgeable about these products and are often unknowledgeable the complete scope of these products), premium affordability, trust in insurance provider, quality of service, claim settlement experience and policy benefit on purchase intention and purchase behavior. The study used a quantitative research design and applied statistical tools such as descriptive analysis, reliability test, correlation, and regression analysis to identify the relative impact of each factor. The results show that confidence on insurers', clarity of policy phrase, & efficiency of claim settlement processes are weighed more over purchase intention, pricing of premiums, & value of the coverage perceived. The results provide the valuable insights for the insurance companies, policymakers, and regulators to create focus-based products, offer better transparency, and strengthen outreach plans to increase insurance penetration.