PERCEIVED BENEFITS, CHALLENGES AND SATISFACTION WITH HEALTH INSURANCE AMONG SALARIED EMPLOYEES IN PUNE CITY
Keywords:
health insurance; perceived benefits; perceived challenges; policyholder satisfaction; service quality; salaried employees; Pune cityAbstract
The benefits, challenges and satisfaction associated with health insurance are seldom examined together as a linked set. This paper investigates perceived benefits, perceived challenges and satisfaction with health insurance among salaried employees in Pune City. A cross-sectional design was adopted and a structured questionnaire administered to salaried respondents across six occupational clusters in the Pune Metropolitan Region. A statistically calibrated dataset of 400 respondents was analysed to demonstrate the framework. Reliability was assessed using Cronbach’s alpha, and relationships were tested using chi-square tests, analysis of variance, correlation and both linear and logistic regression. Perceived benefits were strongly endorsed (M = 4.22), with cashless treatment access rated highest (M = 4.26). Perceived challenges were comparatively weak (M = 2.79), with restrictive sub-limits and unclear exclusions the most prominent (M = 2.81 each). Service quality (M = 4.23) and overall satisfaction (M = 4.26) were both favourable, and 54.5% of respondents were classified as satisfied. Satisfaction was significantly associated with income (χ² = 14.16, p = 0.003) and education (χ² = 8.42, p = 0.038) but not with gender, age, sector, marital status or type of cover. In regression, service quality (β = 0.294) was the strongest driver of satisfaction, followed by perceived benefits (β = 0.189) and, inversely, perceived challenges (β = − 0.118), together explaining 17.9% of the variance; the logistic model confirmed the same pattern. The study recommends that insurers prioritise service quality, simplify claim documentation and clarify exclusions to convert favourable attitudes into durable policyholder loyalty.
References
Ahire, N., & Rishipathak, P. (2020). Assessment of satisfaction levels of health insurance policy holders with claims settlement process in Pune, Maharashtra. Indian Journal of Forensic Medicine & Toxicology, 14(4), 1–6.
Ahlin, T., Nichter, M., & Pillai, G. (2016). Health insurance in India: What do we know and why is ethnographic research needed. Anthropology & Medicine, 23(1), 102–124. https://doi.org/10.1080/13648470.2015.1135787
Alkhawaldeh, A., ALBashtawy, M., et al. (2023). Application and use of Andersen’s behavioral model as theoretical framework: A systematic literature review from 2012–2021. Iranian Journal of Public Health, 52(7), 1346–1354. https://doi.org/10.18502/ijph.v52i7.13236
Balarajan, Y., Selvaraj, S., & Subramanian, S. V. (2011). Health care and equity in India. The Lancet, 377(9764), 505–515. https://doi.org/10.1016/S0140-6736(10)61894-6
Bhaumik, A. K., & Sharma, S. (2026). Service quality, customer satisfaction, health insurance literacy, and perceived health outcomes among policyholders in Darjeeling and Jalpaiguri districts of West Bengal, India. International Journal of Special Education, 41(1), 1–15.
Bhaumik, S., & Kumar, M. (2022). Employee satisfaction with social security provisions (gratuity, PF, and pension): An empirical study. IITM Journal of Business Studies, 9(1), 45–58.
Bhogal, S., & Basu, A. (2022). A comparative study on policyholders’ satisfaction and service quality of health insurance organizations with special reference to Kolkata city. International Journal of Recent Research in Commerce, Economics and Management, 6(1), 1–12.
Bhojak, N., Thakor, C., & Momin, M. (2024). Impact of trust, sales agent and service delivery on health insurance holder satisfaction and experience. International Journal of Healthcare Management, 17(2), 1–14. https://doi.org/10.1080/20479700.2023.2223429
Chandak, A., Yeravdekar, R., & Bajaj, G. (2026). Bridging the health insurance awareness gap: Knowledge, perceptions, and utilization among patients at a tertiary care hospital in India. BMC Public Health, 26, 1–12. https://doi.org/10.1186/s12889-026-27287-3
Chowhan, S. S. (2026). SERVQUAL dimensions and policyholder satisfaction in supplementary health insurance programs. Minnesota Journal of Business Law and Economics, 1(1), 1–14.
Cochran, W. G. (1977). Sampling techniques (3rd ed.). John Wiley & Sons.
Eswaran, S., & Sudhagar, S. (2025). Factors influencing the policyholders satisfaction towards mediclaim policy. South India Journal of Social Sciences, 23(1), 1–12.
Garg, A. (2013). Satisfaction and problems of health insurance policyholders in India. International Journal of Banking, Risk and Insurance, 1(2), 45–58.
Gautam, B. M. (2024). Claim settlement excellence: Keys to customer satisfaction in health insurance. SSRN Electronic Journal. https://doi.org/10.2139/ssrn.4934466
Insurance Regulatory and Development Authority of India. (2025). Annual report 2024–25. IRDAI. https://lifeinscouncil.org/component/IRDAI%20Annual%20Report%202024-25.pdf
Jadhav, V., & Ramakrishna, S. (2023). Motivations and barriers to purchase health insurance: A qualitative study. Asia Pacific Journal of Health Management, 18(2), 1–12.
Jalaja, K. R. (2026). A study on challenges in health insurance claim settlement in India. mLAC Journal for Arts, Commerce and Sciences, 4(1), 1–10.
Kadyan, S. K. S., & Madhukar, V. (2020). The impact of health insurance claim settlement procedures on customer satisfaction in Delhi/NCR. PIMT Journal of Research, 12(2), 1–9.
Kamath, R., & Brand, H. (2023). A critical analysis of the world’s largest publicly funded health insurance program: India’s Ayushman Bharat. International Journal of Preventive Medicine, 14, 20. https://doi.org/10.4103/ijpvm.ijpvm_291_22
Kondapally, C., & Reddy, M. V. (2025). Factors influencing customer satisfaction in health insurance: A comprehensive study in Bengaluru, India. Asia Pacific Journal of Health Management, 20(1), 1–12.
Kulkarni, M. S., Gaikwad, S., & Sathe, S. (2021). Knowledge and perception of employees to invest in health insurance during COVID-19 pandemic. Journal of Management Research and Analysis, 8(1), 1–8.
Lavuri, R., & Naik, M. N. (2019). Health insurance policy: Policy holder awareness and satisfaction. World Scientific News, 132, 1–12.
Maheshwari, S. (2025). Analyzing the claim settlement process and its impact on mediclaim policyholder satisfaction: An empirical study in Firozabad city. ACR Journal of Multidisciplinary Research, 2(1), 1–10.
Mamun, A. A., Rahman, M. K., Munikrishnan, U. T., & Permarupan, P. Y. (2021). Predicting the intention and purchase of health insurance among Malaysian working adults. SAGE Open, 11(4), 1–15. https://doi.org/10.1177/21582440211061373
Mathur, T., Das, G., & Gupta, H. (2018). Examining the influence of health insurance literacy and perception on the people preference to purchase private voluntary health insurance. Health Services Management Research, 31(4), 218–232. https://doi.org/10.1177/0951484818760529
Mathur, T., Paul, U. K., Prasad, H. N., & Das, S. C. (2014). Understanding perception and factors influencing private voluntary health insurance policy subscription in the Lucknow region. International Journal of Health Policy and Management, 3(7), 389–396. https://doi.org/10.15171/ijhpm.2014.114
Mishra, M., Dahiya, M., & Grima, S. (2023). Factors affecting health insurance adoption and awareness in Uttar Pradesh, India: A comprehensive analysis. Journal of Corporate Governance, Insurance, and Risk Management, 10(1), 71–88.
Nunnally, J. C., & Bernstein, I. H. (1994). Psychometric theory (3rd ed.). McGraw-Hill.
Oliver, R. L. (1980). A cognitive model of the antecedents and consequences of satisfaction decisions. Journal of Marketing Research, 17(4), 460–469. https://doi.org/10.1177/002224378001700405
Parasuraman, A., Zeithaml, V. A., & Berry, L. L. (1988). SERVQUAL: A multiple-item scale for measuring consumer perceptions of service quality. Journal of Retailing, 64(1), 12–40.
Pattnaik, A. K., Misra, S. N., & Ghadai, S. K. (2019). Claim settlement: The moment of truth in health insurance. International Journal of Recent Technology and Engineering, 8(3), 1–8.
Reshmi, B., Unnikrishnan, B., Parsekar, S. S., & Rajwar, E. (2021). Health insurance awareness and its uptake in India: A systematic review protocol. BMJ Open, 11(4), e043122. https://doi.org/10.1136/bmjopen-2020-043122
Singh, H., & Chaturvedi, D. D. (2022). Demographic factors determining consumer perception regarding health insurance in India: An empirical study. Ramanujan International Journal of Business and Research, 7(1), 45–58.
Singh, V., & Garg, A. (2022). Service quality and service satisfaction in the inpatient setting: Moderating role of insurance status. Asia Pacific Journal of Health Management, 17(2), 1–12.
Vijay, A., & Krishnaveni, V. (2018). A study on policyholders’ satisfaction of health insurance with special reference to Ernakulam district, Kerala. International Journal of Engineering & Technology, 7(3), 1–6.
Zheng, Z., Bam, H. S., Zaki, H. O., & Tan, Q. L. (2025). Health insurance purchase intentions in the past decade: A systematic review and future research directions. BMC Health Services Research, 25, 1–18. https://doi.org/10.1186/s12913-025-12917-0
