Policy definitions can have unintended consequences
When SSP launched its community health fund it allowed enrollment per policy to include up to five family members. While this definition of a family was simple to administer and also limited exposure to claims per policy, it created unanticipated bias as families selectively enrolled sons, and not daughters, in the scheme. At least 70% of children enrolled were boys, suggesting a preference for insuring boys. SSP was able to isolate and quantify this bias by segmenting the membership data for children by gender.
This is a useful reminder of the importance of detailed analysis of a product’s performance, including segmentation of data by categories such as age and gender, to identify areas for improvement.
For more on SSP’s community health fund, click here.