Skip to main content

Calcutta Kids

About the Project
Project Name: 
Enhancing and sustaining health microinsurance through outpatient counselling
Type of Facility Project: 
Innovation Grant
País de operaciones: 
Asia and the Pacific
Project Thematic Focus: 
Insitutional models and business processes
Type of Risk Carrier: 
regulated insurance company
Type of Distribution Channel: 
Non-governmental organization
Project Description: 

Voluntary health microinsurance schemes worldwide face difficulty in retaining their clients. One reason for this is because the bulk of clients do not make a claim in a given year, and thus see no tangible benefit in the product. Calcutta Kids seeks to address this problem by creating value for non-claimants through an "outpatient counselling service" - an additional service that Calcutta Kids' health insurance product will provide.

When clients access outpatient care with a doctor within Calcutta Kids' network, a health worker will be sent to their house two days later. There the health worker will: (i) check that the client is following the doctor's prescribed treatment (and encourage them to do so if they are not), (ii) in the case of common sicknesses, provide simple behavioural advice to clients, and (iii) record the progression of old symptoms and the onset of new ones in a case file. At the Calcutta Kids office, a manager will review all cases, and, with the assistance of a staff doctor, decide which ones require outpatient follow-up. If follow-up is necessary, a health worker will inform the client the next day.

The service may also reduce the overall claims expense by preventing some minor illnesses from becoming major, and also by encouraging timely admission into hospitals in the case of major illnesses.

Finally, the service will be a means of monitoring the quality of outpatient care within the network, and also the illness patterns of the target population.


The NGO targets the poorest children and pregnant women in an underserved slum area hosting about 18 000 residents. Calcutta Kids targets specifically expectant mothers and their children up to age 3. The outpatient counselling service that is proposed would reach all clients within the NGO's network that access outpatient care at a local clinic.

Lessons from the Project
Learning Agenda: 
  • Do health counselling services add value for clients and if so, how much and why? Do they help the clients feel more satisfied with their insurance? Do health counselling services result in higher renewals of inpatient cover?
  • Are hospitalizations avoided? Are inpatient claims costs reduced due to lower severity of illness?
  • Is the cost of counselling services offset by potential claim cost reductions, and policy renewals? Is it financially sustainable?
Emerging Lessons: 
  • Possible reasons cited for the high retention levels include (1) the good relationship of Calcutta Kids with the community, and (2) the demonstration effect of claims paid.
  • High retention rates indicate a high level of overall satisfaction with the microinsurance scheme, but the precise reasons for the satisfaction need to be determined. 
  • During the first sales period the project operated at a significant loss ratio of over 400% due to low enrollment and a couple of high claims.
  • If an organization is well respected in a community for one type of service provision, it does not necessarily mean that the organization will have an easy time selling a voluntary health insurance program.
  • It is dangerous to assume client behavior towards key project components.
About the Organization
Tipo de vínculo con el Fondo: 
Innovation grantee
Country of Head Office: 
Region : 
Asia and the Pacific
Type of institution : 
Non government organization
Participation in Microinsurance: 
Distribution channel
Organizational Overview: 

Calcutta Kids is an NGO founded in 2003 with a mandate to conduct public health work in slum areas of Howrah, India (the twin city of Calcutta). It increases access to health and nutrition services, providing health information, and encouraging positive health-changing behaviours. Calcutta Kids' community-based programs advance the promotion and delivery of good health care, medical advocacy, and health education. On March 1st, 2009, it will begin operating a health microinsurance scheme in its catchment area. This scheme has been developed and will be operated in partnership with MicroEnsure, Medicare TPA, and United India Insurance company.

More about the Organization

"Calcutta Kids is attempting to perform ordinary miracles on the streets of one of India's poorest cities. Zeroing in on the needs of children, helping them obtain the most basic healthcare as well as help for complicated conditions, this is the mission of Calcutta Kids. Their goals are not only admirable. They are achievable and, most important, being achieved every day, thanks to the hard work and determination of this visionary group." 
Susan Stamberg, National public radio, USA, 8 November 2005