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How does the scheme work
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The programme has been designed after conducting a study of different health insurance models in the country. Minimum administrative expenses and maximum convenience to member remains the basic motto of the programme.

1. Medical expenses up to Rs. 25000/- for a family of five is taken care by the insurance.
2. With each additional member the stakeholder is eligible for an additional medical expense of Rs. 5000/- from the programme
3. Financial assistance from the groups will be provided to pay the insurance premium
4. Every family has to renew its membership every year by paying the specified amount.

The groups will also provide loan to meet the expenses in excess of the insured amount.

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Features 
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1. Member can get cashless treatment of Rs.5000=00, cover increases by Rs 5000/- per member. The coverage is on floater basis in multiple of Rs.5000/- .
2. Yearly Contribution is collected along with the weekly savings of the members of the Self-help group so that it does not strain the finances of the family
3. Cashless treatment facility is available in well equipped hospitals with modern amenities, recognized by SKDRDP.
4. Any one member of the family can avail the benefit for any one ailment to the extent of maximum limit available to the family.
5. In case of normal/accidental death of stake holder of the family (or head of the family) Rs.5000/- will be paid to the nominee as consolation with in 24 hours of the death.
6. In case of accidental death of the stake holder of the family, Rs 20,000/- additional amount will be paid to the nominee subject to production of connected records.
7. In case any disability is suffered by the stake holder of the family due to accident Rs.12500 is given as consolation for partial disability, Rs 25,000/- is given in case of permanent disability.
8. Maternity expenses reimbursement during the first two deliveries of the members of Sampoorna Suraksha: Rs2,000 for normal delivery and Rs 4,000 for caesarian delivery.
9. In case the stake holder under goes domiciliary treatment and is unable to attend to his routine work, rest allowance at Rs.50/- for 30 days is paid depending on his domiciliary treatment.
10. In case of the house damage due to natural calamities such as cyclone, heavy rainfall etc. consolation amount upto a maximum of Rs.1000 is paid to the family.
11. If the medical expenses are not availed then only the insured is eligible for a maximum allowance of Rs. 1500- with Rs.50/- per day based on the doctor's recommendation.
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Who can become a member
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The scheme is open to the members of SKDRDP promoted SHGs. All the members of SKDRDP participate in this programme by contributing an annual subscription.
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The contribution
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Sl.no

Description

Annual contribution

Eligible limit for the family during the year for cashless treatment
1

One member family

190
5000
2

Two members family

305
10000
3

Three members family

420
15000
4

Four members family

535
20000
5

Five members family

650
25000
6

Six members family

765
30000
7

Seven members family

880
35000
8

Eight members Family

995
40000
9

Nine members Family

1110
45000
10

Ten members Family

1225
50000
 

Every family has to renew its membership every year by paying the specified amount. Eg:- A family of five members can get cashless treatment for a whole year up to the family limit Rs.25000/-at a contribution of Rs.650.00 by paying the amount Rs.16.25 per week for 40 weeks. Health security and other benefits for just Rs.2.35 per day for 5 members.
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Benefits given
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Sl.no

Description

First Year 2004-05

Second year 2005-06

1

One member family

   Numbers        

Amount

Numbers       

 Amount

2

Health-treatment

7737 26421143

8587

24989658

3

Delivery allowance

2593 7017268

2761

6012452

4

Death Consolation

227 1135000

208

1175000

5

Domiciliary treatment-Rest allowances

360 202090

518

223165

6

Consolation for natural calamities

893 648061

1061

416392

7

Total

11810 3,542,3562  

3,28,16,667

 

                             



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