VimoSEWA provides a voluntary, integrated insurance product, which is the most challenging type of microinsurance. It is open to all members whether or not they have a loan, and provides life, accident, health and asset protection to a group that has higher risk and lower incomes that the “normal” insurance market. Managing a smaller operating margin with higher claims costs provides a significant challenge.

By January 2005, membership was below target and viability remained 7 years away, with low renewal rates as the principal cause. The paper suggests, however, that there have been some important evolutions of understanding within VimoSEWA:

• There is now a clear concept of the risk of insurance and the requirement to protect the scheme from major catastrophic events;
• Developing a management information system is a necessary element to manage the microinsurance scheme actively;
• VimoSEWA’s management team now has the skills, vision and knowledge to reach the goal of viability;
• The business plan was an important tool to set critical benchmarks; periodic review of goals permitted VimoSEWA to make adjustments to methods and procedures;
• Management and staff teams used reports to actively manage the organisation;
• Developing capacity of each staff person was difficult as microinsurance is new and no clear solutions have been developed;
• The assistance of an outside actuarial and management consultant helped the team to recognise problems, and to realise that solutions had to come from within the organisation;
• Product development must always consider the ability of members to pay for benefits;
• Obtaining a high renewal rate may be difficult, as the widely dispersed membership requires an understanding of insurance and solidarity, facilities to pay premiums, access to health care providers, and methods to obtain reimbursements;
• Adequate accreditation standards for health facilities covering appropriate treatment protocols, as well as health education programmes aimed at the target population, are necessary to keep health claims costs from spiralling out of control.