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Player | Incentive |
Patient | To regain health swiftly and affordably |
Healthcare Provider | Revenue driven by tests, treatments, and prolonged care |
Insurance Company | Minimize claim payouts to maximize profits |
Result | Misaligned Incentives -> Poor Health Outcome, Low Trustβ |
Imagine a health subscription model where the service's profitability is directly tied to your health.
You pay the plan premium and when you're unwell, the plan pays for all of it, aligning its success with your recovery.
That's managed care and Clinikk for you!
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Clinikk operates 11 Health Hubs in Bangalore, all directly managed to guarantee top-quality primary care and effective first-level health gatekeeping, focusing on keeping you healthy.
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The Clinikk Health Plan doesn't stop at the primary care level but extends to cover your hospitalization bills through Health Insurance that comes along.
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The current pricing is age-agnostic and for everyone from 18-60, this is how the post discount premium looks like:
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Plan | Self | Couple | Family |
---|---|---|---|
Doctor Visits | Free & Unlimited | Free & Unlimited | Free & Unlimited |
Tele-consultation | Free & Unlimited | Free & Unlimited | Free & Unlimited |
OPD Limit | 15,000 | 20,000 | 25,000 |
Health Insurance (SI) | 5 Lakh | 5 Lakh | 5 Lakh |
PA Cover (SI) | 5 Lakh | 5 Lakh | 5 Lakh |
Annual Premium | βΉ7,680 | βΉ13,440 | βΉ20,160 |
βNote:
OPD Limit could be used for Medicines, Lab Tests, Specialist Reimbursements
Option to upgrade your Health Insurance SI to 15 Lakh, 55 Lakh
βMicro Objective #1: Characterising User Profiles
-Who else is there in your family? How old are they? Are they all covered under Clinikk's plan? If not, why?
-What do you do for living? Where are you from? Where do you stay?
-Why did you choose to have a health insurance for yourself/family?
-Prior to purchasing our plan, what were your main concerns regarding health insurance?
β
Micro Objective #2: Identifying Effective Acquisition Channels
-How did you first learn about our health plans?
-What made you choose Clinikk's plan over others available in the market? Where did you learn about the other plans available in the market?
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Micro Objective #3: Evaluating Decision-making Factors
-Whose decision was it in the family to have Clinikk plan?
-<Advisor Name> was in touch with you for almost <n> days before you purchased the plan. How was your experience with our Advisor? What are the things that you liked and disliked?
-What all did you check before purchasing the plan?
-Looking back at your decision to choose our health plan, what do you believe we offered that others didnβt?
Interview Date | 26th March | 26th March | 27th March | 26th March | 24th March |
---|---|---|---|---|---|
User Name | Ravi, 28y | Vinay, 34y | Nirmala, 43y | Sandeep, 46y | Anjanamma, 52y |
Product | Monthly-Self | Annual-Self | Annual-Family | Monthly-Couple | Annual-Couple |
Vintage | 11 months | 2 months | 36 months | 23 months | 17 months |
OPD Usage Trend | Have used Tele-consultation twice | Have been a paid user before plan purchase for acute problems | Uses Clinikk's OPD once every 2-3 months for acute problems | Uses Clinikk's OPD regularly for regular checkups | Comes almost every 2 weeks for BP/Sugar checkup |
IPD Claims | Not yet | Not yet | 36k claim this Aug | Not yet | 118k claim till date |
ICP | ICP-1 | ICP-2 | ICP-3 | ICP-4 | ICP-5 |
---|---|---|---|---|---|
ICP Name | Ravi, 28y | Vinay, 34y | Nirmala, 43y | Sandeep, 46y | Anjanamma, 52y |
ICP Category | Young Professionals | Young to Middle age Families (Migrants) | Young to Middle age Families (Locals) | Elderly Families (Migrants) | Elderly Family (Locals) |
Age | 20-30 | 30-45 | 30-45 | 45-60 | 45-60 |
Occupation | Salaried | Salaried | Business | Salaried | Business |
Goals | Financial Security, Health Consciousness, Career Growth | Financial Planning, Health Security, Career Stability | Business Growth, Health Security | Retirement Planning, Managing Chronic Issues | Business Growth, Managing Chronic Issues |
Income Levels | Low to Medium | Medium | Medium | Medium | Medium |
Proximity to Clinikk Centres | Could change with job switch | Could change with job switch | Within 3 Kms | Could change with job switch | Within 3 Kms |
Marital Status | Single, Recently Married | Married with kids | Married with kids | Married with grown-up kids | Married with grown-up kids |
Where do they spend time? | Instagram, Facebook | Facebook, Instagram | Facebook, Instagram, Community Groups | Facebook, LinkedIn | Community Groups |
Pain Points | Stress, Social Pressure, Less focus on health | Managing OPD spends on kids, Growing expenses | Managing OPD spends on kids, Business stress, Work-life balance | Future health insecurity, Increasing chronic spends | Chronic spends, Increasing cost of healthcare |
Current Solution | Company Insurance | Company Insurance, Personal Savings | Personal Savings | Company Insurance, Personal Savings | Personal Savings |
Adoption Curve | High | Medium | Low | Low | Low |
Usage | Low | Medium | High | High | High |
Appetite (Varies) | Low | Medium | Medium | Medium | Medium |
TAM around CHH | Low | Medium | High | Low | Medium |
Distribution Potential | Low | Low | High | High | High |
Claim Ratio | Low | Low | Medium | Medium/High | Medium/High |
β
Category | Influencers | Blockers |
---|---|---|
Personal | Friends/Family experiences: Trust built on the positive outcomes and support during hospitalizations or health crises. | Financial Priorities: Competing financial commitments or perceptions of health insurance as non-essential until needed. |
Practical | Awareness and Education: Understanding the benefits and protections offered by health insurance, potentially through push/marketing | Cost and Accessibility: Perceived affordability and the complexity of purchasing or understanding health plans. |
TAMβ
Category | 2024 Estimated TAM (INR Trillion) β | 2029 Projected TAM (INR Trillion) β | CAGR (2024-2029) |
---|---|---|---|
Total Health Insurance Market | 0.91 | 1.5 | 10.60% |
OPD Insurance Penetration: Assuming it to be 10% of Total Health Insurance market
SAM of Health Insurance with OPD in 2024 = INR 91 billion
β
βSOM for Health Insurance with OPD in 2024 = 0.91 trillion x 1% = INR 9.1 billion
Key Features | Clinikk's Plan | Traditional HI |
Initial Waiting Period | 30 days | 30 days |
PED/Named Ailments | 1 year | 3 years |
OPD | Available | Not Available |
No Claim Bonus | N/A | Up to 50% SI |
Premium | Age-agnostic | Age-dependent |
Clinikk is transition to age-dependent pricing model just like the traditional insurances but the Clinikk's premium for any particular age group would still be lower compared to that of the traditional insurance.
Reason: Lower Claim Ratio (Claims/Premium Collected) at scale because of managed care.
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Core Value Prop | Downsides |
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Affordable compared to Traditional Insurances | Lesser Trust compared to Traditional Insurances |
Better Engagement & Utilisation because of OPD | No Customisations in Plan |
Job | Young-Middle Age Family (Local) | Elderly Family (Local) |
---|---|---|
Functional | To have an easy one-point, hygienic place for my family's complete health needs. | To have an accessible one-stop solution for my regular chronic problems. |
Personal | To feel good that I take my family to a good doctor who provides better care. | To have an assurance in life that my health related risks are mitigated. |
Financial | To mitigate the risk of unexpected medical expenses on OPD and have a sense of financial security at an affordable premium. | To have a cost-effective way of paying for regular chronic health conditions. To feel secure about the savings done till date. |
Social | To show how responsible I'm towards providing a financial risk-free and quality life to my family. | To demonstrate better retirement planning and set examples for peers. |
Introduce an upgrade/downgrade feature for health plans, allowing users to switch between OPD+Insurance and IPD-only plans.
Benefit:
-Dissolves the geographical barrier to plan purchase.
-Customers would continue with Clinikk irrespective of their proximity to Clinikk centres.
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βPlan Purchase Decision Matrix
Customer Proximity Status β | Currently Near Clinikk | Currently Away from Clinikk |
---|---|---|
Recently Relocatedβ | Low (15%) -> Medium | Low (25%) |
Proximity Stability Uncertain | Medium (10%) -> High | Low (20%) |
Stably Located β | High (10%) | Low (20%) |
This would significantly increase the TAM by at least 83%
Current: Medium 5% + High 10%
Future: Medium 7.5% + High 10% + High 10%
Multipliers: High (1), Medium (0.5), Low (0) β
1. Refer your friend
2. Your friend activates a SMART plan worth >βΉ4,000
3. You get a Silver Coin
4. Your friend gets 5% off
β
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User Story & Happy Moments |
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Lead generated on the system |
Plan pitched to the customer |
Customer shows some interest |
Customer asks for some references |
Customer wants to purchase the plan |
Customer makes the payment |
Customer does self-onboarding on the Clinikk App |
COI copy is generated and the plan is "Active" |
Physical activation kit is delivered to the customer |
Customer visits the Clinikk centre for the 1st time |
Customer gets done with his complimentary health checkup |
Customer likes the service and rates the Clinikk centres on Google |
Customer refers his friend who purchases the plan |
Customer receives a "Reward" for successful referral |
Customer visits again but this time when sick |
Customer liked the service and walks out with his medicines |
Customer recovers well in a few days |
Customer gets a feedback call and feels happy about the serviceβ |
β | Present Referral Program | Referral Program 2.0 |
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Whom to ask for Referrals?β |
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How to identify the discovery flow?β |
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Why will someone refer?β |
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How will they refer?β |
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βHow will they track? |
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How will they keep referring?β |
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Platform Currency- Clinikk Coins: Earn, Redeem, Compete
Product name | Frequency of interaction | Importance of these interactions | Can your product add value to these interactions? | Potential to get customers/new use cases? |
---|---|---|---|---|
Low | Somewhat | Not Sure | Low | |
High | Not Much | Not Sure | Medium | |
High | Somewhat | Yes | High | |
Low | Very | Not Sure | High |
Partnering with Policybazaar at Clinikk's current scale is difficult as it might cannibalise the business of other competitors (traditional insurance) listed on the platform.
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Shared via Personal What |
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