Name: Amanpreet Singh , Navneet Seth
Country: India

Year: 2026
Volume: Volume-13, Issue-2, Year-2026 ( july- dec)
Page Number: 9-18
DOI: https://doi.org/10.5281/zenodo.21550751

ABSTRACT
Health-insurance adoption is shaped by the interaction of financial capacity, institutional support and consumers’ evaluations of insurance services. This study examines the role of household economic conditions and central–state government health schemes in influencing health and medical insurance adoption in Punjab. A quantitative, explanatory, cross-sectional design was used. Primary data were collected between February and November 2025 from respondents in Ludhiana, Jalandhar, Bathinda and Ferozepur. Of 1,136 questionnaires distributed, 522 responses were received and 453 valid responses were retained for analysis; 358 responses were collected face-to-face and 95 online. The questionnaire measured economic conditions, government health-scheme awareness and perceived usefulness, insurance awareness, service accessibility, premium cost, trust, customer satisfaction, perceived value and health-insurance adoption using five-point Likert-scale items. Structural equation modelling was used to examine the hypothesised relationships, supplemented by reliability and validity assessment, mediation analysis, moderation analysis and predictive validation. The results reported in the study indicate that economic conditions and government health schemes are positively associated with health-insurance adoption. Premium cost negatively affects customer satisfaction, whereas insurance awareness, accessibility and trust positively influence satisfaction. Customer satisfaction is positively associated with adoption, and perceived value strengthens the relationships between awareness and trust and customer satisfaction. The findings suggest that expanding health-insurance participation requires more than increasing product availability. Affordability, effective public schemes, accessible delivery, transparent administration and trust-building are jointly important for improving adoption in Punjab.

Keywords: health-insurance adoption; economic conditions; affordability; government health schemes; Punjab; customer satisfaction; perceived value; structural equation modelling.