Consumer evaluation of complaint handling in the Dutch health insurance market

Abstract

BackgroundHow companies deal with complaints is a particularly challenging aspect in managing the quality of their service. In this study we test the direct and relative effects of service quality dimensions on consumer complaint satisfaction evaluations and trust in a company in the Dutch health insurance market.MethodsA cross-sectional survey design was used. Survey data of 150 members of a Dutch insurance panel who lodged a complaint at their healthcare insurer within the past 12 months were surveyed. The data were collected using a questionnaire containing validated multi-item measures. These measures assess the service quality dimensions consisting of functional quality and technical quality and consumer complaint satisfaction evaluations consisting of complaint satisfaction and overall satisfaction with the company after complaint handling. Respondents' trust in a company after complaint handling was also measured. Using factor analysis, reliability and validity of the measures were assessed. Regression analysis was used to examine the relationships between these variables.ResultsOverall, results confirm the hypothesized direct and relative effects between the service quality dimensions and consumer complaint satisfaction evaluations and trust in the company. No support was found for the effect of technical quality on overall satisfaction with the company. This outcome might be driven by the context of our study; namely, consumers get in touch with a company to resolve a specific problem and therefore might focus more on complaint satisfaction and less on overall satisfaction with the company.ConclusionsOverall, the model we present is valid in the context of the Dutch health insurance market. Management is able to increase consumers' complaint satisfaction, overall satisfaction with the company, and trust in the company by improving elements of functional and technical quality. Furthermore, we show that functional and technical quality do not influence consumer satisfaction evaluations and trust in the company to the same extent. Therefore, it is important for managers to be aware of the type of consumer satisfaction they are measuring when evaluating the handling of complaints within their company.

Selective contracting by health insurers

“…Also, enrolees who chose a restrictive health plan, for instance to save costs, seem to be more positive about their health plan. [34]. Patients also experience more out-of-pocket costs, because they have to pay a co-payment when they use an out-of-network provider, and endure more administrative barriers in when they are enrolled in a managed care organisation.…”

“…Furthermore, tiering has the most effect when enrolees are looking for a new physician. The effect is absent when enrolees already have a relationship with a physician [34].…”

“…On the other hand, restrictive health plans are usually cheaper compared to free choice health plans. In other countries it was found that young and healthy enrolees more often choose restrictive health plans [27,34,35]. The reason for this may be that young people are more price sensitive and therefore focus more on the price of a health plan instead of having free care provider choice or a short travelling time [36,37].…”

“…Price People on a low income are expected to be more sensitive to price, and may therefore value, more highly, the benefit of a lower premium compared to people on a higher income [32][33][34]. However, one consequence of opting for a restrictive health plan could be that enrolees have to travel further to attend the nearest care provider with whom their insurer has a contract.…”

“…High service quality ratings are very important for health insurers since these could lead to more trust in the company [34]. Trust was found to lead to customer loyalty [35] and was found to play an important role in the acceptance of selective contracting [36].…”