To protect the people from high economic cost of illness and providing financial protection at the time of hospitalization, government of Kerala introduced a unique health insurance scheme in 2008.This study is trying to explore the utilization among insured people and the problems regarding the utilization of the scheme when they are in need. Objectives; to assess the role of CHIS and health care utilization among insured households in Kerala Methods: Explanatory -Case study method. Both quantitative and qualitative methods used to track the objectives of the study. A community based cross sectional survey conducted among 150 insured households in Kerala. In-depth interviews and key informants interviews were also done. Results: Majority of the respondents were females and from BPL families. The main source of income of 40 households were from daily wages and don?t have any other formal insurance coverage. About 30.4 people utilized the service. Qualitative interview revealed that people have positive attitude towards the scheme and wants to expand the coverage to out- patient?s care also. There is delay in settling of claims so the providers are facing problems to keep the sustainability of the scheme. Conclusion: Poor people are getting the benefit of the scheme but delay in settling of claims. More APL families should be encouraged to enroll in the scheme. Empanelled Government hospitals should expand the facilities and improve the quality to attract more people in to public health system. Concerted effort is needed for the successful implementation and sustainability of the scheme.