Team Member – Retail UW Full Time

Business

Health Insurance

Unit

Aditya Birla Health Insurance Company Ltd

Location

Goregaon , Mumbai

Poornata Position Number of the job

Reports to: Poornata Position Number

Poornata Position Title of the job

Reports to: Poornata Position Title

Function

Underwriting

Reports to: Function

Underwriting

Department

Underwriting

Reports to: Department

Underwriting

Designation of the Employee s

OUW7 Underwriter –

Retail

Designation of the Manager

OUW5 Senior Underwriter –

Retail

Date of writing/updation of JD

17/1/2018

• Job Purpose: Write the purpose for which the job exists (in 2-3 lines)

The role is required to carry out the operational tasks for the assigned retail underwriting policies by acting prudently in all aspects while accepting risk.

• Dimensions: Mention quantitative or qualitative parameters that are relevant for the job and provide a better understanding of the scope and scale of the job.

Products Underwritten

Retail Health Indemnity, Personal Accident, Critical illness, hospital cash. Scope would include Retail Travel products, Loan-base products for Banca partners.

Underwriting Authority

Upto INR 3 Crore

UW decision TAT

UW decision to be given in 2 working days & to reduce TAT to 1 working day till next FY

Adherence to guidelines

Regular study of UW guidelines & ensure 99% accuracy in decision making

• Job Context & Major Challenges: Write the specific aspects of the job that provide a challenge (internal and external) to the jobholder in the context of the Business/Unit/Function/Department/Section

About The Health Insurance Industry –

While the current market sees more than 15 non-life players in the private space and 5 exclusive private players in the health insurance space trying to capture a sizable market share, the nationalized service provider (6) remains a strong competitor. In addition to this the business dynamics are such that the overall market on an annual basis which is to the tune of roughly 10,000 Crs sees close to 85 % of the business renewing with the existing service provider itself. This narrows down the opportunity of the fresh business actually being seriously fought in the market to approximately 1500 odd Crs. With the SME and the start-ups being the driving force of Indian economy, the opportunity to cater to these segments is immense and is increasing manifold year on year. The challenge here therefore remains as to how we capture a larger share of the opportunity by developing specific solutions to cater each segment of the business. Also by creating an inexpensive and standardized solution to increase the reach into the pockets of channel partners across the country to harness on their captive business and explore new opportunities with them.

Market Opportunities – With the advent of medical advancements, lifestyle changes, change in Indian socio-economic scenario and Indian healthcare space, and the insurers are facing challenges to cater to the needs of this diverse clientele. Increasingly Indian customers have started considering health insurance partners as extensions of health advisers. In this scenario it becomes extremely important to understand their psyche and then provide tailored solutions with wellness benefits which would help them meet their end objectives and bring in profitable revenue source for the company.

About The Aditya Birla Health Insurance –

Aditya Birla Health Insurance Co. Limited (ABHICL) was incorporated in 2015 as a 51:49 joint venture between Aditya Birla Capital Limited (ABCL) and MMI Strategic Investments (Pty) Ltd. ABHICL commenced its operations in October 2016.

ABHICL has entered the competitive health insurance market with an aim to expand the category to wider customer segments, beyond the ones that health insurance companies traditionally have marketed to. As the 6 th entrant in a category with well-established players, ABHICL is creating differentiation and equity for itself though the unique business proposition of “Health Insurance for All”, a one of a kind proposition in India at the moment. This is a philosophy that is being built through every single consumer touch point and into every single backend process of the company to ensure a customer’s experience of our proposition is continuous and seamless.

ABHI’s unique offering to market includes proposition includes –

• A Comprehensive Incentivized Wellness Program that will attract the young and health conscious and will motivate, guide and reward them to stay healthy
• A Chronic Care Management Program to cater to the unmet needs of a growing Indian population of those suffering from chronic lifestyle conditions like Diabetes, Asthma, High Cholesterol and Hypertension from Day 1
• ABHICL serves as an enabler and influencer of health and healthcare choices that customers make, in addition to being a payer of healthcare expenses. Thus, ABHICL would act like a much needed catalyst to grow the prevalent health insurance landscape in India through product innovations and a wider choice of consumer relevant products.
• ABHICL’s vision has always been digital. The company has been successful in adopting paper-less approach right from identifying to on-boarding to delivering seamless experience of its customers & employees.

Key Challenges for the role –

• With changing lifestyle habits, following a set pattern for retail underwriting is becoming difficult. Hence each case may need to be reviewed individually as similar demographics & geographies no longer have similar medical history & background.
• Ensure seamlessness across different functions on which the team’s deliverables are dependent.
• Handling Customer grievance in view of miss-selling
• Technical System dependency in achieving the targeted TAT
• Key Result Areas: Write the key results expected from the job and the supporting actions for each of these key result areas (For a majority of jobs typically there could be 4- 7 key result areas)

Key Result Areas

Supporting Actions

Ensure adherence to UW guidelines

• Assisting in developing the underwriting guidelines for each product to achieve profitability.
• Aiding in carrying out regular market mapping to gain maximum market share along with maintaining profitability.

Quick and accurate underwriting decision ,maintaining high quality service, standards, meeting business targets

• Underwrite transactions authority limits within defined TATs
• Recommend decisions for transactions beyond authority limits
• Appropriate & timely resolution of escalations

System UAT

• System Requirements to be understood thoroughly
• Assisting in carrying out UAT to ensure the correct delivery of requirements
• Job Purpose of Direct Reports: Describe the job purpose of the direct report/s to the job (in 2-3 lines for each report)

Nil

• Relationships: Describe the nature and purpose of most important contacts or relationship (except superior/team members) with individuals, departments, organizations inside and outside of the organization, that job is required to interact with in order to deliver the job objectives

Relationship Type Frequency Nature

Internal

Sales

IT

Claims

Internal Audit Team

Provider Management Team

Product Team / Actuary Team

Need Based

Query Resolution

System enhancements/issues.

Clarifications / queries

Internal / External Audit

Queries resolution/General enquiry

New product development/launch related

External

Policyholders

Vendors

External auditors

Reinsurers

Need based

Conveying decisions/ query resolution

Recruitment of outsourced employees.

Sending audit reports

For facultative cases completion, Training & Audit etc

• Organizational Relationships: Provide the structure for a level above and below the position for which this job description is written. Use position titles in the structured and indicate all the reports of the position.

SIGN-OFF: Provide the name of the Manager and the jobholder. Signature needed for the hard copy of the JD. Hard copy to be maintained in the organizational record.

Job Holder

Reports to – Manager

Name

Signature (needed for the hard copy)