Medical Underwriter

Ensure that the health underwriting guidelines are understood and implemented effectively by the team

§ Monitor loss ratios, severities, frequencies and identify any red flags, determine and implement relevant corrective actions

§ Support the team in assessment of underlying risk by gathering on-ground market pulse from external stakeholders (intermediaries) and by applying medical knowledge to ensure acquisition of genuine business.

Identify the profitable product segments, determine if product should be on the shelf or not; and if on shelf does it need price revisions; engage with product development team to modify existing products/ bring in new products.

§ Support technology upgrade of the underwriting system by helping to build the system logic and risk control measures; provide all the relevant data and inputs in the desired templates for technology implementations.

2. Risk Management

§ Conduct assessment of risk parameters associated with various health products as per defined underwriting guidelines to ensure coverage of future liabilities and minimization of loss ratios for BAGIC’s retail health business.

§ Provide underwriting inputs for the allocated region, review all escalation cases, legal cases and customer walk-ins.

§ Monitor the TAT of local underwriters and the performance of various intermediaries in the region.

§ Audit for a proportionate inflow of retail underwriting health business from new claims, renewals and portability claims and effectively manage risks by flag out deviations

§ Ensure that there is no straight pass provided for every case where there is a health declaration

3. Relationship Management:

§ Actively engage the intermediaries to maintain profitable working relationships and stay abreast of the latest developments in the sector.

§ Interact with internal stakeholders (Sales channels, Claims, Operations etc.) for back office support, to discuss various health products and risks that can be undertaken in compliance with regulatory requirements and to understand system performance feedback, claims experience of customers.

§ Train the internal teams/IMDs on underwriting guidelines, processes on a periodic basis

4. Audit, Review & Reporting

§ Audit 20% of the cases on a daily basis to ensure adherence to underwriting guidelines and SOPs

§ Review defined metrics periodically and strategize to take appropriate actions in case of any irregularity or variance in the performance.

§ Share periodic reports on product, IMD and claim performance with the Head Health underwriting

§ Monitor adherence of various processes in health underwriting to ensure compliance with regulatory requirements.