Aditya Birla Health Insurance Company Limited

Basic Details: Fill the required information about business, unit, location, position, reports to position and date of updation of JD
Business
Health Insurance
Unit
Aditya Birla Health Insurance Company Ltd
Location
Mumbai
Poornata Position Number of the job
Reports to: Poornata Position Number
Poornata Position Title of the job
Reports to: Poornata Position Title
Function
Services Operations
Reports to: Function
Financial Service Operations
Department
Group Pricing
Reports to: Department
Group Pricing
Designation of the Employee
Team Member – Group Pricing
Designation of the Manager
Lead Group Underwriting
<ul>
<li>Job Purpose: Write the purpose for which the job exists (in 2-3 lines)</li>
</ul>
The purpose of this role is lead the team to assess, evaluate and accept risk based on evidence submitted and to ensure that the same is executed within the risk acceptance parameters as defined.
<ul>
<li>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.</li>
</ul>
No. of quotes in a day
20-25
Underwriting Authority
Upto INR 5 Crore
TAT
2 working days
Conversion rate
5%
Retention rate
60%
U/W Authority of LR
100%
<ul>
<li>Job Context &amp; 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</li>
</ul>
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 -
<ul>
<li>A Comprehensive Incentivized Wellness Program that will attract the young and health conscious and will motivate, guide and reward them to stay healthy</li>
<li>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</li>
<li>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.</li>
<li>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 &amp; employees.</li>
</ul>
Key Challenges For The Role
<ul>
<li>Group Underwriting pricing depends significantly on previous trends however in absence of an industry benchmark, while taking the policy most of the companies doesn’t furnish detailed information. Hence decision making depends significantly on negotiations and approximations.</li>
<li>Different clients have different employee base and the data formats are not uniform. Ensuring uniformity in quality &amp; maintain TATs of Underwriting decisions hence becomes a challenge</li>
<li>Frequent changes / modifications in compliance and regulatory requirements involves elaborate changes in policies, procedures and standards</li>
<li>Clients are not much knowledgeable about the wellness offerings, hence creating by in for additional pricing poses challenge.</li>
<li>Pricing of the policies in competitive market to build up topline &amp; at the same time, maintaining profitability</li>
<li>Structure the offerings which would be and value enhancers and create impact in the market</li>
<li>Meeting varied client’s expectation in terms of solutions, pricing and operational support</li>
<li>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)</li>
</ul>
Key Result Areas
Supporting Actions
Functional Area
<ul>
<li>Key Responsibilities</li>
</ul>
Role Summary
<ul>
<li>Provide strategic leadership in underwriting operations ensuring timely, accurate, and compliant decisions within defined TATs. Drive zero-error quality, strong stakeholder management, and continuous process improvement aligned with business and regulatory goals.</li>
</ul>
Underwriting Governance &amp; Decision Excellence
<ul>
<li>Deliver quick, accurate, and compliant underwriting decisions within authority limits while meeting TAT benchmarks</li>
<li>Recommend decisions beyond authority with strong risk and compliance rationale</li>
<li>Ensure error-free outputs and audit readiness</li>
<li>Manage escalations with timely and structured resolution</li>
<li>Review team decisions for quality, consistency, and TAT adherence</li>
</ul>
Stakeholder Management &amp; Business Alignment
<ul>
<li>Act as a central liaison between underwriting, sales, risk, compliance, and operations</li>
<li>Ensure clear communication and expectation alignment across stakeholders</li>
<li>Balance business growth with risk discipline</li>
<li>Align underwriting practices with market trends and competitive benchmarks</li>
</ul>
Quality Assurance, Compliance &amp; Risk Control
<ul>
<li>Establish and drive robust quality control mechanisms ensuring minimal errors</li>
<li>Ensure strict adherence to regulatory and internal compliance frameworks</li>
<li>Identify risk patterns, deviations, and control gaps</li>
<li>Foster a culture of accuracy, accountability, and continuous improvement</li>
<li>Job Purpose of Direct Reports: Describe the job purpose of the direct report/s to the job (in 2-3 lines for each report)</li>
</ul>
Junior Underwriter – Group
The role will be responsible for underwriting the assigned cases as per assigned limits within the defined timelines.
<ul>
<li>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</li>
</ul>
Relationship Type
Frequency
Nature
Internal
New Business &amp; Policy Administration
Legal/Compliance
Sales
IT
Claims
Internal Audit Team
Provider Management Team
Product Team / Actuary Team
Weekly
Need Based
Daily
Need Based
Need Based
Need Based
Need Based
Need Based
Escalation Resolution wrt Quote management, quote finalization / daily update
Legal &amp; compliance issue w.r.t to policies in Underwriting
Query Resolution, Quotes Reduction
System development /enhancements/issues / UAT / BRD
Updating w.r.t guidelines or resolving queries
Internal / External Audit
Queries resolution/General enquiry
New product development/pricing /launch related.
External
Brokers
Policyholders
Vendors
External auditors
Reinsurers
Need based
Need based
Annually or need based
Annually or Need Based
Need Based
Conveying decisions/ query resolution/Quote Conversion
Conveying decisions/ query resolution
Recruitment of outsourced employees.
Sending audit reports/ Periodic Audit
For facultative cases completion, Training &amp; Audit etc
<ul>
<li>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.</li>
</ul>
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 – Deputy Chief Manager
Name
Signature (needed for the hard copy)

Team Member Group Pricing

Team Member Group Pricing

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