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

MBC, Thane

Poornata Position Number of the job

Reports to: Poornata Position Number

Poornata Position Title of the job (30 characters max)

TM-DM-Grv & Endrm-GM-3-Thn

Reports to: Poornata Position Title

TL-SrCM-Grv & Endrm-GM-Thn

Function

Services Operations

Reports to: Function

Services Operations

Department

Grievance, Service Operations

Reports to: Department

Grievance, Service Operations

Designation of the Employee

Assistant /Deputy Manager Grievance

Designation of the Manager

Team Lead - Grievance

Date of writing/updation of JD

01 st May 2021

Job Purpose: Write the purpose for which the job exists (in 2-3 lines) (Max 1325 Characters)

The purpose of the role is to ensure timely and accurate customer resolution & responses to queries are provided which are received through emails & calls ensuring internal & external compliance in order to enhance customer satisfaction.

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.

Business Workforce Number

(Max 254 Characters)

3

Unit Workforce Number

(Max 254 Characters)

Function Workforce Number

(Max 254 Characters)

Department Workforce Number

(Max 254 Characters)

Other Quantitative and Important Parameters for the job: Budgets/ Volumes/No. of Products/Geography/ Markets/ Customers or any other parameter

Delta improvement in CSAT score

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 ((Max 3975 Characters)

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

Constant updation on process & procedural knowledge to Branch Support staff & Sales is required leading to increase of volume to Service Assurance finally affecting the productivity and efficiency of the team
Inter departmental dependencies for customer resolution
Manage unplanned spike in the volumes
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)- Maximum 10 KRAs can be updated

Key Result Areas (Max 1325 Characters)

Supporting Actions (Max 1325 Characters)

End to end grievance management

To handle all grievance to ensure a clear understanding in order to minimize any potential dissatisfaction, complaints and retention.
To handle grievance cases across outbound calling activities: Welcome calls, Upsell, Cross-Sell, Customer Satisfaction, Payment reminders and follow-up calls.
To meet and exceed call quality guidelines. It is essential that each and every call is conducted at highest standard.
To take ownership of customer problems and ensure they are resolved to the delight of the customer
To meet KPI's as agreed in the Service Level Agreements
To participate and involve and function within the team environment.
To develop and maintain an in-depth understanding of all products, services, promotions and campaigns offered
To maintain a good attitude and ability to maintain effective work behaviour in the face of setbacks of pressure within the grievance environment. Staying optimistic about all the products and maintain a high ethical standard, both personally and professionally
Complete understating of IGMS systems
Timely reporting of IRDA reports of complaints and grievance
End to End RCA and close looping of all complaints and grievances
To actively pursue retention/conservation opportunities by understanding cancellation requests from customers with a view to retaining their business.
To ensure that data entry is recorded in an accurate and timely manner. This will ensure that the appropriate information regarding customer's accounts is forward to the various departments allowing all changes to be made correctly
To participate in associated/relevant project work as and when required by the Inbound Customer Service Supervisor or the CS Contact Centre Manger
Job Purpose of Direct Reports: Describe the job purpose of the direct report/s to the job (in 2-3 lines for each report)

Executive/Sr. Executive – Grievance

The purpose of the role is to support in ensuring timely & satisfactory resolution to all customer queries & grievances inline with the SOP

The role is required to support the customer service & grievance team in ensuring timely execution of daily transactional & operational activities

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 (Max 80 Characters)Frequency Nature (Max 1325 Characters)

Internal

Corporate Operations (All teams)Sales/ Zonal Operations/ Compliance

Accounts

Regular

Regular

Resolution of Complaints & Queries

Payments

External

Courier companies

Shared Services

Need based

Dispatch of Documents & Cheques

Call Centre (Inbound/Outbound calls) activities

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)

Team Member - Grievance