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 6th entrant in a category with well-established players, ABHICL is creating differentiation and equity for itselfthough the unique business proposition of Health Insurance for All, a one ofakindpropositionin 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 propositionincludes -

• 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.

Challenges

• Sales queries resolution in agreed timelines
• Resolving Walk-in customer queries in time with satisfactory resolution
• Resolving Active agent's queries in time with satisfactory resolution
• Coordination with COPS for sales and customers query resolution
• Follow-up with sale for Issuance in agreed TAT
• Third party processing unite management
• Karvy processing management with utmost accuracy
• Coordination with Medi assist for arranging and smooth performing customers medical

4) Key Result Areas:Writethe 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)

Carry out the receipting process accurately of fresh applications and renewal premium within timelines as per the set process.

• Check applications/policies for payment.
• Issue receipts for fresh application andrenewal premium for individual, group and rural business.

• Send original applications & related documents to H.O. /other designated agencies.
• Follow the receipt cancellation process as & when required.

Carry out the banking and reconciliation process of policy cash/Cheque/DD as per guidelines.

• Generate report for cash and cheque collection from system and reconciliation with physical instrument
• Make accurate payment entry & system updation towards cash collections as and when cash premium is received.
• Deposit cash and cheques with authorized bank and file deposit slip.
• Co-ordinate with collection bank for any follow ups.
• Solve reconciliation queries from HO
• Inform H.O.-Banking team, if entire cash or cheque is not picked by bank/collection.

Handle petty cash and third party (vendor) and employee reimbursement as per guidelines.

• Check vendor's bill and process payment of vendors.
• Handover cheques to vendor on time
• Send petty cash requisition request to H.O.
• Keep petty cash within the specified limit.
• Maintain petty cash register
• Send EERS and TERS payment vouchers to H.O.
• Perform petty cash and vendor's ledger reconciliation.

Handle the Advisor's servicing in coordination with Distribution Management team as per guidelines.

• Hand-over commission cheque to AM/advisor
• Resolve commission queries of advisor in coordination with Distribution Management team as & when needed.
• Co-ordinate with Distribution Management team & commission team at H.O. for any discrepancy.
• Ensure timely receipts and hand-overofTDS certificate to advisors and dispatch the same to concerned team at HO

Handle the New Business log in at the branch as per the New Business and Underwriting guidelines to ensure high levels of input accuracy and support in enhancing the issuance to submission ratio.

• Log in applications at branch and scrutinize as per New Business and Underwriting guidelines in a timely and accurate manner.
• Scanning & In-warding of discrepant free applications for further processing & issuance.
• Dispatch and track applications/ supporting documents to vendor/ HO in a timely manner.
• Coordinate in facilitating medical management in coordination with sales force, PPMC team and medical service providers for faster medical tests by customers and faster movement of medical reports so as to reach underwriting team in least possible time.
• Highlight cheque dishonor, free look and cancelled applications to the sales force.
• Coordinate with head office process owners/vendors to facilitate faster decision and better internal / external customer service through faster issuance of policies.
• Support co- team members and sales force on new business and underwriting guidelines for smooth functioning of entire operations value chain
• Ensure local dispatch / hand delivery of undelivered policy documents forwarded to the branch.

Act as a SPOC between Customer and Head office to ensure speedy and quality customer service.

• Engage with the customer who walks in to the branch.
• Ensure 1^st contact resolution for customers service related requests and record & track those requests through prescribed systems and ensure closure in coordination with process owners
• Process / forward customers requests as per company guidelines and coordinate with Head Office / vendors as per the timelines prescribed to facilitate faster resolution.
• Track all branch level customers query and complaints and coordinate with Head Office Process owners for closure.
• Share feedback & suggestion received at branch to improvise customer service via channels specified by company.
• Visit customers as per directives of zonal / head office operations on need basis to resolve customer complaints / increase persistency.
• Scrutinize claim documentation as per set guidelines and coordination with sales force and claimant for speedy fulfillment of claim requirements.

Provide support in Customer Services & Persistency Management.

• Update contact details of policy holders and intermediaries in the system through coordination with sales force and customers during customer visits to the branch.
• Facilitate renewal collection in coordination with sales force by ensuring that renewal information reaches branch sales force.
• Participate in promotional activities for alternate mode of payments & initiatives on automated self help for customers.
• Manage of Operations related communication materials for facilitation of customer service & persistency initiatives.
• Facilitate servicing of No Advisor Policy by assigning such policies to retention team.
• Process policy reinstatement requests & process as per set guidelines.
• Participate in data cleansing exercise for both internal & external customers based on undelivered communications.

Handle MIS, process and document management pertaining to Operations & Accounts.

• Ensure safe custody and management of all policy related documents, tracking and record management.
• Ensure all existing and new operations processes are implemented and managed as per zonal operations guideline and are complaint to the internal audit guidelines.
• Prepare daily, weekly and monthly MIS such as daily collection report, accruals, petty cash report etc.
• Act as whistle blower from branch

Render sales support to Branch Head / Relationship Head to ensure smooth business Issuance.

• 1. Assist Branch Head to follow up for New Business Application requirements with the sales force of the branch