Improving underwriting efficiency, compliance and capacity

Effective underwriting is key to health insurance success. Retail medical underwriting requires carefully evaluating the complex personal, social and clinical profile of a proposer to ensure appropriate risk selection. Maintaining consistency and accuracy is key. Our experienced clinical consultants conduct operational audits that include on-site visits, staff interviews, SOP reviews, file audits and decision support system reviews. We help you answer questions such as:

• Are underwriting practices aligned with business strategies?
• How does underwriting referral criteria, medical test grids and decision metrics compare against peers in the market?
• Are the UW practices consistent across personnel and compliant with protocols, regulation and best practices?
• How can you ensure efficiency and accuracy in the underwriting process in line with risk appetite?

By assessing consistency and rigour in your underwriting practices and systems, we identify opportunities for efficiency, automation and compliance with India’s legal and regulatory requirements. We help in building capacity through training, formulating an underwriting approach and automated risk assessment process development.