Pankaj Pawar, Fiii, Cert Cii, Pgdm Email & Phone Number

Dammam, Eastern, Saudi Arabia

• Extract and manage comprehensive data related to the medical portfolio, providing actionable insights to the Head of the Department through detailed dashboards and reports.
• Providing key inputs related to Key Result Area of product performance and providing suggestion for further improvement. It includes suggestion to revise Product features, Marketing Strategy and Price mechanism.
• Gathering market intelligence and play a key role in product design and development, ensuring that products meet the needs of customers and are competitive in the marketplace.
• Prepare all necessary regulatory reports, reinsurance reports, and actuarial data information for medical underwriting and claims, ensuring compliance and accuracy at all times.
• Review and analyze the medical claims cycle, identifying any gaps & inefficiencies and providing regular feedback to the Head of the Department and claim team
• Creating detailed policy performance reports for top clients, providing feedback and recommendations for improvement to both the Head of Medical and clients.

Dammam, Eastern, Saudi Arabia

• Evaluate and analyze medical business risks and determine premium rates for medical insurance policies.
• Collect and analyze information from IMCM (In-House TPA) for settled claims, outstanding claims, and IBNR information to compute renewal/new quotation data through actuarial medical pricing parameters by age band.
• Assess documents sent by clients/brokers for quotation for group health insurance for large and medium groups, including obtaining verification of documents and further processing flow.
• Coordinate with the Re-Insurance Department for monthly reporting of Bordeaux and handling reinsurance queries pertaining to underwritten business.
• Analyze loss ratio and overall policy performance on quarterly, providing feedback to clients on a regular basis.
• Prepare Claims Experience Report Forms upon client requirements on claims experience for renewal policies according to the regulator format and procedure.

Dammam, Eastern, Saudi Arabia

• Verifying the quotation and issuing the policy as per policy terms, condition and compliance of regulatory.
• Coordinate effectively with clients to process future endorsements and ensure accurate data uploading in CCHI.
• Process endorsements (additions, deletions, status change or corrections) by screening and verifying required documents and issuing timely endorsement confirmation or new membership cards to client.
• Maintain accurate records of all documents relating to underwriting in hard copies and on the system.
• Maintain and update the policy register tracker and ensure the workflow is conducted as per the agreed timelines.

Mumbai, Maharashtra, India

• Collecting information about claim form insured for delegation of surveyor
• Deputing the surveyor with co-ordination with corporate office
• Scrutinizing the claim lodged by the client & Verifying the claim document
• Claim registration & Documentation
• Co-ordination with surveyor and insured for finalization of survey report
• Co-ordination with corporate office for settlement of claims

Mumbai, Maharashtra, India

• Data compilation and updating database from Insurance companies.
• Verification of data downloaded from e-mail sent by Insurance companies and managing of file as per requirements to avoid duplication.
• Communicate with Insurance Companies offices when deficient and in complete data are forwarded to us.
• Reconciliation of premiums uploaded in database on day to day basis.

Fellowship, Insurance

Cert Cii, Insurance

Master'S Programme, Post Graduate Diploma In Management, Specialization Banking, Investment & Insurance

Bachelor Of Commerce - Bcom, Financial Accounting And Auditing

Ifce, Insurance