The Digital Insurer Award - Max Bupa Health Insurance

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Underwriting Engine
by
Max Bupa Health Insurance

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Traditional Underwriting process:
Customer purchases a policy journey
Goes to underwriter who can take one of the following
decisions
Accept and issue the
policy
Ask for Additional
Premium
Reject the
application
Customer can pay the
additional payment and get
the policy issued
Customer can reject and
the case gets closed.
Customer is told about
the additional premium

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40% NSTP cases
Underwriting is manual process, error
prone
10% Rejection
For 90% not
rejected
• Each case costs about INR 500-700 in underwriting costs
• Refunded over 20 Days
• Additional premium irritates customers
• Cancellations are higher
• Policy issuance takes about 7-10 Days

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Customer Experience is Super bad
Policy Issuance is not clear
• Whether the policy will be issued or
not
• If there will be any change in
premium
Policy issuance takes time:
• Policy issuance takes 7-10 days

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Underwriting Engine: The concept
• So, Max Bupa planned to put the underwriting process upfront to
the customers.
• The customer is asked medical questions upfront in the journey.
• Basis the declarations, a complex underwriting engine decides
the decision to be made.
• In case of additional premium, the premium is added to the base
premium and a complete premium is charged.

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Underwriting engine: Patent Pending
Technology & Process
• Huge set of analytics went into the same to
identify the declarations made and the rules
associated with it. The rules are a complex set of
combinations of various diseases and their
parameters such as drug level, recency, status,
and frequency among others.
• So, the rule engine uses a highly sophisticated
analytical method to identify the loading to be
applied.
• Apart from this, Underwriting engine is highly
scalable to incorporate different products and
their complicated conditional scenarios.

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Impact on Customer experience
• The Rule Engine solves both the issues by
providing underwriting decision upfront at the
time of policy purchase itself and the customer
only pays if the Underwriting process accepts
the case.
• Apart from this, in case any additional payment
needs to be made due to declarations, the
customer is shown upfront and the overall
payment is made thus improving customer
experience.

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Max Bupa costs savings
• The policy is getting issued instantly with the
implementation of Rule Engine which has saving of
about 70Lac during the POC phase. Overall savings of
over INR 2 crores is expected using the same engine.
• Apart from this, there used to be significant errors in
application logging and issuance. During the medical
disclosure, multiple wrong information used to be
passed along with the correction and rejections of
the same. Now these errors have reduced to
negligible thus additional savings of INR 2 crores.

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Thank You