Job Description

Evaluating and examining of all Retail product applications for health insurance coverage. In reference to the applicant’s medical history, assess and determine terms for risks presented within set standards of service in a manner to ensure quality selection of risks and timely service.

KEY TASKS AND RESPONSIBILITIES

• Review all new applications for Retail product prior to onboarding which shall cover the following aspects:
• Acceptance/Decline of standard terms & premiums.
• Prepare acceptance letters. Indication of exclusions.
• Enforcing waiting periods.
• Enforcing premium loading.
• Review of renewing policies which shall cover the following:
• Loadings applied for renewal members.
• Approval of Downgrade or Upgrade of cover limits or benefits.
• Prepare renewal cover terms when there is a change.
• Ensure the above information is captured on SharePoint for filing and ease of access.
• Determine acceptability of risks, recommend risk surveys, monitor and review terms of acceptance.
• Check proposal form / underwriting document to authenticate it.
• Prepare and follow up renewal notices to ensure retention.
• Ensure that premiums are paid in respect of benefits & limits chosen.
• Maintain effective business relationships to ensure effective delivery of service.
• Monitor service standards within the section to ensure high quality customer.
• Acquisition and enhance health loss ratio.

SKILLS AND COMPETENCIES

Education

• Bachelor’s degree in a clinical or medical field (e.g., Medicine, Nursing, Clinical Medicine, Pharmacy, Public Health or related discipline).

Experience

• At least 1 year of experience in clinical underwriting, medical risk assessment, or a related health insurance role.

Professional / Insurance Qualifications

• Possession of or active enrollment in a recognized insurance certification such as:
  • ACII (Associate of the Chartered Insurance Institute)
  • Diploma/Certificate in Insurance (e.g., CII, IIK or equivalent)
  • LOMA or other relevant underwriting/insurance programs
• Progress toward professional underwriting or insurance qualifications is an added advantage.

Technical Competencies

• Strong understanding of medical terminology, diagnosis, and treatment protocols.
• Knowledge of underwriting principles and risk assessment in health insurance.
• Familiarity with policy terms, exclusions, and benefit structures.

KNOWLEDGE & EXPERIENCE

• Analytical and decision-making skills.
• Attention to detail and accuracy.
• Ability to interpret medical reports and documentation.
• Good communication and stakeholder management skills.