Ehetsham Ul Haque

Accomplished health insurance executive with 15+ years of progressive experience in medical underwriting, health claims management, operational leadership, and cross-functional stakeholder engagement. Currently serving as North India Head – Health Administration & Claims at Bajaj Allianz General Insurance, overseeing underwriting strategy, claim adjudication, loss control initiatives, and compliance across North India.

Holds

Executive MBA from IIM-Kolkata, with robust clinical background (B.H.M.S.), and certified by the Insurance Institute of India. Combines medical expertise with a data-driven approach to enable underwriting precision, process efficiency, and enhanced customer experience in a highly regulated industry. Geographically flexible and willing to relocate based on organizational needs.

Head-North India, Health Administration Team (HAT) at Bajaj Allianz General Insurance Co. Ltd. (2016-10 – Present)

Lead underwriting operations and claim governance for health, personal accident, and group business across North India.

• Lead underwriting operations and claim governance for health, personal accident, and group business across North India.
• Manage a team of medical underwriters and claim processors, ensuring adherence to guidelines and minimal error audit scores.
• Define and execute loss control strategies via agent, hospital, and product performance analytics.
• Collaborate with actuarial, sales, and operations teams to align underwriting outcomes with business goals.
• Spearhead medical underwriting using proposal forms, tele-interactions, medical reports, and historical records.
• Interfaced with the IRDAI on compliance, audit responses, product filings, and underwriting justifications for declined or high-risk cases during regulatory reviews.
• Managed escalated customer complaints and queries forwarded through the IRDAI Integrated Grievance Management System (IGMS) ensuring adherence to response timelines and resolution quality standards.
• Represented the underwriting department in insurance ombudsman hearings, preparing detailed medical and contractual responses, and facilitating settlements in line with legal and policy frameworks.
• Conduct ongoing training for channel partners and branch staff; act as SPOC for medical queries across the zone.
• Standardize underwriting protocols and improve turnaround time through digital enhancements and SOP optimization.

Manager – Medical Underwriting at Max Bupa Health Insurance Ltd. (2013-01 – 2016-10)

Independently underwrote retail and group health insurance policies and led tele-underwriting operations.

• Independently underwrote retail and group health insurance policies up to ₹1 crore sum assured.
• Led tele-underwriting, renewal risk assessment, non-disclosure handling, and claims support.
• Oversaw underwriting audits, authority level compliance, and team-wide quality initiatives.
• Delivered customer resolution on escalated cases (declines, exclusions, reconsiderations).
• Played a pivotal role in launching and underwriting Bancassurance and Telesales verticals.

Sr. Executive – Medical Records Summarization & IPR Reviewer at EXL Services Pvt. Ltd. (2010-07 – 2012-12)

Reviewed and summarized U.S. claimant records for legal teams and managed quality control for team of associates.

• Reviewed and summarized U.S. claimant records for legal teams, identifying injury types, fraud, and treatment discrepancies.
• Acted as In-Process Reviewer for a team of 20+ associates; trained new recruits and reported quality metrics.

Medical Consultant (Internship) at Bakson's Centre for Allergy (2009-09 – 2010-05)

Managed case-taking, diagnosis, and treatment planning for allergy patients.

• Managed case-taking, diagnosis, and treatment planning for allergy patients; contributed to operational support.

Executive MBA in Management – Indian Institute of Management (IIM) – Kolkata

B.H.M.S. in Homoeopathic Medicine – Nehru Homoeopathic Medical College & Hospital, University of Delhi (2004 – 2010)

Associateship in Insurance – Insurance Institute of India