Abhijeet A Kudre
Vertical Head- Technical Health , Personal Accident And Travel Claims
Pune
Summary
Professional with strong leadership skills and proven track record in management. Expertise in strategic planning, financial analysis, and risk management. Effective team collaborator with focus on achieving results and adapting to changing needs. Known for reliability, integrity, and exceptional problem-solving abilities.
Overview
3
3
Language
4
4
Certifications
22
22
years of professional experience
Work History
Assistant Vice President
Bajaj Allianz General Insurance Co Ltd
07.2005 - Current
- Technical Vertical Head of Health Claims - Cashless and Reimbursement Claims Team, and Customer Care Management.
- Implemented a comprehensive loss control strategy, resulting in a reduction of claim leakages, and improved claim ratio and average claim size.
- Analysis of the claims data and implementing various strategies for controlling the loss.
- Claims Mobile App - Creating and modifying in the app as per customer and partner requirements.
- Designing the Claims Module according to the policy coverage of the product.
- System integration with vendors for various outsourced services.
- Negotiation with the vendor for health-related services.
- Proposal Clearing – Procurement Team, Legal, and Compliance.
- Handling and Managing Audit: IRDA, ISO 9001:2015, Half-Yearly Statutory Audit, and Internal Audit.
- Created and monitored exceptional reports to control claim leakages.
- Assessment Claims Approval Group and Retail Medical Claim, Personal Accident, Additional Benefits Policy: Hospital Cash, Critical Illness, Loan Protection, EMI Option, Loss of Income, Transportation, Transportation, Funeral, and Education Benefit.
- TAT - Monitoring and maintaining the least TAT for claim settlement.
- Addressed and resolved customer grievances to improve satisfaction.
- Coordinated with relationship managers, corporate clients, brokers, and hospitals to gather feedback and address complaints about claim services.
- Conducting training and sessions for implementing the process and newly launched products.
- Handling various projects based on the company’s initiative.
Trainee (Hospital Empanelment)
TTK Healthcare Services Pvt Ltd
10.2004 - 07.2005
- Coordinated with hospitals and divisional offices to address client queries, and facilitate timely settlement of claims.
- Coordinated with headquarters to issue Medicards for clients.
- Cost negotiation with the hospital.
- Conducted weekly visits to hospitals to follow up on outstanding payments, strengthening relationships, and facilitating smoother transactions.
- Maintaining updated MIS for hospitals on a weekly basis.
- Negotiated costs with hospitals to secure favorable rates.
- (TTK, being a licensed TPA (third-party administrator), processes and settles Medi Claims on behalf of all leading insurance companies, which include both public and private sectors.)
- Attended training courses to build understanding of processes, techniques, and industry.
Education
Bachelor in Computer Science - Computer And Information Systems
H V Desai College
Pune, India 04.2001 -
HSC - Science
Nowrosjee Wadia College
Pune, India01-2001
SSC - School
Abbasheb Atre English Medium School
Pune, India01-1999
Skills
Claims Management
Claims Transformation
Claims Operations
Regulatory compliance
Data analytics
Data Visualization
Software applications
Internet security
Accomplishments
- Won the Hackathon Competition 2025-26 for Innovative Ideas through Co-Pilot.
- Successfully handled 2 IRDA Audits and Multiple Internal Audits. 2020-21 and 2025-26
- Spearheaded the integration of systems modules with external vendors – Document Identification (Forgery, Tampering, Duplication, QR Code and Similarity)- 2024-25
- Excellence Award for handling pandemic Claims 2020-21
- Extraction of billing data from hospital Bill and converted in the structured data and Non-Medical Deduction. – 2019-20
- Co-insurance loader for the co-insurance claims 2018-19
- Developed and Implemented the Claims Mobile App and Digital Portal for Digital Claim processing for Customer and Partners. - 2016-19
- Designed and Integrated claims module aligned with policy teams and conditions.- 2015-16
- Developed and Integrated a Health Claims Module for the Retail Health Claims – Imaged Based, AI and ML based System.- 2013-14
Certification
Licentiate Exam passed from Insurance Institute of India.
Interests
Playing Cricket, Traveling, Watching News and Reading Books
Timeline
Certified Course of Auditor from DNV for ISO 9001:2015
06-2021
Fellowship Exam passed from Insurance Institute of India.
06-2018
Associated Exam passed from Insurance Institute of India.
05-2013
Licentiate Exam passed from Insurance Institute of India.
01-2009
Assistant Vice President
Bajaj Allianz General Insurance Co Ltd
07.2005 - Current
Trainee (Hospital Empanelment)
TTK Healthcare Services Pvt Ltd
10.2004 - 07.2005
Bachelor in Computer Science - Computer And Information Systems
H V Desai College
04.2001 -
HSC - Science
Nowrosjee Wadia College
SSC - School
Abbasheb Atre English Medium School
Personal Details
Date of Birth :- 4th December 1983 Gender :- Male Marital Status :- Married Date: 25-Aug-2025 Place: Pune
Self - Evaluation
Conceive self as ambitious go-getter. Inculcated with an element of sensivity, self-discipline & adaptability
Language
English, Hindi and Marathi