Senior Manager - Market Conduct

About the Role

The Senior Manager - Market Conduct at Aditya Birla Health Insurance Company Limited (ABHICL) is responsible for overseeing prevention, detection, and monitoring of sales and business practices with a focus on enhancing processes and controls in Market Conduct. This role promotes ethical compliance, company code of conduct adherence, and champions a zero-tolerance stance toward fraud and misconduct within the North Zone.

Company and Business Context

ABHICL, established in 2015 as a joint venture, aims to expand health insurance accessibility with unique propositions such as a comprehensive incentivized wellness program, chronic care management from day one, and a strong digital presence offering seamless experiences to customers and employees. The health insurance sector faces challenges with market competition and evolving customer needs, especially from SMEs and start-ups representing significant growth potential.

Key Responsibilities

• Conduct Anti-Fraud Awareness Training regularly for all North Zone employees to foster voluntary compliance.
• Perform branch visits and engage in training programs to cultivate a fraud-free culture.
• Engage regularly with Branch Managers, Field Leaders, and Advisors to promote zero tolerance to fraud and reduce business leakage and loss ratios.
• Lead thematic sessions targeting branches showing adverse trends.
• Organize Fraud Awareness Week activities to enhance vigilance and alertness.
• Coordinate annual compliance certification for all North Zone employees regarding code of conduct and organizational policies.
• Host monthly governance meetings with the North Zone leadership to review critical cases and improvements.
• Investigate cases from diverse stakeholders covering sales, finance, underwriting, claims, fraud, and operations.
• Monitor financial fraud, including employee reimbursements, premium misappropriation, and policy churning.
• Recover fraudulent amounts and manage reinvestigations of high-value claims and whistleblower cases.
• Assist other departments such as Legal, HR, and Supervisors in investigations and special projects focusing on high-risk areas and fraud trends.
• Benchmark to incorporate industry best practices and drive process improvements based on investigative findings.
• Ensure investigations comply with set turnaround times.
• Implement corrective actions on proven fraud cases, issuing show cause notices, and managing disciplinary proceedings in collaboration with HR and DOPS.
• Liaise with legal authorities to initiate police actions such as complaints or FIRs in critical cases.
• Maintain detailed investigation trackers and prepare regular reports, including monthly sales compliance decks and quarterly fraud monitoring and whistleblower reports for senior management and regulatory bodies.

Working Relationships

• Internal: Frequent interaction with all company functions to discuss market conduct related activities and execute function responsibilities.
• External: Coordination with investigators and vendors on a need basis for planning and conducting investigations.

Additional Details

• Reports to the Lead – Market Conduct (RLC-8).
• The role belongs to Legal, Risk & Compliance function and department.
• Job description last updated in February 2026.