Eric Baluya
Senior Claims Expert in Center of Competence Life and Health @Allianz
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WORK HISTORY
Senior Claims Expert in Center of Competence Life and Health @Allianz
Munich, DE
As a Senior Claims Expert, I have developed and implemented Functional Rules and Guidelines for Life & Health Claims Management that will focus on supporting a sustainable and profitable Life & Health business, establish a consistent approach to Claims Management and treating our customers fairly. This includes: Expert consultant navigating EU\'s Right to be Forgotten (RTBF) for cancer survivors, driving compliance and resilience in our Life and Health businessImplement agreed Claims KPIs for the purposes of ongoing OE monitoring against the Claims Maturity ModelImplement CLH Anti-Fraud Standards for Claims Management and monitor associated KPIs Provide expert content (e-learning and training modules) for the Claims modules of the Life & Health Academy and conduct the Silver and Gold Level Classroom trainingsConduct regular Claims Closed File Reviews (CFRs) based on proven technical audit techniques with the view to assess and benchmark Claims assessment expertise across the Group and ensure OE authority levels are appropriate and reflect the skills and abilities of the local expertsDevelop and lead the Underwriting & Claims Expert Community (UCC) community; pro-active communication through various platform; web-ex meetings and discussions; curating topics and post for the expert community pageResearched and advised on claims automation and digital anti-fraud tools, leading a global implementation project. Integrated AI and Generative AI to enhance fraud detection and efficiency while ensuring compliance with the EU AI Act. Collaborated with stakeholders to drive AI-driven strategies and foster partnerships.Review and provide input into new OE protection product launches; Participate in innovation discussions and working groups on new proposition developmentManage collaborative OE projects to implement best practice processes, guidelines and technical expertise in Life & Health Claims Management this includes best practice sharing from the OEs
EDUCATION
Western Visayas Medical Center
Internal Medicine Residency Program
Iloilo Doctors' College - Molo, Iloilo City
Doctor of Medicine (M.D.), General Medicine
Iloilo Doctors' Hospital
Internal Medicine Residency Program
University of San Agustín
Bachelor Degree, Medical Technology
Post Graduate Internship The Doctors Hospital
Bachelor's degree, Medicine
ABOUT ERIC BALUYA
Insurance Medicine expert on Operations on Global Life and Health with clinical experience as an Internal Medicine specialistSignificant operational experience in a multinational environment with the business acumen of managing multiple initiatives in a diverse business environment across a cross-functional team that delivers resultArea of expertise: Claims automation, Process optimisation, Strategy, Fraud Management and Innovative products and solutionSpecial interest in Genomics, Precision Medicine, Oncology, Cardiology, Endocrinology, and Orthopaedics.
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