Settlement Claims Professional

6 hours ago


Tiruchi, Tamil Nadu, India beBeeInsurance Full time ₹ 90,00,000 - ₹ 1,20,00,000
Job Title: Insurance Claim Settlement Specialist

We are seeking an experienced professional to manage the entire claims settlement process from submission to final resolution.

  • Main Responsibilities:
  • Claims Processing: Handle the entire claims process, from reviewing submitted documentation to determining eligibility based on policy coverage.
  • Data Analysis: Analyze data according to provided standard operating procedures (SOPs) to ensure accurate and efficient claim handling.
  • Claim Validation & Investigation: Conduct thorough investigations by collecting relevant data, conducting interviews, and working with adjusters and external experts to verify claim validity.
  • Client Communication: Keep policyholders and agents informed on the status of claims, provide clarity on coverage decisions, and guide them through the settlement process.
  • Settlement Negotiation: Negotiate settlement amounts with claimants and third parties, ensuring that settlements are fair, within policy limits, and compliant with legal standards.
  • Documentation & Reporting: Maintain detailed records of claims processing activities, including assessments, investigation reports, and settlement documentation.
  • Fraud Detection: Identify and flag potential fraudulent claims, collaborating with the fraud investigation team when necessary.
  • Compliance: Ensure all claims are processed in adherence to industry regulations and legal requirements.
  • Coordination with Legal Team: Collaborate with the legal team on disputed claims or cases involving litigation to ensure proper handling.
  • Customer Service: Deliver exceptional customer service by addressing claim-related inquiries, resolving disputes, and ensuring a smooth claims experience for policyholders.
  • Continuous Improvement: Recommend improvements to enhance efficiency and reduce claims processing time.

Key Qualifications:

  • Strong understanding of insurance policies, claims processes, and regulatory requirements.
  • Proven negotiation and conflict resolution skills.
  • Ability to analyze complex claims data for fair settlement decisions.
  • Strong communication skills, both verbal and written.
  • Attention to detail with excellent organizational abilities.
  • Ability to work independently and manage multiple claims simultaneously.


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