Team Member-executive Claims Legal

4 days ago

Rajarhat Kolkata West Bengal, India bajajallianz Full time

**Claims Management (Approvals)**:

- Once a High Value Claim, Super High Value Claim or Critical Claim is registered and intimated, review the petition and suggest/approve the appropriate reserve as well as course of action to the execution team as per the TAT.
- Authorize a suitable reserve amount for the claim; review and modify the reserves for the case based on updated case facts & inputs from execution team.
- On receiving the investigation report in HVCs, SHVCs & critical claims, suggest a line of action for defense cases or suggest limit for compromise amount after discussion with senior authorities as per financial limits.
- Scrutinize all the documentation pertaining to the cases that are referred to the team to ascertain the veracity of the claim made.
- Suggest appeal for quantum and negligence cases; send it to the appeal team with an opinion on the same after discussion with senior authorities as per financial limits.
- Get approvals/approve all interim payments - pertaining to third party payments, advocate fees, claims payments; also decide on whether to appeal a particular interim order or not.
- Once a final award is submitted, review and approve the payment of claims or get the payment approved from seniors as per financial authority.
- **Review & Reporting**:

- Conduct quality checks on claims processed by reviewing case details and suggest process and /or strategy improvements that could be undertaken and noted for future reference in all HVCs.
- Study and prepare case study on HV claims, SHVCs and critical claims that could have been contested better/ could be approached in a better way by noting lacunas.
- Share regular and periodic reports on the above findings with the team leader & VH as well as all relevant stakeholders.
- Review the MIS on an on-going basis for claims closure, settlement ratio for the allocated region.
- **Relationship Management**:

- Collaborate with the execution team, LPU team & other members of approval team to determine whether the case should be contested/compromised in court; in case any significant stage in strategy, share the updated line of action.
- Provide recommendations to Team Members w.r.t cases and guide them as and when required.
- **Process Improvement & Knowledge Enrichment**:

- Keep abreast with the Judicial Changes and strategize the claims management accordingly.

**Mandatory Skills**:
Industry Understanding & Competitive Awareness; Claims Assessment; Communication

**Education/Qualification**:
Graduate/Post Graduate

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