Claims end-end
7 days ago
Candidate Specification & Job Description:
- Excellent communication skills with 8+ years of work experience
- Individual contributor roles are acceptable
- Strong knowledge of insurance claims (General Liabilities, Auto/Motor & Direct)
- Candidates with experience in Subrogation total loss, admin team, Property & Casualty, or Health Insurance are not preferred
- Review and validate claims submissions for completeness and eligibility
- Capture claim details accurately in the system, ensuring proper documentation
- Coordinate with policyholders, agents, or brokers to obtain necessary supporting documents
- Evaluate claim merits based on policy terms and conditions
- Liaise with surveyors, investigators, hospitals, or repair vendors for fact verification
- Identify potential cases of fraud or misrepresentation and escalate appropriately
- Determine liability and admissibility in line with underwriting guidelines
- Calculate claim amounts, applying sub-limits, deductibles, and exclusions where applicable
- Ensure adherence to internal SLAs and regulatory timelines
- Prepare claim settlement letters and process payments
- Communicate claim decisions (approval/rejection) with clarity and empathy
- Maintain complete documentation for audit and compliance purposes
- Act as a single point of contact for claim-related queries and escalations
- Collaborate with internal teams (Underwriting, Legal, Finance, Customer Service) for resolution
- Drive customer satisfaction through proactive updates and transparent communication
- Ensure adherence to IRDAI and internal compliance policies
- Identify process gaps and contribute to claims automation and digitization initiatives
- Analyze claims trends to recommend improvements in risk management and policy design
- Flexible with Shifts.
Contact Person - Hemalatha
Email-
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