Sr. Associate Claims

2 days ago

Bengaluru, Karnataka, India ACKO Full time ₹ 2,50,000 - ₹ 7,50,000 per year
About Job

The Life Insurance Group Claim Adjudicator is responsible for reviewing, analyzing, and adjudicating group life insurance claims in accordance with policy terms, company guidelines, and regulatory requirements. The role ensures timely and accurate assessment of claims while maintaining a high level of customer service and compliance. The adjudicator will work closely with internal teams, clients, and external partners to ensure efficient claims processing and resolution.

Skills & Qualification

  • Education: Bachelor's degree or equivalent

  • Experience: 0-2 years of experience in claims processing, data entry, insurance, or a related administrative

  • Technical Skills: Proficiency in Microsoft Office Suite (Word, Excel) and the ability to quickly learn and navigate claims processing software/systems.

Responsibilities

  • Review and assess group life insurance claims to determine eligibility, validity, and settlement amount based on policy provisions and documentation.

  • Verify claim documentation, including medical records, death certificates, employer statements, and other supporting evidence.

  • Coordinate with the investigation team when required to confirm authenticity and prevent fraud.

  • Ensure claims are processed within defined turnaround times and regulatory timelines.

  • Maintain adherence to internal quality standards and audit requirements.

  • Liaise with underwriters, reinsurers, and other internal stakeholders for complex or high-value cases.

  • Communicate claim decisions and rationale clearly to clients, intermediaries, and policyholders.

  • Support process improvement initiatives and contribute to the enhancement of claims procedures.

  • Maintain updated knowledge of insurance products, regulatory changes, and industry best practices.

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