- 3+ Years of experience in Life Insurance preferably from Claims background.
- Graduate with Computer Proficiency with Insurance background
- Meet the TAT stipulated by the regulator
- To assess the claim and come up with a recommendation based on the given facts.
- System enhancements and test result validations
- Preparation of MIS
- Providing requirements for system related enhancements
- Scrutiny of Claim Eligibility, assessments.
- Follow up on claim Documents / Investigation Reports
- Checking the correctness of claim amount calculations vis a vis product benefits
- Timely Processing Claims in line with company TAT’s and KPI’s for settlement / repudiation
- Maintaining Claims statistics and analysis in respect to Claims intimated, settled, pending and pending for investigation. Preparing MIS Reports.
- Preparation of Repudiation note for approval. Repudiation letter draft sent to legal for approval.
- Claim Record Maintenance (hard copy and scanned soft copy) as per guidelines
- Identify problems if any in Life 400 and complete necessary form for intimation to IT. Discuss enhancements if any with seniors. Coordination with MOT
- Investigator Empanelment and Review
- New Initiatives to improve claim processing
- Claims investigations and fraud identification.
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