01Key Responsibilities
Manage and oversee the complete claims lifecycle for commercial insurance products including WC, Fire, Marine Cargo & Hull, Engineering, Liability, and other corporate lines.Review, evaluate, and authorize claims in accordance with policy terms, underwriting guidelines, and regulatory requirements.Act as the primary point of contact for corporate clients, insurers, surveyors, TPAs, advocates, and other stakeholders.Ensure accurate documentation, timely follow-ups, and effective coordination with insurers for prompt claim settlements.Handle complex, high-value, and disputed claims, including negotiations and escalations with insurers and service providers.Provide guidance and mentoring to the claims team, ensuring adherence to internal processes and service benchmarks.Identify potential fraud, red flags, or policy breaches and coordinate investigations where required.Collaborate closely with underwriting, legal, finance, and compliance teams to resolve claims efficiently.Monitor claims TATs, settlement ratios, and service quality; prepare MIS, dashboards, and periodic reports for management.Ensure compliance with IRDAI regulations, policy conditions, and internal governance standards.Drive process improvements, automation initiatives, and best practices to enhance operational efficiency and client satisfaction.Qualifications & Experience:Proven experience in commercial insurance claims management, preferably in a brokerage, insurance company, or TPA.Strong hands-on expertise in claims related to WC, Fire, Marine, Engineering, and other corporate insurance lines.In-depth understanding of policy wordings, endorsements, exclusions, and claims documentation.Excellent analytical, negotiation, and problem-solving skills.Strong communication and stakeholder management abilities.Proficiency in claims management systems and Microsoft Office Suite.Ability to manage multiple claims, deadlines, and team responsibilities in a fast-paced environment.Sound knowledge of insurance laws, IRDAI regulations, and industry best practices. .
