Assistant Manager – Claims

A leading life insurance company is seeking a dedicated Assistant Manager – Claims to join its core operations team in Mumbai. In this pivotal role, you will be responsible for the assessment and adjudication of individual death and rider claims. Furthermore, you will collaborate with investigation agencies and reinsurers to ensure fair and accurate claim decisions. Consequently, this position is vital for driving customer satisfaction while maintaining robust fraud mitigation standards across the organization.

The Assistant Manager – Claims must provide technical support in drafting requirements for claims automation and new product launches. Additionally, you will perform rigorous system testing and maintain detailed process documentation to support operational efficiency. Therefore, the company is looking for a professional with 3 to 4 years of experience in life insurance claims management. If you possess a medical background and high ethical standards, this Assistant Manager – Claims role offers a premier platform for career growth.

Key Responsibilities for the Assistant Manager – Claims

• Adjudicate individual death, rider, and group claims in strict accordance with policy terms and regulatory guidelines.
• Coordinate effectively with external investigation agencies and reinsurers to validate complex claim cases.
• Identify and highlight emerging fraud trends to protect the organization and its stakeholders.
• Support the drafting of technical requirements for claims system maintenance and digital automation projects.
• Perform comprehensive system-related testing to ensure all updates are completed within defined timelines.
• Manage the claims helpdesk and respond to queries from customers, partners, and sales teams.
• Prepare detailed MIS reports and maintain updated process documentation for the claims department.
• Address industry-related emails and technical queries pertaining to the end-to-end claim process.
• Liaise with internal departments including Legal, Compliance, Finance, and IT to resolve claim issues.
• Clearly demonstrate energy and perseverance toward achieving departmental goals and service standards.

Requirements and Qualifications

• Graduate or Post-Graduate degree (Medic or Paramedic backgrounds are highly preferred).
• Professional certification such as Licentiate, Associate, or Fellow from the Insurance Institute of India.
• Minimum of 3 to 4 years of experience specifically within the Claims Department of a Life Insurance company.
• Strong professional attitude with a proven ability to demonstrate high ethical standards.
• Excellent analytical and communication skills for handling complex claim adjudications.
• Ability to adapt and thrive in a dynamic, fast-paced corporate environment.

Key Internal Stakeholders

In this role, you will interact with various internal customers to enable success in your day-to-day work, including:

• Sales and Partner teams
• Customer Service and Finance
• IT, Legal, and Compliance departments

If you are a claims professional ready to drive the Assistant Manager – Claims function for a premier insurer, we encourage you to apply today!