. Monitor KPIs and ensure service level agreements (SLAs) and regulatory timelines are met with TAT.
. Data management for TP claim and validations on regular basis, coordination with internal stakeholders
. Ensuring Quality Checks for all cases are completed within the specified turnaround time (TAT), maintaining adherence to deadlines and quality standards
. Publishing weekly dashboard to respective LOB’s for the QC done cases and sharing list of cases to rework
Ensure timely follow-up on rework cases according to
. Oversee thorough and efficient investigation of third-party motor claims (including property damage, bodily injury, and liability assessments)
. Ensure the accurate application of liability, indemnity, and policy coverage evaluations.
. Direct complex investigations, including staged accidents, organized fraud, and exaggerated claims.
. Fraud Detection & Prevention, Collaborate with Special Investigation Units (SIU), legal teams, and external stakeholders on suspicious and fraudulent claims.
. Implement anti-fraud strategies, data analytics, and red flag detection procedures.
. Liaise with third-party service providers (law firms, adjusters, garages), internal departments, and regulatory bodies through RTI, appeal
Key Responsibilities
. Ensure timely and professional communication with claimants, brokers, and third-party representatives.
Key Requirements :
. Bachelor’s degree in insurance, law, business administration, or a related field.
. Minimum 8 years of experience in motor claims, with at least 2–3 years in a managerial / supervisory capacity.
Technical Skills :
. In-depth understanding of third-party motor claims handling processes and insurance principles.
. Strong knowledge of liability laws, claims fraud indicators, and legal procedures.
. Proficient in claims management systems and MS Office tools.
. Excellent analytical, investigative, and problem-solving abilities.
. Familiarity with digital investigation tools available in market