Head of Insurance Operations & Compliance

Position : Insurance Operations & Compliance Manager & Founder Mentor

Industry : Insurance (Health / Motor / Life / General – flexible)

Experience : 5–7 Years

Engagement : Full-time

Location : India (Remote)

Start Date : Immediate

Key Responsibilities

Set up and manage day-to-day insurance operations (policy issuance, endorsements, renewals, cancellations, claims coordination, etc.)

Draft, review, and maintain policy wordings, proposal forms, schedules, SLAs, broker agreements, and basic reinsurance contracts

Build and manage the policy administration process – from proposal to policy issuance, documentation, and post-issuance servicing

Coordinate with insurers, reinsurers, brokers, TPAs, aggregators, corporate clients, and individual clients

Design and implement SOPs, workflows, and basic KPIs for enquiries, quotations, underwriting referrals, policy issuance, endorsements, claims handling, and collections

Ensure regulatory compliance with local insurance regulations (e.g. IRDAI / local regulator), including documentation standards, onboarding KYC, and reporting requirements

Implement basic internal controls to avoid mis-selling, unauthorized discounts, policy backdating, and manipulation of premiums or claims

Support / guide in product development : features, exclusions, premium structure, and documentation for new products or schemes

Set up simple MI / reporting dashboards for :

Policies issued, endorsements, renewals, and lapses

Premium written vs. earned, claims ratio, and basic profitability per product / client

Collections, outstanding premiums, and credit control

Coordinate with accounts / finance for premium collections, reconciliations with insurers, commissions, and TDS / GST / VAT-related aspects

Assist in vendor and partner onboarding (TPAs, brokers, agents, tech vendors) with proper documentation and checks

Support future team building (policy admin, claims desk, customer support, maybe sales support) as the business grows

Required Expertise

5–7 years of experience in insurance operations / underwriting / policy administration / claims with an insurer, broker, TPA, or large corporate with in-house insurance desk

Strong working knowledge of at least one or more lines :

Health insurance (retail / group)

Motor insurance (retail / fleet)

General insurance (property, liability, marine, etc.)

Life insurance exposure is a plus but not mandatory

Solid understanding of :

Policy structures, coverage, exclusions, deductibles, co-pay, sub-limits, waiting periods

Underwriting guidelines and when to seek approvals / referrals

Claims processes – FNOL, documentation, assessment, repudiation, approvals, and TATs

Local insurance regulations and basic compliance requirements

Experience in end-to-end case handling from proposal / quote to policy issuance and claims coordination

Prior exposure to corporate / group policies and international or cross-border clients is a plus

Founder Mentoring Responsibilities

Train and mentor the founder on :

Basic insurance fundamentals – how products are structured and what really matters in coverage

Pricing logic and premium structures – risk-based pricing, loadings, discounts, NCB, experience rating (for group)

How claims ratios, loss ratios, and combined ratios affect pricing and negotiations with insurers

How fraud, leakage, and misuse can happen in insurance :

Fake claims / inflated claims

Misuse of group policies

Unauthorized discounts / off-the-book deals

Manipulation of backdating, endorsements, or coverage details

Designing controls to prevent fraud, margin leakage, and mis-selling

How to read and compare policy wordings and find hidden gaps or exclusions

Help the founder to shadow calls and emails with insurers, brokers, and clients to understand the business practically

⚙️ Technical & Management Skills

Comfortable using insurance core systems / broker portals / policy admin systems / CRM

Strong MS Excel / Google Sheets skills for rate comparisons, premium calculations, and simple dashboards

Ability to design simple but robust SOPs and checklists for :

New policy issuance

Endorsements and renewals

Claims intake and documentation

Compliance and documentation checks

Good understanding of credit risk related to premiums, collection cycles, and insurer payment terms

Strong analytical mindset for product comparison, margin protection, and basic portfolio performance tracking

Familiarity with compliance, KYC / AML basics, and regulatory documentation standards

✅ Ideal Candidate Traits

Operator + teacher mindset – can run operations independently while patiently explaining concepts to a non-insurance founder

Comfortable letting the founder shadow calls, negotiations, and day-to-day operations

Hands-on, detail-oriented, and comfortable working in a zero-structure, startup environment

Transparent and ethical , with a strong focus on clean deals, documentation, and regulatory compliance

Strong ownership mentality – treats the business as their own and is willing to build the foundation for future scale