Deputy General Manager - Claims - Life/Health Insurance

- Overall responsibility of managing Individual & Group claims function including rider/health claims. Position reporting to the Vice president- CSO. Ensuring that all eligible claims are paid accurately and speedily.

- Monitor the TATs / responsible for reporting claims statistics internally and to the Regulator.

- Managing/coordinating with other departments/investigators/vendors. Digitising the claims process.

- Oversees the claims process to meet strategical/operational/financial/service requirements.

- Keeping pace with necessary regulatory/compliance changes.

- Maintaining the industry best practices/ advancing in technological changes.

- Guide the team with respect to analyzing and interpreting medical documents and understanding diseases (their etiology, symptoms, treatment and prognosis)

- Coordination with external medical entities like doctors, clinics, pharmacies, hospitals and visits where needed

- Coordination with internal departments like Underwriting, Legal, AFT, BA as required in the process of each claim

- Coordination with external investigators

- Regular follow up on the pending claims (coordinate and communicate with branches, advisors and claimant for completion of documentation) and reporting on the same

- Maintain stricter TATs and reduce average claim processing time through various interventions.

- Review various key metrics to avoid any leakages at claims stage and provide timely feedback to various departments at every level to reduce outflow of claims.

- Responsible to arrange various timely business MIS internally and externally

- Coordinating with IT to implement new technologies/process improvements in claims process.

- Implement operational best practices with various process/financial controls