Head - Claims - Insurance

This role is responsible for the smooth operational functioning of the health claims function, involving, all claims viz. health indemnity, health benefit, critical illness, travel, and accident & disability.

- Development and publication of adjudication guidelines to the processors for standardization

- Pay and process claims within designated authority level.

- Recruit, empower, plan and lead the claims operations team of the hubs

- Innovate and drive improvement initiatives in the process

- Investigate, evaluate, and settle claims, applying technical knowledge and human relations skills to effect fair and prompt disposal of cases and to contribute to a reduced loss ratio.

- Resolve complex, severe exposure claims, using high service oriented file handling.

- Deliver exceptional customer experience by timely and error free processing of claims

- To monitor and control error rates and consistency in processing.

- To review SOP for claims processing and to develop & execute better processes.

- To monitor and appraise performance of claims team.

- To monitor customer complaints, trend and timely resolution.