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Manager - Claims (Legal)

Job Code:
  • Insurance
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Job Details

The activities to be performed to achieve the Job Objectives mentioned in 8 above 11.1) Financials/Output related activities (Income/Expenses/Profit) (e.gGross written premium, Top line, Combined ratio, cost of acquisition, loss ratio, management expenses etc) 1. Maintain outstanding claims count as per the intimations received 2.Pre litigation of TP claims 3. Claims to be adequately reserved. Gain/drain on reserve should not be more than 10% of paid amount 4.20% of the cases disposed by way of judgement 11.2) Customer/Product/Market related activities (Internal / External) (e.g. Satisfaction, Acquisition, Retention, Cross-sell/Share-of-wallet, Relationship, Service, Product/Solutions) 1. Cordinate with BI for all regulatory reporting 2.payment of fees to be made within 7 working days from the date of receipt of the final investigation report in case of investigators and from decision date in case of lawyers. In any case, the payments should not be later than the final loss payment date. 3. Follow up on ombudsman and consumer cases 11.3) Process/Technical related activities (productivity, efficiency, process, quality etc.) (e.g. Risk, Controls, Compliance, Audit, Productivity, Quality, Discipline, Change Management, Adaptability, Success Transfer) 1. Registration of claim within 2 working days from intimation 2. Appointment of surveyor/ advocate within 2 working days from intimation 3. Temporaray Orphan claims to be tracked to policy within 30 days 4. To determine the case as compromise/ defence and adequecy of reserve within 15 days of reciept of Investigation report 5.Decision on award to be taken within 7 working days from the receipt of the award. Payment to be processed within 2 working days from the date of decision 6.Appeals to be filed within limitation period & ensuring stay order in appeals filed by the Company 7. Analysis of MIS reports for ensuring bottom line and suggestion on LOB loss ratios 8.Final investigation report within 30 days from the date of appointment with quality report 9.Submission of Insurance particulars within 15 days in case of TOC claims. Submission of opinion within 3 working days from the receipt of the copy of the award copy with quality inputs 11.4) People/Leadership/Teamwork/Corporate Citizenship related activities (e.g. Collaboration/Team work, Knowledge sharing, Development (Self & Team), Sharing Resources/Helping others) 1. To develop technical skills 2. To develop competancy of team members Maintain confidentiality in data sharing
Additional Degree: BL/LLB

Experience: 2-4


Financial Services | Mergers & Acquisitions | Regulatory Affairs
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