Deputy Manager - Claims

Role Overview: As a Claims end-end Deputy Manager, you will be responsible for reviewing and validating claims submissions, coordinating with various stakeholders, evaluating claim merits, determining liability, calculating claim amounts, ensuring adherence to internal SLAs and regulatory timelines, communicating claim decisions, maintaining documentation, analyzing claims trends, and contributing to claims automation and digitization initiatives. Your role will also involve collaborating with internal teams for resolution, driving customer satisfaction, and identifying process gaps for improvement. Key Responsibilities: - Review and validate claims submissions for completeness and eligibility. - Capture claim details accurately in the system, ensuring proper documentation. - Coordinate with policyholders, agents, or brokers to obtain necessary supporting documents. - Evaluate claim merits based on policy terms and conditions. - Liaise with surveyors, investigators, hospitals, or repair vendors for fact verification. - Identify potential cases of fraud or misrepresentation and escalate appropriately. - Determine liability and admissibility in line with underwriting guidelines. - Calculate claim amounts, applying sub-limits, deductibles, and exclusions where applicable. - Ensure adherence to internal SLAs and regulatory timelines. - Communicate claim decisions (approval/rejection) with clarity and empathy. - Maintain complete documentation for audit and compliance purposes. - Act as a single point of contact for claim-related queries and escalations. - Collaborate with internal teams (Underwriting, Legal, Finance, Customer Service) for resolution. - Drive customer satisfaction through proactive updates and transparent communication. - Ensure adherence to IRDAI and internal compliance policies. - Identify process gaps and contribute to claims automation and digitization initiatives. - Analyze claims trends to recommend improvements in risk management and policy design. Qualifications Required: - Excellent communication skills with 8+ years of work experience. - Strong knowledge of insurance claims (General Liabilities, Auto/Motor & Direct). - Individual contributor roles are acceptable. - Candidates with experience in Subrogation total loss, admin team, Property & Casualty, or Health Insurance are not preferred. (Note: Additional details of the company are not available in the provided job description.),