Insurance Claim Head

Job Purpose: To lead and manage the end-to-end claims operations, ensure efficient claim assessment and settlement processes, minimize claim leakage, and uphold customer satisfaction and regulatory compliance. The role is also responsible for developing and executing claims strategy aligned with overall business goals. Key Responsibilities: Lead and oversee the entire claims department including operations, assessment, investigation, approval, and settlement. Formulate and implement claims policies, procedures, and strategies for effective and timely claims management. Ensure fair, consistent, and prompt resolution of claims in line with company guidelines and regulatory standards. Monitor claim ratios, turnaround times (TAT), settlement efficiency, and customer satisfaction metrics. Manage large or complex claims and support legal teams in case of disputes or litigations. Implement controls to reduce fraudulent or exaggerated claims. Lead, mentor, and develop a high-performing claims team across locations. Liaise with underwriting, sales, legal, finance, and compliance teams to ensure claims alignment with business practices. Monitor industry trends, regulatory changes, and competitor benchmarks to guide policy adjustments. Handle audits and interface with regulatory bodies (e.g., IRDAI in India) as required. Review and optimize vendor relationships (surveyors, TPAs, investigators, etc.). Prepare periodic reports for the executive team and board on claims performance. Qualifications: Bachelor’s degree in Insurance, Business Administration, Law, or related field; MBA or professional certification (e.g., ACII, CPCU) preferred. 10+ years of progressive experience in claims management, including at least 3–5 years in a leadership or head-of-department role. Key Skills & Competencies: Deep knowledge of insurance claim processes, policy structures, and regulatory frameworks. Strategic thinking with strong analytical and problem-solving abilities. Excellent leadership, decision-making, and stakeholder management skills. Familiarity with digital claims platforms and modern claims automation tools. Strong understanding of risk assessment and claims fraud detection. Excellent communication and presentation skills. Preferred Industry Experience: [General/Life/Health/Motor/Marine] Insurance (customize as required) Experience managing large-scale claims portfolios Exposure to digital transformation in claims processes is a plus Job Type: Full-time Pay: ₹45,000.00 - ₹60,000.00 per month Benefits: Cell phone reimbursement Schedule: Day shift Morning shift Supplemental Pay: Commission pay Performance bonus Experience: General insurance : 5 years (Required) Sales Head: 5 years (Required) Insurance Claim Head : 5 years (Required) Work Location: In person