Insurance Specialist

Job Title: Insurance Agent – Claims

Experience Required: Minimum 2 Years
Employment Type: Full-Time

Job Summary

We are seeking a detail-oriented and customer-focused Insurance Agent – Claims with a minimum of 2 years of hands-on experience in insurance claims handling. The role involves managing end-to-end claims processes, coordinating with policyholders and internal teams, and ensuring timely and accurate claim settlements in compliance with regulatory and company guidelines.

Key Roles and Responsibilities

• Handle end-to-end insurance claims processing, including claim intimation, documentation, assessment, and settlement.
• Act as the primary point of contact for policyholders during the claims lifecycle, ensuring clear communication and timely updates.
• Verify policy coverage, exclusions, and claim eligibility as per policy terms and conditions.
• Scrutinize claim documents to ensure completeness, accuracy, and compliance with regulatory requirements.
• Coordinate with surveyors, hospitals, garages, TPAs, and internal underwriting teams as required.
• Investigate and resolve claim discrepancies, escalations, and customer grievances efficiently.
• Ensure adherence to IRDAI guidelines, company SOPs, and turnaround time (TAT) standards.
• Maintain accurate records of claims, correspondence, and settlement details in internal systems.
• Identify potential fraud indicators and escalate suspicious claims for further investigation.
• Support audits, MIS reporting, and periodic reviews related to claims operations.

Eligibility Criteria

• Minimum 2 years of relevant experience in insurance claims handling (life, health, or general insurance).
• Bachelor’s degree in any discipline; certification in insurance or claims management is an added advantage.
• Sound knowledge of insurance policies, claims procedures, and regulatory guidelines.
• Strong analytical skills with attention to detail and accuracy.
• Excellent communication and customer-handling skills.
• Proficiency in MS Office and claims management systems.
• Ability to work independently and manage multiple claims simultaneously within defined timelines.

Preferred Skills

• Experience in dealing with escalated or complex claims
• Understanding of fraud detection and risk assessment
• Strong documentation and reporting skills
• Customer-centric mindset with problem-solving ability

Job Type: Full-time

Pay: ₹30,000.00 - ₹50,000.00 per month

Benefits:

• Health insurance

Ability to commute/relocate:

• Pune, Maharashtra: Reliably commute or planning to relocate before starting work (Required)

Work Location: In person