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Job Summary: We are looking for a dynamic and detail-oriented professional with a legal background and strong understanding of insurance laws to manage Group Personal Accident (GPA) insurance claims. The candidate will handle grievance redressal, legal escalations, ombudsman complaints, and high-severity claims. The role requires excellent problem-solving skills, legal acumen, and a thorough understanding of grievance mechanisms within the insurance domain. Key Responsibilities: End-to-end handling of GPA claim grievances, legal matters, and escalated claim cases. Manage & support Insurance Ombudsman cases to Insurance Company. Analyse claim documents to ensure policy coverage, legal compliance, and risk exposure. Coordinate with insurers, clients, and internal stakeholders to ensure timely claim resolution. Draft legal replies, settlement proposals, and case summaries. Review and monitor complaints received through IRDAI/Grievance Portals, client escalations, and legal notices. Maintain proper documentation for legal and audit purposes. Support in data analysis, reporting trends, and recommending process improvements. Ensure all actions are in compliance with IRDAI regulations, insurance laws, and internal SOPs. Required Qualifications & Skills: Education: LLB / LLM with specialization in Insurance Law (preferred). Experience: 2–4 years of hands-on experience in GPA or Health Claims grievance management. Strong understanding of insurance laws, policy wordings, and regulatory frameworks. Familiarity with Insurance Ombudsman process, consumer court procedures, and alternate dispute resolution. Excellent written and verbal communication skills. Proficient in MS Office and insurance claims portals. Ability to work under pressure with attention to timelines and detail. Preferred Attributes: Experience working with brokers, insurers, or TPAs. Exposure to Defence / Corporate GPA policies. Analytical thinker with negotiation and drafting skills. Show more Show less
