Role & responsibilities:

The Manager Fraud Control Unit will independently lead, mentor, and govern a specialized team of risk assessors conducting comprehensive pre-post-issuance forensic reviews and early claim investigations. The core mandate of this role is to identify material misstatement, non-disclosure, and systemic syndication fraud within the strict boundary lines of Section 45 of the Insurance Act, India. The ideal candidate ensures that all field/desktop investigations are legally bulletproof, structured within strict regulatory timelines, and tightly coordinated with internal legal and underwriting stakeholders.

Key Responsibilities & Scope of Work

1. Section 45 Governance & Post-Issuance Forensic Audits

- Contestability Window Analysis: Oversee the review of high-risk issued policies approaching or within the 3-year contestability window specified under Section 45.
- Evidentiary Standard Enforcement: Ensure that all investigation reports present clear, legally admissible evidence of intentional fraud, suppression of facts, or identity fraud to sustain contract repudiations.
- Pre-Claim Scrutiny: Manage backward-looking investigations on early claims (policies failing within 1-3 years of issuance) to mitigate severe financial leakages.

2. Team Leadership & Field Agency Management

- People Management: Direct, train, and track the daily throughput of a team of Assistant Managers, senior executives, and data analysts.
- Vendor Governance: Empanel, audit, and manage external legal and private investigation agencies across various geographies.
- TAT & Quality Controls: Strictly monitor agency Turnaround Time (TAT) and perform surprise calibration audits on field report quality to eliminate vendor collusion.

3.



Cross-Functional Synergy & Technical Strategy

- Underwriting & Claims Partnership: Provide actionable field intelligence back to the Underwriting unit to update risk scoring models and improve future point-of-sale triggers.
- Legal and Compliance Liaison: Partner with the internal Legal cell to represent the company in ombudsman cases or consumer courts regarding challenged policy cancellations.
- Dashboarding & Analytics: Build data pipelines and visual matrices using Power BI to present weekly trends on emerging fraud patterns and savings reports to executive leadership.

Role Requirements & Qualifications

- Minimum Requirement: Graduate or Post Graduate in Risk Management, Finance, Insurance, Law, or Business Administration.
- Preferred Certifications: Certified Fraud Examiner (CFE) or Associate/Fellowship from the Insurance Institute of India (III).

Experience Range

- Minimum 57 years of core experience in the Risk Containment Unit (RCU) / Fraud Control Unit (FCU) domain within the BFSI sector, with a solid preference for Life or Health Insurance operations.
- At least 2 years of direct experience handling team management and managing vendor networks across India.

Technical & Core Competencies

- Regulatory Expertise: Thorough working knowledge of the Insurance Act of India (specifically Section 45 rules), IRDAI fraud management guidelines, and consumer court precedents.
- Analytical Tools: Intermediate to advanced proficiency in Microsoft Excel, Office 365 automation, and data visualization tools like Power BI or Tableau.
- Soft Skills: Exceptional stakeholder negotiation skills, uncompromising integrity, and a methodical mind capable of linking disparate data points to uncover syndicates.

📌 Manager (Hyderabad)
🏢 Shriram Life Insurance
📍 Hyderabad