Description To lead the Grievance Redressal Cell of the company, ensuring that all policyholder complaints are resolved with speed, empathy, and strict adherence to IRDAI (Protection of Policyholders’

Interests) Regulations. This role is critical for maintaining the company’s regulatory standing and ensuring high-priority for escalations appearing from various portals like CPGRAMS/IRDAI

SOCIAL MEDIA etc. & they are handled with zero-error precision.Claims & Ombudsman Liaison • Dispute Resolution: Review "Repudiated" (rejected) claims that have been appealed. You will chair the internal Grievance Committee to decide if a rejection should be overturned or upheld based on policy terms.

• Ombudsman Representation: Prepare the "Statement of Case" (S.O.C.) for Insurance Ombudsman hearings.

Analyze

Ombudsman awards to identify if the company needs to change its policy wording or claims process.

Process

Improvement & Root Cause Analysis (RCA) • Trend Mapping: Categorize grievances into sub-buckets (e.g., Delay in Survey, Short Settlement, Non-receipt of Policy Document) to identify "Hotspots." • Cross-Functional Collaboration: Lead monthly meetings with Product and IT teams to fix the "Root Cause" of recurring complaints to reduce the overall grievance inflow (Grievance per 10,000 policies). PPGRM & Board Presentations • PPT Synthesis: Responsible for the end-to-end preparation of the PPGRM Deck. This involves translating raw data from NL-45 and Bima Bharosa into high-impact visual presentations for the Policyholder Protection Committee (PPC).

• Thematic Reporting: Moving beyond numbers to present "Thematic Analysis"—grouping grievances by product lines (Motor vs. Health) and distribution channels (Agency vs. Digital) to identify systemic failures.

• Action Taken Reports (ATR): Presenting the status of previously agreed-upon process changes, demonstrating how the Grievance Cell has actively reduced the "Grievance Inflow Rate."

Responsibilities





Regulatory Reporting & Compliance (NL-45)/ IGMS/Bima Bharosa • Monthly/Quarterly Disclosure: End-to-end ownership of NL-45 reporting. You must ensure that the "Grievance Disposal" data published on the website and submitted to the regulator is 100% accurate, reflecting correct aging and disposal ratios.

• IGMS/BIMA BHAROSA Integration: Maintain seamless synchronization between the company’s internal CRM and the IRDAI’s Bima Bharosa (formerly IGMS) portal.

• Audit Readiness: Act as the primary point of contact for IRDAI onsite and offsite inspections regarding consumer protection.

• Direct responsibility for the NL-45 (Grievance Disposal) report. You must ensure that cases resolved by the GRC are correctly reflected as "Resolved" or "Partially Accepted" in the regulatory filings.

• IGMS/Bima Bharosa: Ensure that the status of committee-level escalations is updated in the IRDAI portal in real-time to avoid "escalation aging" penalties. High-Priority Escalation Management (PRAGATI/CPGRAMS) • Monitor the PRAGATI dashboard. Since these grievances are reviewed at the Prime Minister’s Office (PMO) level, you are responsible for coordinating with the Claims or Underwriting heads to provide a resolution within 48–72 hours.

• Drafting "Action Taken Reports" (ATRs) for CPGRAMS that are factual, legally sound, and devoid of technical jargon.Detailed PPT Structure (Technical Skill Required) The candidate must be proficient in building the following slides for the PPGRM: 1.

Grievance Dashboard: A high-level view of Total Received vs. Resolved vs. Outstanding,



with a specific focus on the Ageing Analysis (0-15 days, 15-30 days). 2.

Regulatory Benchmarking: A slide comparing the company’s disposal ratios against the IRDAI industry average and the status of NL-45 filings. 3.

The PRAGATI / PMO Slide: A dedicated highlight of high-sensitivity cases received via the PRAGATI portal and the specific resolutions provided to the PMO. 4.

Ombudsman Analysis: A summary of "Awards Won" vs. "Awards Lost," including a cost benefit analysis of cases that went to the Insurance Ombudsman.

5. Voice of Customer (VoC): Qualitative insights derived from common complaint narratives and the "Root Cause Analysis" (RCA) performed to prevent future occurrences.Updated "Technical Competencies" Section • Advanced Data Visualization: Must be skilled in creating automated dashboards in Excel/PowerBI and exporting them into clean, executive-level PowerPoint decks.

• Narrative Building: Ability to explain why a spike in grievances occurred (e.g., a specific natural calamity leading to Motor claims spikes) rather than just reporting the numbers.

• Committee Liaison: Experience in presenting these PPTs to the Policyholder Protection Committee and answering queries from Independent Directors. GRC (Grievance Redressal Committee) Management • Committee Secretariat: Organize and convene the periodic GRC meetings. You are responsible for the agenda, which includes disputed claims, policy servicing failures, and cases where the initial resolution was rejected by the customer.

• Case Synthesis: Prepare the "Case Summary" for the GRC members (usually senior heads of Claims, Underwriting, and Legal). You must translate complex insurance jargon into a explicit narrative of "Customer Stand" vs. "Company Stand." • Minute Management: Maintain the official Minutes of the GRC meetings, documenting the rationale behind every decision to uphold or overturn a grievance.

Qualifications

Graduate

📌 Grievance Manager (Maharashtra)
🏢 Universal Sompo General Insurance
📍 Maharashtra