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."