Prudential (UK) in partnership with the HCL group plans to set-up a standalone Indian health insurance company to address the growing healthcare needs of the Indian consumer.

This joint venture will combine Prudential's global expertise in insurance and financial services with HCL Groups experience in technology and healthcare solutions.

Prudential, with its longstanding presence in India, already operates two leading businesses in life insurance and asset management with the ICICI Group. Prudential was also the proud sponsor of the 1983 Cricket World Cup, Indias first World Cup Victory

Prudential Health India is a Zero to One team undertaking a no-legacy, greenfield health insurance deployment in India, building journeys that truly empathize with the customer and offer a differentiated experience.

To partner with us in this mission, we are looking for a talented Grievance Management Medical Specialist to join our Customer Service team in Mumbai.

Your typical week might include the following:
- Reviewing and analyzing health-claims-related grievances to ensure accurate, fair,



and timely resolution within defined regulatory timelines.
- Conducting detailed medical assessment of claim files, discharge summaries, investigation reports, and clinical notes to validate decisions and ensure fairness.
- Collaborating closely with Claims, Underwriting, Legal, and TPA teams to provide clinical clarity and assist in resolving complex health-related complaints.
- Ensuring grievances received through regulatory and public portals (e.g., Bima Bharosa, IGMS, PG Portal) are closed within prescribed IRDAI timelines.
- Preparing and supporting medical summaries and responses for Ombudsman and litigation cases.
- Identifying recurring medical issues, performing root cause analysis (RCA), and recommending corrective and preventive actions.
- Acting as the voice of the customer, ensuring empathetic, transparent, and accurate communication of medical decisions.
- Contributing to kno

📌 Grievance Management Medical Specialist (Mumbai)
🏢 Prudential Technology And Services
📍 Mumbai