Position Summary:
The Claims Specialist is responsible for managing claims assessment and driving the closure of insurance claims as per policy and regulations. The role performs claims assessment, determines coverage, evaluates damages, and negotiates settlements with claimants or their representatives. They collaborate closely with clients, adjusters, and legal teams to ensure fair and timely resolution of claims while adhering to company policies and industry regulations.
Location:
Mumbai - India
What will your job entail?
Job Responsibilities:
• Reviews incoming insurance claims to ensure they are complete by examining documentation such as accident reports, medical records, and policy information.
• Determines the extent of coverage provided by the insurance policy, compares the details of the claim with the terms and conditions to determine claim eligibility and payment.
• Utilizes knowledge and experience in insurance to assess, investigate, and evaluate claims. Ensures compliance with company policies, local regulations,



and industry standards while handling and processing claims.
• Facilitates seamless claim processing and resolution, investigates the circumstances surrounding a claim to determine its validity by interviewing associated stakeholders and inspecting sites or reviewing technical documentation etc.
• Calculates the amount of compensation or perks the claimant is entitled to receive based on factors such as deductibles, policy limits, depreciation, and applicable laws or regulations.
• Engages in negotiation with claimants or their representatives to reach a fair settlement in cases where there are disputes or disagreements regarding the claim.
• Communicates with various stakeholders involved in the claims process, including claimants, policyholders, insurance agents, medical professionals, and legal representatives.
• Maintains detailed records of all claim-related activities, including correspondence, investigation findings, payment calcul

📌 Specialist - Claims (Mumbai)
🏢 Ryan Specialty
📍 Mumbai