Job Description:

Manager / Senior Manager Individual Death Claims

Role-Specific Responsibilities within Life Insurance Individual Death Claims

Key Responsibilities

Claims Adjudication & Decision-Making
- Own end-to-end adjudication of individual death claims settlement, repudiation, or partial payment — within assigned Delegation of Authority (DOA) and liability bands.
- Review medical, financial, and policy documentation to arrive at claim decisions in line with policy terms and IRDAI guidelines.
- Escalate high sum-assured, complex, or contentious cases to the next level of authority with a transparent recommendation.
- Ensure claims are processed within regulatory and internal turnaround time (TAT) norms.

Investigation & Risk Containment
- Identify early death claims (typically within 3 years of policy commencement/revival) and warrant for investigation if necessary.
- Evaluate investigation findings and apply Section 45 provisions in cases of suspected misrepresentation, non-disclosure, or fraud.
- Coordinate with RCU, empanelled investigators, medical referees,



and legal counsel on suspicious or high-risk claims.
- Approve repudiation/void ab initio decisions with legally sound rationale and complete documentary evidence.

Team Leadership & SPOC Management
- Lead and mentor the individual death claims team, allocating cases by sum assured band and complexity.
- Act as Single Point of Contact (SPOC) for escalations from branches, Channels and the grievance redressal cell.
- Build team capability on medical underwriting nuances, documentation checks, and fraud-indicator recognition.

Compliance & Audit Readiness
- Ensure claims processing adheres to IRDAI claim settlement regulations and the internal claims manual/SOPs.
- Maintain audit-ready records — NOP (Notice of Proceeding), DOA approvals, and claim files — for internal, statutory, and reinsurance audits.
- Monitor and control the repudiation ratio, ensuring every repudiation letter is legally vetted and defe

📌 Manager/Senior Manager (Hyderabad)
🏢 Shriram Life Insurance
📍 Hyderabad