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