Role:

1.Claims Management: Managing Individual rider claim & Group Affinity claims, ensuring
all genuine claims are paid accurately and speedily to provide seamless experience to
the claimant

2. System development: Accountable for ensuring the development of system
functionalities, providing explicit, detailed user stories and requirements for functionalities
needed to ensure the smooth operation of claim processes. This helps drive
automation, eliminate manual interventions, minimizing the risk of errors, and ensure
compliance with product terms and conditions as well as regulatory requirements.

3. Stakeholder management: Connect with CMO/Underwriting/ Legal/ Finance/Customer
Service/IT as required for claim processing for seamless experience to customer during
entire claims journey

4. Re-insurance management: Managing Reinsurance support and co-ordination for
processing and settlement of Claims and for Reinsurance reporting

5. Audit management: Accountable for managing all audits related to the claims function,
including providing comprehensive process walk-throughs and detailed requirements to
auditors. This ensures transparency, adherence to internal controls, and compliance
with regulatory and audit standards.

6. FFA Migration: SPOC for migration- related activities, responsible for sharing detailed
requirements, test cases, artefacts testing as well as conducting thorough testing and




providing sign-off to ensure smooth system migration and accurate claim processing

7. MIS management: Accountable for sharing monthly claims reports with Finance and
Actuarial teams, monthly reconciliations with the Finance team to ensure data accuracy
for financial and regulatory reporting. Ensure timely and accurate preparation and
submission of financial and regulatory reports, maintaining full compliance with all
regulatory requirements to avoid discrepancies or escalations from regulatory bodies

8. SOP management: Ensure functional SOPs are always updated with the claim
processes.

9. People management: Responsible to train team members for claim processing skills,
impart domain knowledge and provide assistance to enable them to effectively execute
their roles and responsibilities

10. Reporting management: Responsible for the automation and availability of data fields
on QuickSight, ensuring claims data is readily accessible for analysis and presentation
to key stakeholders. This enables meaningful insights into the volume, trends, and
types of claims received by the organization.
11. Product development: Responsible for sharing detailed requirements as per product
specifications to product team. Responsible for co-ordination with IT for development of Day 2 product features

Qualification & Competencies:

Graduate with 5-8 years experience in claims management in life insurance industry

📌 Claims Manager (Mumbai)
🏢 Bandhan Life
📍 Mumbai