Executive-Execution

Job Description :

• Claims Management
• Once a High Value Claim, Super High Value Claim or Critical Claim is registered and intimated, review the petition and suggest/approve the appropriate reserve as well as course of action to the execution team as per the TAT.
• Authorize a suitable reserve amount for the claim review and modify the reserves for the case based on updated case facts & inputs from execution team.
• On receiving the investigation report in HVCs, SHVCs & critical claims, suggest a line of action for defense cases or suggest limit for compromise amount after discussion with senior authorities as per financial limits.
• Scrutinize all the documentation pertaining to the cases that are referred to the team to ascertain the veracity of the claim made.
• Suggest appeal for quantum and negligence cases send it to the appeal team with an opinion on the same after discussion with senior authorities as per financial limits.
• Get approvals/approve all interim payments - pertaining to third party payments, advocate fees, claims payments also decide on whether to appeal a particular interim order or not.
• Once a final award is submitted, review and approve the payment of claims or get the payment approved from seniors as per financial authority.
• Review & Reporting:
• Conduct quality checks on claims processed by reviewing case details and suggest process and /or strategy improvements that could be undertaken and noted for future reference in all HVCs.
• Study and prepare case study on HV claims, SHVCs and critical claims that could have been contested better/ could be approached in a better way by noting lacunas.
• Share regular and periodic reports on the above findings with the team leader & VH as well as all relevant stakeholders.
• Review the MIS on an on-going basis for claims closure, settlement ratio for the allocated region.
• Relationship Management
• Collaborate with the execution team, LPU team & other members of approval team to determine whether the case should be contested/compromised in court in case any significant stage in strategy, share the updated line of action.
• Provide recommendations to Team Members w.r.t cases and guide them as and when required.
• Process Improvement & Knowledge Enrichment
• Keep abreast with the Judicial Changes and strategize the claims management accordingly.