Roles and Responsibilities About the Department
Group Business is a unique line of business with multi partner arrangement between the insurer, the master policy holder & the members. Group Operations department manages issuance and claims for products like Credit Protect, Group Term Insurance, Employer Employee schemes, etc. HDFC Life is an industry leader in this line of business and we are expanding at a rapid pace in this sphere.
What are we looking for?
The AVP Group Operations primary responsibility will be overseeing claims processing for non-reinsurer cases across different product lines in Group Operations. This will involve handling the claims processing, minimizing process and operational risk, while ensure settling of genuine claims in the quickest and easiest possible manner for claimants and reducing adverse claim pay-outs for HDFC Life.
What does the job entail?
The role will be entail managing the team with focus on the important operational aspects of the Life Claims function: -
Claims Decisions: Ensuring the right claim decisions while pursuing the shortest possible TAT which will involve claim adjudication and ensuring regulatory compliance - Reviewing decided claims for quality check of assessment, on sample basis and improve the process controls.
Reporting: Standardizing regulatory and financial reporting and reducing the manual dependencies with a view to improve speed, efficiency, transparency and customer convenience in claims. Compliance of all regulatory guidelines and ensuring reporting on quarterly, half-yearly and yearly basis reports.
Operational Quality: Ensuring all transactional and process risks are covered and mitigation measures are envisaged and deployed by implementing learnings from past claims decisions. Ensuring that the team is equipped and complying with the mitigation measures.
Knowledge Management: Capturing and institutionalizing the tacit adjudication logic and processing logic to ensure people dependency is minimized. Ensure training to Claims team members through internal training modules, reinsurers, legal team for repudiation cases, etc.
Leadership Quality : Lead the teams towards the desired goals and drive ESAT and CSAT scores for the unit and function - Relationship management across key functions such as Sales, Process, Audit, BS&T, Legal, Products and Underwriting at Corporate office and branches and external stakeholders like Reinsurers for claims decisions and controls