Executive - Life Insurance Claims Processing

Job Overview

This role involves thorough handling of life insurance claims including death claims, maturity claims, survival benefits, and riders. The professional will verify all claimant documents such as death certificates, medical records, policy details, identification proofs, and beneficiary information to ensure completeness and correctness.

Key Responsibilities

• Assess and process life insurance claims efficiently and accurately.
• Confirm claim eligibility based on policy conditions, waiting periods, exclusions, and underwriting records.
• Update and maintain claim information meticulously in claims management systems.
• Collaborate with medical examiners, healthcare institutions, legal departments, underwriting teams, and fraud investigation units as necessary to support claim processing.
• Engage with beneficiaries or agents to clarify missing data or communicate claim progress.
• Investigate and escalate claims that are suspicious or require contestation.
• Calculate settlements precisely and ensure payouts are processed within prescribed timelines and quality standards.
• Ensure adherence to insurance regulations, privacy policies, and internal audit guidelines.
• Compile daily and weekly claim status reports and actively participate in process enhancement initiatives.