Manager - Claims

1. Litigation Handling & Case Management

• Manage end-to-end litigation lifecycle for motor/health/other insurance claims.
• Track court cases, MACT matters, consumer complaints, arbitration, and recovery suits.
• Ensure timely filing of replies, written statements, affidavits, and appeals.
• Maintain litigation MIS and case status updates.

2. Coordination with Legal Teams

• Liaise with panel advocates, internal legal team, and external consultants.
• Provide claim documents, investigation reports, and evidence required for legal proceedings.
• Review legal drafts prepared by lawyers before submission.

3. Claims Analysis for Litigation

• Evaluate claims from a legal standpoint to decide defensibility.
• Identify fraudulent or inflated claims and recommend legal actions.
• Provide litigation strategy inputs for high-value or complex claims.

4. Court & Regulatory Compliance

• Ensure adherence to timelines set by courts, tribunals (MACT), and regulators (IRDAI).
• Monitor case filings, hearings, and judgments.
• Ensure compliance with legal documentation and record-keeping standards.

5. Settlement & Negotiation

• Evaluate out-of-court settlement opportunities to reduce litigation costs.
• Negotiate settlements in coordination with legal and claims teams.
• Recommend reserve adjustments based on case developments.

6. Reporting & MIS

• Prepare litigation MIS reports (case aging, win/loss ratio, provisions).
• Analyze trends in litigation to improve claim handling processes.
• Highlight high-risk cases to senior management.

7. Vendor & Legal Panel Management

• Monitor performance of panel advocates.
• Ensure cost control of legal expenses.
• Evaluate effectiveness and recommend empanelment/de-empanelment.

8. Risk Management & Process Improvement

• Identify gaps in claims handling leading to litigation.
• Recommend process improvements to reduce future litigation.
• Support fraud detection and prevention initiatives.

Key Skills & Competencies

• Strong knowledge of insurance claims and litigation processes
• Familiarity with legal frameworks (MACT, Consumer Protection Act, Civil laws)
• Analytical and decision-making skills
• Stakeholder management and negotiation
• Attention to detail and documentation accuracy
• Ability to manage multiple legal cases simultaneously