Senior Associate

• Claim Control,claims settlement and average claim size, Responsibility to achieve over all targets of the __ Locations. Claim Closure : Death - ___, Injury - ___. • Monintoring of Orphan, high value & appeal cases,Ensuring timely closure of cases.,Intimation to team leaders & zonal manger on report of high value , appeal and orphan case .Regular follow up with RLMU_x0002_Legal / FCU for investigation report. Maintain the ageing of TOC claim below 2 months.Review of HVC and Appeal Cases quarterly. • TP Claims success ratio,% (DEW) of cases in favour of the Co.,Over all achievements of DEW___ % of the respective location • TP Module & Mobile App,Proper implementation of TP module process And education given,Ensure that it should be implemented and advocate to update in system atleast ____% of the allocated. ____% of the advocates to be using the mobile APP • Claim processing & compliance,Maintain service standard as per the SOP,Ensure minimum of 5% TOC cases counts against O/s but not older than Two months. Ensure timely registration, allocation of brief to advocates and timely review of claims. Ensure SOP compliance right from registration to payment. Ensure periodical meeting and followup with the RLMU team • Defence Cases,Preparation of case notes for defence cases,Case notes to be _____% of the defence cases and communicated to the advocate • Attendence and Evidence before Court,proper representation before all proceedings,% of attendence and evidence before the Court out of the case on evidence in defence and High Value cases and Appeal hearings. • Recovery in claims,Ensure increase in recovery of total recovery claims,Recovery of ____ cases. • Projects / Additional Responsibilities,Undertake and complete assigned project / additional responsibilities as per defined timeline,Assigned project completion within timeline • Self development,Soft skills and other training including eQuest,Training program nominated by co. Financials/Output related activities • Maintain outstanding claims count as per the intimations received • Pre litigation of TP claims • Claims to be adequately reserved. Gain/drain on reserve should not be more than 10% of paid amount • 20% of the cases disposed by way of judgement Customer/Product/Market related activities • Cordinate with BI for all regulatory reporting • payment of fees to be made within 7 working days from the date of receipt of the final investigation report in case of investigators and from decision date in case of lawyers. In any case, the payments should not be later than the final loss payment date. Process/Technical related activities • Registration of claim within 2 working days from intimation • Appointment of surveyor/ advocate within 2 working days from intimation • Temporaray Orphan claims to be tracked to policy within 30 days • To determine the case as compromise/ defence and adequecy of reserve within 15 days of reciept of Investigation report • Appeals to be filed within limitation period & ensuring stay order in appeals filed by the Company • Decision on award to be taken within 7 working days from the receipt of the award. Payment to be processed within 2 working days from the date of decision • Analysis of MIS reports for ensuring bottom line and suggestion on LOB loss ratios • Final investigation report within 30 days from the date of appointment with quality report • Submission of Insurance particulars within 15 days in case of TOC claims. Submission of opinion within 3 working days from the receipt of the copy of the award copy with quality inputs • Maintain confidentiality in data sharing