Central Coordinator (Motor Own Damage Claims)

Universal Sompo General Insurance; Navi Mumbai; On-site; INR 800,000 - 1,400,000; Full time

Job summary

Universal Sompo General Insurance invites applications for the role overseeing Motor OD Claims Investigation & Quality Control. You will monitor investigations nationwide, analyze reports, and ensure adherence to fraud protocols while driving process improvements.

The position involves risk assessment, triggers management, data auditing, and collaboration with IT and vendor partners to enhance controls and reporting. Strong analytical skills are essential.

Qualifications

• Graduation or post-graduation in any field.
• Certifications in Insurance, Risk Management, Fraud Investigation, or Analytics preferred.
• Experience in claims investigation or analytics is a plus.

Responsibilities

• Monitor and review Pan India motor OD claims investigations for quality and compliance.
• Analyze investigation reports and propose corrective actions for process improvements.
• Support risk assessment, fraud control, and loss mitigation initiatives.
• Collaborate with IT for system enhancements and UAT.

Skills

Data analysis

Fraud detection

Education

Graduation/Post Graduation

Certifications in Insurance/Risk Management/Fraud Investigation/Analytics

Tools

Data analytics tools

Job description

Role & responsibilities

Motor OD Claims Investigation & Quality Control

• Monitor and review Pan India Motor OD claims investigations to ensure quality, consistency, and compliance with company guidelines.
• Analyze investigation reports and recommend corrective actions for process improvement.
• Ensure adherence to established investigation and fraud control protocols.

Risk Assessment & Fraud Control

• Identify, analyze, and assess risks associated with Motor OD claims.
• Detect suspicious claim patterns and potential fraud indicators.
• Develop and implement fraud prevention strategies to minimize claim leakages and financial losses.
• Support risk management initiatives and loss minimization programs.

Trigger Management & Process Enhancement

• Coordinate with Claims, Underwriting, Investigation, and other internal stakeholders to review existing claim investigation triggers.
• Recommend and implement new triggers based on emerging fraud trends, claims experience, and operational insights.
• Continuously improve fraud detection frameworks and control mechanisms.

Data Analysis & Auditing

• Conduct data audits to identify anomalies, trends, and exceptions in claims data.
• Collaborate with Data Analytics teams to derive actionable insights for risk mitigation.
• Prepare MIS reports, dashboards, and analytical presentations for management review.

System Development & UAT

• Work closely with IT teams for system enhancements, automation initiatives, and process improvements.
• Prepare business requirements for technology solutions.
• Perform User Acceptance Testing (UAT) and ensure successful implementation of system changes.

Vendor Management

• Build and maintain effective relationships with investigators, surveyors, and other external partners.
• Monitor vendor performance and service quality.
• Ensure adherence to company standards and SLAs.

Team Coordination & Leadership

• Guide and support investigation teams on quality standards and fraud management practices.
• Encourage collaboration and knowledge sharing across teams.
• Drive a culture of accountability, continuous improvement, and operational excellence.

Problem Solving & Decision Support

• Investigate complex claims scenarios and recommend suitable resolutions.
• Provide analytical support for high-risk and suspicious claim cases.
• Contribute to strategic initiatives related to claims efficiency and fraud management.

Preferred candidate profile

Qualifications

• Graduation/Post Graduation
• Certifications in Insurance, Risk Management, Fraud Investigation, or Analytics will be an added advantage.