Claims Adjustor- Workers Compensation -Claims (P&C Insurance)

ALLIANZ SERVICES PRIVATE LIMITED; Pune District; On-site; INR 600,000 - 800,000; Full time

Job summary

Allianz Services India is seeking a Claims Adjustor for Workers' Compensation Claims in Pune. The candidate will independently manage all stages of workers' compensation claims, evaluate high-exposure cases, and conduct timely investigations with a focus on accurate reserving and regulatory compliance.

The role requires 2–5 years of P&C claims experience, strong communication, and knowledge of adjudication.

Qualifications

• Minimum of 2 to 5 years experience with claim adjusting in property & casualty (workers compensation)
• Good knowledge and experience in claim adjudication
• Medical and litigation management can be an added advantage
• California/Texas Insurance Adjuster license certification mandatory
• Experience in training colleagues in an adjuster role will be an added advantage
• Will be required to clear claims adjuster license certification as per state requirements
• Renewal of license certification will also need to be undertaken at timely intervals

Responsibilities

• Independently handle all aspects of workers' compensation claims from set-up to closure
• Evaluate and manage high dollar, high exposure, and complex claims
• Conduct timely 3-point contact investigations with claimant, insured, and medical provider
• Mitigate complex exposure while achieving the best possible outcome
• Determine timely and accurate compensability decisions within statutory requirements
• Set and adjust timely reserves within authority limits
• Present claims to senior management and stakeholders with clarity
• Administer statutory medical and indemnity benefits throughout the claim life
• Comply with applicable statutory guidelines, rules, and regulations
• Prioritize early resolution opportunities and negotiate settlements

Skills

Strong communication

Critical thinking

Problem solving

Advanced analytical ability

Claim decision making

Job description

130 years of trust, time to shape what's next. Allianz Group is one of the world's leading insurers and asset managers - built on over a century of stability, expertise, and financial strength. Allianz Services is where that legacy meets the future. 8,200+ people. Eight countries. Three continents. We deliver specialized services to clients within Allianz Group, powered by AI, advanced analytics, and a mindset that refuses to stand still. From core insurance operations to engineering and consulting services, we reimagine how insurance works. What truly sets us apart are our people and the trusted partnerships we build, anchored in our values of expertise, integrity, and empowerment. We don't support the business. We shape it.

Job Role: Claims Adjustor (Workers Compensation Claims -P&C Insurance )

Work Location: Pune

Work Mode: Work from Office

Shift timing : US shift

Experience

• Minimum of 2 to 5 years experience with claim adjusting in property & casualty experience (workers compensation claims ) is required.
• Good knowledge and experience in claim adjudication
• Medical and litigation management can be an added advantage.

Certifications and Additional Requirements

• California/Texas Insurance Adjuster license certification mandatory , CPCU, AIC Certification will be an added advantage.
• Experience in training colleagues in an adjuster role will be an added advantage
• Will be required to clear claims adjuster license certification as per state requirements
• Renewal of license certification will also need to be undertaken at timely intervals

Key Responsibilities

Claims Technical Management

• Independently handle all aspects of workers' compensation claims from set-up to closure.
• Evaluate and manage high dollar, high exposure, and complex claims.
• Conduct timely 3-point contact investigations (Claimant / Insured / Medical Provider), with a focus on continued investigation as facts of the case evolve.
• Mitigate complex exposure while achieving the best possible outcome.
• Determine timely and accurate compensability decisions within statutory requirements.
• Set and adjust timely/accurate reserves within authority limits, ensuring reserving activities are consistent with case facts and company best practices.
• Present claims to senior management, internal and external stakeholders with clarity and confidence.
• Administer statutory medical and indemnity benefits in a timely manner throughout the life of the claim.
• Comply with all applicable statutory guidelines, rules, and regulations.
• Prioritize early resolution opportunities, evaluate claim exposure, and negotiate settlements.

Claims Customer Service

• Serve as a point of contact for partner agents and customers to provide general claim guidance and set claim process expectations.
• Assist in providing claim status to agents and insureds, coverage verification, loss run reports, and related inquiries.
• Deliver excellent customer service to internal and external customers and business partners.
• Advocate to ensure a leading claims customer experience.
• Continuously improve claims operations by identifying opportunities and gaps in claim service, handling SOPs, protocols, and processes.

Skills & Competencies

• Strong Communication Skills (Written & Verbal): Ability to deliver complex information effectively to diverse audiences, including senior leadership, legal counsel, agents, and policyholders. Must be able to articulate claim positions clearly and present persuasive arguments in both written and verbal formats.
• Critical Thinking: Demonstrated ability to analyze complex claim scenarios, assess multiple data points, identify patterns, and make sound decisions with incomplete or evolving information. Must be able to challenge assumptions, evaluate evidence objectively, and arrive at well-reasoned conclusions.
• Strong Problem-Solving Skills: Ability to manage complex tasks and work through to solutions with minimal guidance and direction.
• Advanced Analytical Ability: Capable of analysing and taking necessary action in multiple focus areas based on several data points.
• Claim Decision-Making: Ability to make claim decisions to mitigate exposure while achieving the best outcome. Demonstrated proficiency in interaction with third parties and clearly articulating outcomes verbally or via written communication

At Allianz, we believe in a diverse and inclusive workplace and in giving fair and equitable opportunities to all our employees, so everyone can succeed. We, the Allianz Services India family, welcome all applications from all regardless of gender identity and/or expression, sexual orientation, race or ethnicity, age, nationality, religion, disability, or philosophy of life.