Claims Head

Livlong 365; Thane; On-site; INR 1,200,000 - 2,300,000; Full time

Job summary

Livlong 365 seeks a Head - Claims to lead end-to-end Retail and Corporate Claims operations with a broker-first mindset. Prior insurance-broking experience and multi-insurer portfolio handling are preferred to advocate for customers while ensuring policy and regulatory compliance.

You will drive claims strategy across Retail (Health) and Corporate portfolios, establish SOPs and SLAs, oversee complex claims, and lead KPI-driven teams with accountability.

Responsibilities

• Lead claims strategy across Retail (Health) and Corporate portfolios.
• Establish broker-driven SOPs, escalation frameworks, and TAT benchmarks.
• Oversee complex retail claims including repudiations, deductions, and grievance redressals.
• Manage corporate employee benefit claims including large losses, ICU cases, and CXO-level escalations.
• Negotiate corporate buffers, special approvals, and business-call settlements with insurers.
• Act as the senior broker interface with insurers, TPAs, and key hospital networks.
• Drive claims MIS, loss ratio analysis, ageing reports, and renewal-support insights.
• Support cross-sell initiatives including OPD, top-ups, wellness, and AHC solutions.
• Lead, mentor, and scale retail and corporate claims teams with clear KPIs and accountability

Job description

The Head - Claims will lead end-to-end Retail and Corporate Claims operations with a strong broker-first mindset. The role preferably requires prior experience in an insurance broking environment, managing multi-insurer portfolios and acting as the customer’s primary advocate while ensuring policy and regulatory compliance.

• Lead claims strategy across Retail (Health) and Corporate (GMC, GPA, GTL & GI) portfolios.
• Establish broker-driven SOPs, escalation frameworks, and TAT benchmarks.
• Oversee complex retail claims including repudiations, deductions, and grievance redressals.
• Manage corporate employee benefit claims including large losses, ICU cases, and CXO-level escalations.
• Negotiate corporate buffers, special approvals, and business-call settlements with insurers.
• Act as the senior broker interface with insurers, TPAs, and key hospital networks.
• Drive claims MIS, loss ratio analysis, ageing reports, and renewal-support insights.
• Support cross-sell initiatives including OPD, top-ups, wellness, and AHC solutions.
• Lead, mentor, and scale retail and corporate claims teams with clear KPIs and accountability