Deputy Manager - Risk and Loss Mitigation

PeopleStrong; Lucknow; On-site; INR 1,200,000 - 1,800,000; Full time

Job summary

HDFC ERGO General Insurance is seeking a Deputy Manager - Risk and Loss Mitigation to conduct physical field investigations of claims, verify through field visits to hospitals, pharmacies, and diagnostic centers, and collect evidences for insurer action.

The role requires gathering and analyzing facts, creating in-house reports in CIMA, and ensuring ethics and compliance throughout the investigation process. You will identify malpractices and coordinate with police authorities as needed.

Qualifications

• 0–6 years of experience in risk, loss mitigation or investigations.
• Experience in handling field investigations and evidence gathering preferred.
• Familiarity with regulatory ethics and compliance in investigations.

Responsibilities

• Conduct physical field investigations of claims using system-assigned cases.
• Perform field verifications at hospitals, pharmacies, and diagnostic centers; collect evidence and report to insurers and corporates.
• Prepare reports based on findings and guide actions; gather and analyze facts to build evidence for court use.
• Submit MIS reports and reconcile data.
• Maintain relationships with hospitals and TPA desks; ensure evidence quality as per triggers.
• Escalate issues and manage grievances; file police complaints when fraud is suspected.
• Analyze utilization data to identify trends and cost-saving opportunities; present findings to management.

Skills

Investigation

Evidence collection

Data analysis

Report writing

Tools

CIMA

Job description

Deputy Manager - Risk and Loss Mitigation

• HDFC ERGO General Insurance
• India>North>Uttar Pradesh>Lucknow>Lucknow>Lucknow>1101>Corporate

HDE/JC/17803

Required Experience 0 - 6 years

Basic Section

New Job Title Deputy Manager - Risk and Loss Mitigation

No. Of Openings 1

Grade JM2

Campus/Non Campus Non Campus

Employment Type Permanent

Organisational

Company HDFC ERGO General Insurance

Legal Entity HDFC ERGO General Insurance

SBU/ Channel Enabling Function

Business Function Risk and Loss Mitigation

Cost Center Risk and Loss Mitigation

Cost Center Code 1671

Department Risk and Loss Mitigation

Function Risk and Loss Mitigation

Business Zone NA

Job Role TM-FCI

Country India

Region North

City Lucknow

Physical Branch Lucknow

Branch Lucknow

Branch Code 1101

Type of Office Corporate

Job Description

Physical field Investigation of claim assigned through system.

Handling physical verification, field visits to hospitals, pharmacies, diagnostic centers etc, collect evidences and report for further action to Insurers, Corporates etc.

Preparing reports based on findings and observations and guide / Gathering and Analyzing the facts and developing & creating evidence which stands in court of law

Report submission in CIMA (In house system that is being used for Investigation)

Maintain healthy and cordial relationship with hospitals and TPA desk.

Ascertain evidence quality as per matrix Validate each & every evidence with the case triggers

MIS preparation and report reconciliation

Ensure the ethics and compliance while investigating a claim

Analyze data on utilization, outcomes to determine trends and identify problem areas.

Present findings to the management, which may include reviews, proposed solutions, and implementation of long- and short-term solutions for improvements in claim processing and cost savings.

Identification of Hospitals / individuals involved in malpractices to create database

Escalation & Grievance Management for the investigated cases

Filing of police complaints and liaising with the police authorities for taking necessary action against fraudulent individuals / hospital and others