Manager

Shriram Life Insurance; Rangareddy; On-site; INR 1,800,000 - 2,400,000; Full time

Job summary

The Manager Fraud Control Unit will independently lead, mentor, and govern a specialized team of risk assessors conducting comprehensive pre- and post-issuance forensic reviews and early claim investigations. The core mandate is to identify material misstatement, non-disclosure, and systemic fraud within the boundary lines of Section 45 of the Insurance Act, India.

The role requires strong leadership, regulatory knowledge, and hands-on analytics using Power BI to deliver timely insights to

Qualifications

• Graduate or Post Graduate in Risk Management, Finance, Insurance, Law, or Business Administration.
• Certifications: CFE or III Associate/Fellowship preferred.

Responsibilities

• Section 45 governance and post-issuance forensic audits within regulatory timelines.
• Lead, mentor, and manage a team of risk assessors and field agency partners.
• Develop analytics and dashboards using Power BI to track fraud trends and savings.
• Collaborate with underwriting, legal, and compliance units.

Skills

Regulatory Expertise

Stakeholder Negotiation

Data Analytics

Leadership

Education

Graduate or Post Graduate in Risk Management, Finance, Insurance, Law, or Business Administration

Tools

Power BI

Tableau

Microsoft Excel

Job description

Role & responsibilities:

The Manager Fraud Control Unit will independently lead, mentor, and govern a specialized team of risk assessors conducting comprehensive pre-post-issuance forensic reviews and early claim investigations. The core mandate of this role is to identify material misstatement, non-disclosure, and systemic syndication fraud within the strict boundary lines of Section 45 of the Insurance Act, India. The ideal candidate ensures that all field/desktop investigations are legally bulletproof, structured within strict regulatory timelines, and tightly coordinated with internal legal and underwriting stakeholders.

Key Responsibilities & Scope of Work

1. Section 45 Governance & Post-Issuance Forensic Audits

• Contestability Window Analysis: Oversee the review of high-risk issued policies approaching or within the 3-year contestability window specified under Section 45.
• Evidentiary Standard Enforcement: Ensure that all investigation reports present clear, legally admissible evidence of intentional fraud, suppression of facts, or identity fraud to sustain contract repudiations.
• Pre-Claim Scrutiny: Manage backward-looking investigations on early claims (policies failing within 1-3 years of issuance) to mitigate severe financial leakages.

2. Team Leadership & Field Agency Management

• People Management: Direct, train, and track the daily throughput of a team of Assistant Managers, senior executives, and data analysts.
• Vendor Governance: Empanel, audit, and manage external legal and private investigation agencies across various geographies.
• TAT & Quality Controls: Strictly monitor agency Turnaround Time (TAT) and perform surprise calibration audits on field report quality to eliminate vendor collusion.

3. Cross-Functional Synergy & Technical Strategy

• Underwriting & Claims Partnership: Provide actionable field intelligence back to the Underwriting unit to update risk scoring models and improve future point-of-sale triggers.
• Legal and Compliance Liaison: Partner with the internal Legal cell to represent the company in ombudsman cases or consumer courts regarding challenged policy cancellations.
• Dashboarding & Analytics: Build data pipelines and visual matrices using Power BI to present weekly trends on emerging fraud patterns and savings reports to executive leadership.

Role Requirements & Qualifications

• Minimum Requirement: Graduate or Post Graduate in Risk Management, Finance, Insurance, Law, or Business Administration.
• Preferred Certifications: Certified Fraud Examiner (CFE) or Associate/Fellowship from the Insurance Institute of India (III).

Experience Range

• Minimum 5-7 years of core experience in the Risk Containment Unit (RCU) / Fraud Control Unit (FCU) domain within the BFSI sector, with a strong preference for Life or Health Insurance operations.
• At least 2 years of direct experience handling team management and managing vendor networks across India.

Technical & Core Competencies

• Regulatory Expertise: Thorough working knowledge of the Insurance Act of India (specifically Section 45 rules), IRDAI fraud management guidelines, and consumer court precedents.
• Analytical Tools: Intermediate to advanced proficiency in Microsoft Excel, Office 365 automation, and data visualization tools like Power BI or Tableau.
• Soft Skills: Exceptional stakeholder negotiation skills, uncompromising integrity, and a methodical mind capable of linking disparate data points to uncover syndicates.