Motor Claims Specialist

Onecircle Insurance Brokers; Pune District; On-site; INR 900,000 - 1,500,000; Full time

Job summary

Onecircle Insurance Brokers is seeking a senior professional for Client Advocacy & Claims Management in Pune to oversee end-to-end processing, document tracking, and policy evaluation for coverage viability. You will lead complex, high-value claims and coordinate with surveyors and insurers to ensure fair loss assessments.

Additionally, you will drive SLA adherence, manage escalations up to the Ombudsman level if needed, and mentor junior team members to improve technical skills and client

Responsibilities

• Oversee the registration, documentation, and tracking of all claims.
• Analyze policy wordings, terms, and exclusions to advise clients on coverage viability.
• Personally manage complex, high-value, or commercial fleet accidental claims, ensuring rapid resolution.
• Coordinate with independent surveyors, workshop managers, and insurance company assessors for fair loss assessment.
• Maintain Turnaround Times (TAT) with insurers for cashless approvals, spot surveys, and final disbursements.
• Negotiate and resolve deductions or claim repudiations by presenting technical representations to insurers.
• Maintain detailed MIS reports on claim ratios, settlement statuses, and outstanding claims for corporate clients.
• Manage escalations through internal mechanisms and handle queries up to the Insurance Ombudsman level if required.
• Guide and mentor junior claims executives to improve technical assessment skills and client handling.
• Identify, tie up with, and build a network of preferred garages and workshops to offer seamless claims experience to customers.
• Draft and enforce SLAs with partner workshops covering vehicle pickup, estimation turnaround, repair quality, and delivery timelines.
• Conduct regular audits and performance reviews of network workshops to ensure adherence to customer-satisfaction SLAs and control repair costs.

Job description

Client Advocacy & Claims Management

• End-to-End Processing: Oversee the registration, documentation, and tracking of all claims.
• Technical Evaluation: Analyze policy wordings, terms, and exclusions to accurately advise clients on coverage viability.
• High-Value Escalations: Personally manage complex, high-value, or commercial fleet accidental claims, ensuring rapid resolution

Insurer & Surveyor Liaison

• Surveyor Coordination: Coordinate with independent surveyors, workshop managers, and insurance company assessors to ensure fair loss assessment.
• TAT Reduction: Work with insurers to maintain strict Turnaround Times (TAT) for cashless approvals, spot surveys, and final disbursements
• Dispute Resolution: Negotiate and resolve deductions or claim repudiations by presenting technical representations to insurers.

Operations & Strategy

• MIS & Reporting: Maintain detailed daily, weekly, and monthly MIS reports on claim ratios, settlement statuses, and outstanding claims for corporate clients.
• Grievance Redressal: Manage escalations through internal mechanisms and handle queries up to the Insurance Ombudsman level if required.
• Team Leadership: Guide and mentor junior claims executives to improve technical assessment skills and client handling

Network Expansion & SLA Management

• Preferred Workshop Network: Strategically identify, tie up with, and build a robust network of preferred garages and workshops across key geographies to offer seamless claims experience to OneCircle customers.
• SLA Formulation & Implementation: Draft and enforce strict Service Level Agreements (SLAs) with partner workshops covering critical metrics like vehicle pickup time, estimation turnaround, repair quality, and delivery timelines.

Performance Monitoring: Conduct regular audits and performance reviews of network workshops to ensure adherence to defined customer-satisfaction SLAs and control repair costs.