Senior Associate - Motor Claims Audit

Navi Limited; Bengaluru; On-site; INR 900,000 - 1,300,000; Full time

Job summary

Navi is seeking a Senior Associate, Motor Claims Audit to conduct end‑to‑end audits of motor OD claims. The role requires reviewing surveyor reports, repair estimates, and settlements to ensure compliance with policy and regulatory guidelines.

You will work with Claims, Operations, Product, and Technology teams to identify gaps, leakage, and corrective actions. Strong data analysis and stakeholder communication are essential.

Qualifications

• 3+ years of experience in Motor Claims, with exposure to audits, quality, or investigations.
• Strong understanding of Motor OD claims lifecycle (FNOL to settlement).
• Knowledge of vehicle damage assessment, repair processes, depreciation, and settlement practices.
• Proficiency in Excel/Google Sheets; SQL or analytics tools an advantage.

Responsibilities

• Conduct end-to-end audits of Motor Own Damage (OD) claims across cashless and reimbursement journeys.
• Review claim processing, surveyor assessment, repair estimates, approvals, deductions, settlements, and claim closure.
• Validate alignment with policy terms, coverage, exclusions, deductibles, depreciation, and guidelines.
• Identify incorrect approvals, incorrect rejections, excess payments, missed deductions, under-deduction, and financial leakage.
• Evaluate the accuracy and completeness of claim documentation and supporting evidence.
• Review high-value, high-risk, exception, and targeted claims.

Skills

Motor Claims

OD lifecycle

Damage assessment

Excel/Sheets

SQL

Data analytics

Communication

Independent working

Tools

SQL

Power BI/Tableau

Job description

About the Team

The Procex team is responsible for ensuring the accuracy, compliance, efficiency, and financial integrity of motor claims processing. The team independently reviews motor claims to identify process gaps, incorrect claim decisions, financial leakages, system/process errors, potential fraud indicators, and opportunities for improvement.

About the Role

As a Senior Associate, Motor Claims Audit, you will be responsible for conducting end-to-end audits of motor claims to assess whether claims have been processed in accordance with policy terms, internal guidelines, regulatory requirements, and defined processes.

The role requires a strong understanding of motor claims, vehicle damage assessment, repair estimation, surveyor assessment, claim documentation, settlement practices, and the ability to identify errors, inconsistencies, and potential leakage through detailed claim-level analysis.

You will also work closely with Claims, Surveyors, Garages, Operations, Product, Technology, and other stakeholders to drive corrective actions and strengthen motor claims processes.

Key Responsibilities

1. Motor Claims Audit

• Conduct end-to-end audits of Motor Own Damage (OD) claims across cashless and reimbursement journeys.
• Review claim processing, surveyor assessment, repair estimates, approvals, deductions, settlements, and claim closure.
• Validate whether claim decisions are aligned with policy terms, coverage, exclusions, deductibles, depreciation, limits, and applicable guidelines.
• Identify incorrect approvals, incorrect rejections, excess payments, missed deductions, under-deductions, and other financial leakages.
• Evaluate the accuracy and completeness of claim documentation and supporting evidence.
• Review high-value, high-risk, exception, and targeted claims based on defined audit parameters.

2. Surveyor & Garage Assessment

• Review surveyor reports and validate the assessment of vehicle damage, repair/replacement decisions, labour charges, parts, and estimates.
• Identify instances of inappropriate repair versus replacement decisions or unsupported claim costs.
• Assess the reasonableness of repair estimates and settlement amounts.
• Identify recurring issues across surveyors, garages, locations, or claim handlers.
• Highlight potential collusion, inflated estimates, duplicate billing, abnormal repair patterns, or other fraud/fraud-risk indicators.

3. Process & Compliance Audit

• Evaluate adherence to defined Motor Claims SOPs, processes, approval matrices, and internal controls.
• Identify gaps in claim documentation, mandatory checkpoints, approvals, system usage, and claim disposition.
• Distinguish between people, process, system, and policy-related errors and identify the root cause.
• Review whether appropriate escalation and approval mechanisms have been followed for exception and high-value claims.
• Identify gaps that could result in regulatory, financial, operational, or customer-impacting risks.

4. Data Analysis & Targeted Audits

• Use claims data to identify trends, anomalies, and potential risk areas for targeted audits.
• Develop and refine audit sampling logic based on claim characteristics, value, repair type, garage/surveyor performance, claim duration, and other risk indicators.
• Analyse audit findings to identify recurring problem statements and systemic gaps.
• Prepare periodic dashboards and MIS covering audit coverage, error trends, financial impact, root causes, and corrective actions.
• Use data-driven insights to improve audit coverage and identify potential leakage proactively.

5. Fraud & Leakage Identification

• Identify suspicious claims and patterns requiring further investigation.
• Analyse claim-level and portfolio-level indicators to identify potential fraud or abuse.
• Support investigation teams by providing relevant claim findings, supporting evidence, and data analysis.
• Track identified financial impact and potential savings/recovery opportunities.
• Recommend preventive controls based on recurring fraud and leakage patterns.

6. Stakeholder Management

• Work closely with Motor Claims, Operations, Product, Technology, and other relevant teams to close audit observations.
• Present audit findings with clear evidence, root cause, financial impact, and recommended corrective actions.
• Drive timely closure of audit observations and monitor action plans.
• Escalate critical or recurring gaps to relevant stakeholders and leadership.
• Support calibration sessions to ensure consistent interpretation of policies and audit standards.

7. Process Improvement & Automation

• Identify opportunities to simplify and automate repetitive audit activities.
• Partner with relevant teams to improve claim controls, system validations, and audit checkpoints.
• Provide feedback on system/process enhancements based on audit observations.
• Identify opportunities for preventive controls rather than relying only on post-claim audits.
• Contribute to development of automated dashboards, exception reports, and risk-based sampling mechanisms.

Must Haves

• 3+ years of experience in Motor Claims, preferably with exposure to claims audit, quality, claims processing, surveyor assessment, or claims investigation.
• Strong understanding of the Motor OD claims lifecycle, including FNOL, survey, assessment, repair estimation, approval, settlement, and closure.
• Good knowledge of vehicle damage assessment, automobile parts, repair processes, labour charges, depreciation, and claim settlement practices.
• Ability to identify claim processing errors, financial leakage, process deviations, and control gaps.
• Strong analytical and problem-solving skills with an ability to interpret large claim datasets.
• Strong attention to detail and ability to validate claim-level documentation and evidence.
• Good understanding of Excel/Google Sheets; exposure to SQL, dashboards, or analytics tools will be an advantage.
• Strong written and verbal communication skills.
• Ability to present findings clearly to business and senior stakeholders.
• Strong ownership, structured thinking, and ability to work independently.

Good to Have

• Experience in Motor Claims Audit / Quality Assurance / Claims Investigation / Fraud & Risk.
• Exposure to digital claims platforms and automated claim assessment tools.
• Experience in developing audit sampling/risk-based selection logic.
• Knowledge of IRDAI guidelines and motor insurance regulatory requirements.
• Experience in process improvement, automation, or data analytics.
• Experience working with surveyors, garages, and motor claims service providers.

Key Success Metrics

• Audit coverage and completion within defined TAT.
• Accuracy of audit findings and identification of critical errors.
• Financial leakage identified and prevented.
• Reduction in recurring process and claim decision errors.
• Timely closure of audit observations.
• Identification of fraud/suspicious claim patterns.
• Effectiveness of corrective and preventive actions.
• Improvement in motor claims process quality and controls.

About Navi

We are on a mission to make finance simple, accessible and affordable for a billion Indians. Guided by a strong customer-first approach, we are building tech‑first solutions that work at scale. Our offerings include a range of financial products and services across Loans, Insurance, Mutual Funds, Digital Gold, and UPI.

Founded by Sachin Bansal & Ankit Agarwal in 2018, Navi is one of India's fastest‑growing financial services organisations.

Our Culture

At Navi, we are a place where ambition meets opportunity and ideas turn into impact quickly. We empower people with high ownership from the start, encouraging them to solve meaningful problems and build with excellence. Teams work in an environment that values speed, collaboration, learning, and shared wins.