Senior Executive - Risk and Loss Mitigation

PeopleStrong; Kolkata District; On-site; INR 350,000 - 500,000; Full time

Job summary

HDFC ERGO General Insurance is seeking a Senior Executive - Risk and Loss Mitigation in Kolkata to perform physical field investigations of claims and verify information through hospital, pharmacy, and diagnostic site visits. The role involves collecting evidences, reporting to insurers and corporates, and ensuring data quality for dispute resolution.

You will prepare findings, analytics, and MIS reports, maintain ethical conduct, and escalate issues as needed.

Qualifications

• Graduation or higher qualification required.
• Proficiency in Excel and basic computer skills.
• Medical graduates with health insurance/claims investigation exposure preferred.

Responsibilities

• Physically verify claims by field investigation and collect evidence.
• Coordinate field visits to hospitals, pharmacies, diagnostic centers; report findings to insurers and corporates.
• Prepare observation reports and guide case development for legal action; maintain evidence quality.

Skills

Graduation

Excel

Education

Medical graduates e.g. BAMS/BHMS/BPT/BDS

Job description

Senior Executive - Risk and Loss Mitigation

HDE/JC/17839

• HDFC ERGO General Insurance
• India>East>West Bengal>Kolkata>Kolkata>Kolkata>3101>Corporate

Posted On 10 Sep 2026

End Date 10 Sep 2027

Required Experience 0 - 3 years

Basic Section

New Job Title Senior Executive - Risk and Loss Mitigation

No. Of Openings 1

Grade JM1

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 East

City Kolkata

Physical Branch Kolkata

Branch Kolkata

Branch Code 3101

Type of Office Corporate

Skills

Skill

Graduation

CERTIFICATION

Working Language

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

Required Qualifications:

Medical Graduates such as BAMS/BHMS/BPT or BDS with working experience of Health insurance industry preferably with Claims investigation/ processing experience

Excel and computer