Claims Head

Livlong 365 · Maharashtra, India

The Head - Claims will lead end-to-end Retail and Corporate Claims operations with a strong broker-first mindset. The role preferably requires prior experience in an insurance broking environment, managing multi-insurer portfolios and acting as the customer's primary advocate while ensuring policy and regulatory compliance.

• Lead claims strategy across Retail (Health) and Corporate (GMC, GPA, GTL & GI) portfolios.
• Establish broker-driven SOPs, escalation frameworks, and TAT benchmarks.
• Oversee complex retail claims including repudiations, deductions, and grievance redressals.
• Manage corporate employee benefit claims including large losses, ICU cases, and CXO-level escalations.
• Negotiate corporate buffers, special approvals, and business-call settlements with insurers.
• Act as the senior broker interface with insurers, TPAs, and key hospital networks.
• Drive claims MIS, loss ratio analysis, ageing reports, and renewal-support insights.
• Support cross-sell initiatives including OPD, top-ups, wellness, and AHC solutions.
• Lead, mentor, and scale retail and corporate claims teams with clear KPIs and accountability