Senior Executive-Appeal & Specialised Claims Senior Executive-Appeal & Specialised Claims
Claims Management
Review the MIS on an on-going basis for claims closure, claim size and settlement ratio for the allocated region.
Propose the amount that needs to be reserved for each case after consultation with claims team to the based on case facts
Collect all evidences relevant to the case in coordination with claims team and thereby devise an appropriate case strategy in consultation with claims team .
Prepare and file the WS,affidavit and document in the court; appear in court when required
Collaborate with the advocate vendors on implementing the case strategy
Prepare for effective contest before appropriate court/forum or tribunal and early closure of claims if it is categorized as compromise (No defense case); conduct a thorough review, meticulous follow-up on pending cases, attempt compromise in possible cases. Adherence of TAT relating to litigation and compliance.
To ensure that all compliances should be done in time relating to court orders, NO attachment or warrant should be issued
Drive the team to meet their targets by conducting regular meetings to track progress on set targets
Guide the team to execute the appropriate line of action in respect of defense/contest case so as to have quick and proper closure of cases.
Act as guide for team for tough negotiations (for compromise possible cases) and critical defense/contest cases.
Control the claim size for the region by checking and maintain the quality of claims that are settled
Liaise with other internal functions such as Claim teams, ILM, Operations, underwriting to ensure successful closure of cases
Evaluation on merits for cases preferring for appeal in High Court and State Commission on basis facts, evidence and law points and advising on best suitable decision is an additional role for cases to be filed before State Commission and High Court.
To represent company alongwith claims team before Ombudsman office being a nodal officer of company for Particular State Ombudsman forums.
Be abreast with the latest case laws and precedents in order to arrive at a judicious decision while defending a claim or suggesting for compromise or for compliance of an award.
Vendor Management
Effectively engage, build relationships and expand the existing network of advocates in the region
Address the grievances of the vendor partners, provide trainings on latest developments with regards to legal aspects that impact their area of work as well as the latest developments in BAGIC
Negotiate costs, partnership terms as well as scope of work, for best possible arrangement for the services provided
Conduct regular and periodic review meetings to share feedback and improve the overall quality of services rendered.
To Select Appropriate Senior advocate considering technicalities, expertise and bench hearing the case.
Provide and get feedback from the vendors and also efficiently communicate the expectation of the organization for delivery of better and required results.
Nurture the new vendors by guiding them, providing them with relevant study materials in order to develop them for future stakeholders in the success path of the organization.
Team Management and Development
Provide recommendations to Team Members w.r.t. cases and guide them as and when required.
Keep the team abreast of the latest judgments and its impact on the GI business
Establish individual performance expectations and regularly review individual performance of the team
Engage with the team in a timely manner to understand the bottlenecks and the support their need.
Provide guidance to team members on how to engage with the Lok Adalat, advocates and judges.
Guide the team in their personal as well as professional growth in order to prepare the team members as future team leaders.
Analysis and Reporting
Review MIS reports pertaining to claims management in the region and draw insights that would be helpful to improve the performance of the team as well as vendor partners
Apply trend analysis on certain types of cases, courts etc. that would be helpful in future cases to decide on whether to appeal/contest and the case strategy
Legal Fundamentals