Vice President - Claims

Job Summary

Responsible for the overall direction, governance, control, and management of Claims Operations for the organization. The role is focused on building a customer-centric, risk-aware, compliant, and future-ready Claims function that contributes significantly to business growth, customer trust, and organizational profitability. The position requires strategic leadership to drive operational excellence, industry-leading customer experience, risk management, digital transformation, and talent development while ensuring adherence to regulatory requirements and Company policies.

Key Responsibilities

Drive Claims Strategy & Functional Excellence

·Formulate and drive the long-term strategy, objectives, and priorities for the Claims function in alignment with organizational goals and market dynamics

·Ensure effective governance and oversight of all claims decisions within the ambit of regulatory guidelines, industry practices, and Company policies.

·Lead engagement with Claims Council, industry forums, reinsurers, and regulatory bodies to influence and adopt best practices.

·Ensure effective management of high-value, complex, and sensitive claims cases.

Build Strong Risk Management Practices

·Drive prudent risk management in claims by effective assessment & investigation processes.

·Lead building of sound risk management practices by enabling experience analysis, feedbacks to distribution, participation in mortality management and product development.

Compliance with Regulatory guidelines

·Ensure adherence to all applicable IRDAI regulations, Insurance Act provisions, customer protection guidelines, grievance redressal requirements, and internal governance standards.

People Management

·Build and lead a highly engaged, capable, and customer-focused claims organization.

·Develop leadership pipelines, succession plans, and critical talent capabilities across the Claims function.

·Partner with HR to drive employee engagement, capability building, leadership development, retention, and recognition initiatives.

Measures of Success

• Industry-leading Claims Settlement Ratio and Claims Settlement TAT.
• Achievement of SLA and regulatory compliance requirements across all business lines.
• Strong audit ratings with timely closure of control gaps and regulatory observations.
• Effectiveness of engagements with Claims Council to deliver on key agendas.
• High level of distributor & customer satisfaction scores.
• Successful implementation of digital transformation and automation initiatives.
• Effectiveness of Change Management

Desired qualification and experience

• Post Graduate/MBA preferably in Law, Finance, Medicine or Insurance
• Strong technical knowledge of Life Insurance Claims, Risk Management, Regulatory Frameworks, and Reinsurance.
• Added qualifications from Insurance Institute of India, LOMA, ICA etc will be preferred.
• Professional certifications from LOMA, ICA, Insurance Institute of India, or equivalent institutions desired
• Minimum 15-18 years of relevant experience with significant leadership experience in Claims Management.
• Excellent business writing, presentation, stakeholder management, and negotiation skills.
• Experience in managing regulatory and industry-level interactions.