Complaints & Escalated Claims Specialist, Assurant-India

Reporting into the Outsource Vendor Manager, CL you will be the primary contact for complaints and (escalated) claim inquiries. You will resolve formal complaints and additionally, will track escalation data for operations and reporting purposes and propose settlement agreements. Oversight of the business’s Complaints Claims Assessment system and processes.

This position will be Work from Office at our Mumbai, India location.

What will be my duties and responsibilities in this job?

• Oversight of our Complaints Claims Assessment system and processes.
• Manage multiple issues/cases at one time simultaneously based on workload.
• Accurately, independently and fairly assess and review claims and complaints based on the T&C and to conduct claims reviews on high value claims
• Identify and escalate serious or urgent cases to the MD.
• Identify opportunities for a process improvement for the betterment of the customer experience and Assurant Operations from a cost-saving perspective.
• Communicate with medical advisor, to discuss medical conditions and complex cases where required and report findings.
• Ensure that Service Levels Agreements, Internal and Regulatory timelines are met.
• Required to log and track each issue in multiple tracking systems for the purpose of generating reports.
• Maintain a high level of Complaint-handling skills, following agreed service level agreements, contracts and against policy conditions.

What are the requirements needed for this position?

• 7 + years in experience in composing responses to external contacts
• Experience with claim handling and dealing with complaints.
• Work experience in insurance industry is important.
• Experience within customer focused roles.