Job Description

Fraud Detection Manager - Life Insurance

- The role would be directly responsible for early detection of fraud/adverse selection policies and preparing product/partner risk guidelines to mitigate fraud risk

Key Responsibilities :

- To be directly responsible for early detection of suspicious cases at new business login and post issuance cases

- To provide insights and learning from adverse cases to strengthen proactive detection of frauds and sourcing guidelines

- To be responsible for assurance on portfolio quality through review of partners/distributor, adverse regions/branches, and products.

- To create risk guidelines to mitigate adverse selection risk for specific channels/products/partners/geographies

- To assess and mitigate pre & post issuance risk in the portfolio by ensuring process adherence, sales process governance

Specific Authorities(Financial & Non Financial)

- To be authorized to give sign off for new partner/distributor onboarding

Key Performance Indicators :

- Claims A/E
- To increase fraud hit ratio by 10% via identifying adverse policies for conducting IPV

- Higher pre issuance rejection compared to post issuance cancellation

Job Requirements :

- Qualifications MBA, Degree in Statistics/Engineering preferred

Experience :

- 7-10 years of experience (Life Insurance experience preferred)

Functional Competencies :

- Prevention & Detection: Understanding of fraud risk in Insurance domain

- Risk framework and process knowledge: Understanding of U/W process/risks and guidelines for product risk assessment

- MIS & Analytics: Risk & data analytics

Behavioral Competencies :

- Collaboration

- Building Talent & Teams

- Execution Excellence

Key Interactions :

Internal Nature or purpose of interaction :

- Ops/Claim/U/W/Actuary & Sales

- Regular feedback to underwriting / Claims / other functions on process improvement areas basis risk findings

External Nature or purpose of interaction :

- Industry Regular interaction with Industry forum (IIB)/peers to understand trends/best practices and obtain adverse findings among the declined/cancelled/death claims policies.

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