CoverYou - Head - Legal - LLB (6-8 yrs)

Head - Legal

Position Overview:

- The Legal Head will manage the claims and legal operations, ensuring regulatory compliance, efficient claims resolution, and strategic legal guidance.

- This role requires strong leadership to oversee legal risks, support the claims lifecycle, and foster a robust governance framework to drive operational excellence and client satisfaction.

Key Responsibilities:

1. Claims Management:

- Oversee the complete claims process, ensuring timely and efficient resolution.

- Develop and execute strategies to enhance claims handling procedures and client experiences.

- Serve as the escalation point for complex or high-value claims, negotiating settlements as needed.

- Collaborate with insurers to ensure impartial claims evaluation and resolution.

- Analyze claims data to identify risks and recommend preventive measures.

Legal Operations:

- Provide legal counsel on claims disputes, policy interpretations, and regulatory adherence.

- Draft, review, and negotiate contracts, agreements, and insurance policy documents.

- Represent the organization in legal proceedings, including mediation, arbitration, and court cases.

- Ensure strict compliance with relevant laws, regulations, and industry standards.

- Build and maintain relationships with external legal counsel and other stakeholders.

Risk Management:

- Identify and mitigate legal and operational risks linked to claims and brokerage activities.

- Uphold adherence to internal policies, regulatory frameworks, and ethical standards.

- Conduct legal audits and lead training sessions to bolster compliance awareness.

Team Leadership:

- Lead, mentor, and manage a team of claims specialists and legal professionals.

- Promote a culture of collaboration, continuous improvement, and operational excellence.

- Track team performance, providing constructive feedback and facilitating professional growth opportunities.

Qualifications and Skills:

Essential Qualifications:

- Bachelor's degree in Law (LLB) or equivalent; a Master's degree or certifications in Insurance/Claims Management is advantageous.

- 6-8 years of proven experience in claims management and legal roles, handling negligence/liability claims, preferably in the insurance or financial services sector.

- Deep understanding of insurance laws, regulations, and claims processes.

- Strong negotiation, analytical, and decision-making skills.

- Ability to manage competing priorities, work effectively under pressure, and make sound strategic decisions.

- Excellent communication and interpersonal skills for interaction with clients, insurers, and regulators.

Preferred Skills:

- Knowledge of Drafting

- Someone who has handled Liability/negligence cases for doctors and hospitals.

- Experience in Civil and Criminal Court Cases.

- Knowledge of Doctor Code of Conduct.

Key Performance Indicators (KPIs):

- Timeliness and accuracy of claims processing.

- Resolution rate of complex or high-value claims.

- Compliance with regulatory requirements and audit standards.

- High client satisfaction ratings for claims services.

- Reduced frequency and impact of claims disputes and legal risks.

Work Details:

- Location: Gurgaon

- Employment Type: Full-Time