About the role
To strengthen the organization's fraud risk management framework through proactive fraud detection, investigation, monitoring, analytics, and process control. The incumbent will be responsible for identifying fraud risks across the policy lifecycle, conducting investigations, recommending preventive controls, and driving fraud awareness across the organization.
Key Responsibilities Fraud Monitoring & Investigation- Conduct investigations into suspicious proposals, customer complaints, death claims, persistency-related frauds, and other high-risk cases.
- Review fraud alerts and exceptions generated through internal monitoring systems.
- Perform root-cause analysis of fraud incidents and recommend corrective actions.
- Coordinate with business teams, operations, underwriting, claims, legal, and compliance functions during investigations.
- Fraud Analytics & Risk Assessment
- Analyze fraud trends, emerging risks, and modus operandi across channels and products.
- Develop and maintain fraud monitoring dashboards, scorecards, and exception reports.
- Identify high-risk geographies, intermediaries, products, and processes requiring intervention.
- Support enhancement of fraud detection models and analytical tools.
- Support regulatory and management reporting related to fraud risk.
- Maintain accurate case records, investigation reports, and fraud MIS.
- Ensure adherence to IRDAI guidelines and internal fraud management policies.
- Assist during audits, regulatory reviews, and compliance assessments.
- Recommend process improvements to reduce fraud vulnerabilities.
- Partner with business stakeholders to strengthen preventive and detective controls.
- Participate in new product, process, and system reviews from a fraud risk perspective.
- Support implementation of fraud risk management initiatives across the organization.
- Conduct fraud risk awareness sessions for sales, operations, underwriting, claims, and partner teams.
- Share industry fraud trends, case studies, and emerging risk practices.
- Promote a strong fraud risk and compliance culture across the organization.
- Professional qualifications in Risk, Forensics, Investigation, Compliance, Insurance, or Analytics will be an advantage.
- 5+ years of experience in Life Insurance, General Insurance, Banking, NBFC, Risk Management, Fraud Investigation, Claims Investigation, Underwriting, or Compliance functions.
- Prior experience in Fraud Risk Management, Investigation, Risk Containment Unit (RCU), Fraud Monitoring Unit (FMU), Claims Investigation, or Customer Verification preferred.