Malathy Nair
Mumbai
Summary
Being a Master in Commerce, my career vision is to contribute my working skills in enhancing an organization which offers diverse opportunities. Hardworking and passionate job seeker with strong organizational skills eager to secure mid-level Senior Advisor position. Ready to help team achieve company goals. Energetic and enthusiastic insurance professional motivated to succeed in fast-paced and deadline-driven professional environment.
Overview
7
7
years of professional experience
1
1
Certification
Work History
Senior Claims Adjuster
Willis Towers Watson
Thane
02.2024 - Current
- Analyzed policy provisions, endorsements, exclusions and conditions to determine claim validity.
- Investigated complex property and casualty claims to determine appropriate coverage, liability and damages.
- Verified documents to ensure accuracy of information provided by customers.
- Prepared detailed reports on claim status, payment history, and other relevant information.
- Maintained accurate records of all claim activities in accordance with company policies.
- Resolved customer inquiries promptly while ensuring compliance with applicable laws and regulations governing the insurance industry.
- Ensured that all payments were made within established time frames outlined in the policy agreement.
- Conducted regular audits of closed files to verify accuracy of data entry into the system.
- Analyzed and interpreted policy provisions to determine coverage and liability.
- Determined liability, compensability and benefits due on each claim.
Senior Advisor
TCS
Mumbai
05.2021 - 11.2021
- Verified insurance claims and determined fair amount for settlement.
- Examined claims forms and other records to determine insurance coverage.
- Negotiated with policyholders and claimants to reach mutually satisfactory resolutions.
- Maintained suspicious claims database and prepared reports for supervisors.
- Mitigated risks and increased profitability with well-developed strategies for reducing future claims and costs.
- Researched and analyzed policy contracts to verify proper payment of claims.
- Evaluated insurance policies and analyzed damages to determine coverage.
- Substantiated legitimate claims and denied unjustified claims.
Claims Advisor
Willis Towers Watson
Thane
08.2019 - 04.2021
- Followed up with customers on unresolved issues.
- Conducted full claim investigations and reported updates and legal actions.
- Reviewed new files to determine current status of injury claim and to develop plan of action.
- Utilized appropriate cost containment techniques to reduce overall claim costs.
- Escalated files with significant indemnity exposure to supervisor for further investigation.
- Understood requirements for disputes, gathered evidence to support claims and prepared customer cases to handle appeals.
- Reviewed insurance and claims documents to verify required information and secure any missing data for settlements.
- Monitored compliance with regulations and industry best practices to promote fair and proper treatment for insured customers.
- Provided advice to customers regarding claims, rights and insurance processes to prevent disputes.
Transaction Process Associate,
Accenture Pvt Ltd
Mumbai
01.2017 - 04.2019
- Performed quality assurance checks on transactions and account actions to assess compliance with state and federal regulations.
- Identified and resolved process issues to drive optimal workflow and business growth.
- Collaborated with team to define business requirements for organizational processes, achieve productivity standards, and adhere to accuracy standards.
- Assessed clients' financial data to determine loan suitability.
- Collaborated with and facilitated communications between borrowers and lenders to obtain ideal loans for home purchases.
Education
Mcom - Commerce
Mumbai University
BBI - Bcom in Banking And Insurance
SIES College
Commerce -
Vani Vidyalaya High School
Holy Angels High School And Jr College
Skills
- Strong interpersonal skills
- Insurance fraud expertise
- Strategic Decision-Making
- Analytical Problem Solving
Certification
Tally ERP 9
Accomplishments
- Excellence in delivering performance (Accenture - 2017)
- Starr Performer (WTW - 2018)
- Performer of the month (WTW -2019)
Languages
Tamil
First Language
English
Intermediate (B1)
B1
Hindi
Intermediate (B1)
B1
Marathi
Intermediate (B1)
B1
Timeline
Senior Claims Adjuster
Willis Towers Watson
02.2024 - Current
Senior Advisor
TCS
05.2021 - 11.2021
Claims Advisor
Willis Towers Watson
08.2019 - 04.2021
Transaction Process Associate,
Accenture Pvt Ltd
01.2017 - 04.2019
Mcom - Commerce
Mumbai University
BBI - Bcom in Banking And Insurance
SIES College
Commerce -
Vani Vidyalaya High School
Holy Angels High School And Jr College
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