Manjari Pathak

Experience

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  Bajaj Allianz General Insurance Co. Ltd.

  May 2009 - Aug 2011

  Senior Executive, TP Claims

  • Monitoring cases of the company in Tribunals and High Courts, consumer disputes at District Forums and State Commission, and workmen’s compensation disputes. • Ensuring successful negotiations and compromises. • Drafting replies & WS along with Written notes to be filed in Court of law. Managing and administering day to day proceedings of the courts. • Managing empanelled advocates and investigators in proper settlement of claims and complaints. Monitoring of Legal compliances from Head Office at local level and keep a check upon frauds cases against the company.• High service delivery related to Third Party Claims, Third Party Claim query handling. Responsible for Scrutiny of claim documents and adjudication of all life insurance claim types. • Analyze & Understand medical terminologies. Liaison with underwriters and reinsurers for re-underwriting of claims and seeking reinsurance opinion. • Documentation and report maintenance. Ensure timely circulation of claims MIS. Timely Tracking of Pending cases and follow-up with various customers touch points like branches, agents/advisors. • Timely Publishing of various claims MIS/Reports Timely updating of Process manuals Ensure Turnaround Time is maintained for all activities as per IRDA guidelines and internal TATs as set by function. Responsible for preparing Monthly Reinsurance, Actuarial, and IRDA MIS. • Understand claims system and its core functionalities, track defects and reporting, development of new tools. Preparation of test cases for claims UAT, testing cases and implementation. • Actively contribute to the Third Party Claims strategy and its implementation & monitoring at regular intervals. Hence be able to contribute and participate in the audits by IRDA, reinsurers, Prudential and internal audits• To contribute in the training of junior Third Party Claims assessors and any other internal stakeholder if required. Show less

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  Royal Sundaram Alliance Insurance Company Limited

  Aug 2011 - May 2014

  Head, Contest and Defense, TP & Corporate Legal team

  • Monitoring cases of the company in Tribunals and High Courts, consumer disputes at District Forums and State Commission, and workmen’s compensation disputes. • Ensuring successful negotiations and compromises. • Drafting replies & WS along with Written notes to be filed in Court of law. Managing and administering day to day proceedings of the courts. • Managing empanelled advocates and investigators in proper settlement of claims and complaints. Monitoring of Legal compliances from Head Office at local level and keep a check upon frauds cases against the company.• High service delivery related to Third Party Claims, Third Party Claim query handling. Responsible for Scrutiny of claim documents and adjudication of all life insurance claim types. • Analyze & Understand medical terminologies. Liaison with underwriters and reinsurers for re-underwriting of claims and seeking reinsurance opinion. • Documentation and report maintenance. Ensure timely circulation of claims MIS. Timely Tracking of Pending cases and follow-up with various customers touch points like branches, agents/advisors. • Timely Publishing of various claims MIS/Reports. • Understand claims system and its core functionalities, track defects and reporting, development of new tools. Preparation of test cases for claims UAT, testing cases and implementation. • Actively contribute to the Third Party Claims strategy and its implementation & monitoring at regular intervals. Hence be able to contribute and participate in the audits by IRDA, reinsurers, Prudential and internal audits• To contribute in the training of junior Third Party Claims assessors and any other internal stakeholder if required.• Call centre support: Support the call centre with the information desired for query resolution & Claim status. Show less

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  Teach For India

  Jun 2014 - Apr 2015

  Teaching Fellow

  Taking up the responsibility of overall growth of students in government school by ensuring they excel academically with right amount of exposure and access and have apt values and mind set. Spreading the vision of the organization by channelizing various sources and creating awareness within and outside the community.

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  Teach For India

  Jun 2015 - Apr 2017

  Teaching Fellow

  Worked as a fellow teaching Grade 2 students in underprivileged schools across Pune and Chennai. Focused on improving education quality and student performance by applying innovative teaching methods. Promoted the organization's mission, enhancing educational opportunities and fostering holistic development in students. Engaged with community stakeholders to strengthen educational infrastructure and support systems.

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  Bajaj Allianz General Insurance Co. Ltd.

  Aug 2017 - Sept 2023

  Claims

  Managed a diverse portfolio of claims, providing leadership in claims adjudication, negotiations, and settlements over a span of 6 years. Enhanced processes for claim handling, improving efficiency and compliance with regulatory standards. Collaborated with cross-functional teams to analyze complex claims and develop strategic solutions to minimize settlements and maximize customer satisfaction.

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  Sirius Wellness & Outreach Medical Services Pvt. Ltd.

  Oct 2023 - now

  Co-Founder & Director

  As a COO, responsible for Overseeing daily operations and ensure the efficiency and scalability of the company’s processes. Lead the design and implementation of effective business strategies, plans, and processes. Optimize resource utilization and ensure compliance with industry best practices, policies, and standards. Lead, mentor, and develop high-performing teams to support business growth. Foster a collaborative and agile culture that encourages continuous learning and development. Build and maintain strong relationships with key clients, partners, and stakeholders. Show less

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  Tajurbaa

  Mar 2024 - now

  Co-Founder & Director at Tajurbaa-the Experience

  As a Co-Founder & Director, responsible for overseeing the entire operation and strategic planning of the organization. Instrumental in establishing partnerships with local healthcare providers and expanding outreach services across regions in Pune. Leading a team focused on increasing community health awareness and providing wellness services. Actively involved in financial management, marketing strategies, and program development to ensure sustainable growth.