Fraud Control & Claims Investigator Professional

I am currently available for work
Serial No: 102232
(02/28/1973, male)
Skills keywords: claims investigator, debt management, fraud investigation;
List Of Qualifications:

B.Sc. (Physics) from Parle College, Mumbai University in 1994.
Qualteam Consultants (India) Private Limited: Internal Quality Auditor (ISO 9001:2000): 5th February 2002 – 6th February 2002
G E Crotonville: Hiring the Right People: 5th November 2007
Benchmark Six Sigma: Six Sigma Green Belt Certification: 11th June 2008 – 14th June 2008
Institute of Forensic Science Gujarat Forensic Sciences University: Role of Forensic Science in Insurance Claims Management: 30th Jan 2014 – 31st Jan 2014
RSM Astute Consulting Private Limited: Internal Auditor Training in Quality Management System (ISO 9001: 2008): 13th August 2014
X – Claim: Fraud Containment & Loss Mitigation: Challenges & Way Forward: 19th November 2014

Previous Employment Details:

June 2012 – Till Date – HDFC Ergo General Insurance, Mumbai, Assistant Vice President – Fraud Control & Investigations (erstwhile Risk & Loss Mitigation Unit) – Western & Southern India.

Growth Path:
Senior Manager – Western Region
June ’12 – March’16
Assistant Vice President – Western & Southern Region
April ’16 – till date

Significant Accomplishments:
Conceptualized and developed “Case Investigation Management Application (CIMA)“to record and track investigation of claims.
Reward of excellence for achieving Highest Investigations Success Ratio for 2015-2016.
Reward of excellence for initiative on driving Road Safety Awareness Campaign with Mumbai Police for 2016-2017.
Consistently rated 1 in appraisal process, for years 2015, 2016, 2017, 2019 and rated 2 for years 2013, 2014, 2018.

Heading the Fraud Investigation, Loss Minimization, Claims Investigation and Claims Settlement for: Motor Theft & Recovery, Motor Accident Own Damage Claims, Motor Third Party Claims / Bodily Injury (Injury and Death) Claims, Fire Claims, Marine Investigation & Recovery, Property Miscellaneous Claims, Indemnity Claims, Credit & Debit Card Claims, Workmen Compensation Claims and Personal Accident Claims.
Developing operational model & shaping strategic agenda for Fraud Risk Management, mitigating fraud risk, assisting businesses by implementing 'best in class' tools & processes to minimize fraud losses.
Reviewing susceptible and vulnerable areas across various functions within the organization which are prone to fraud risk including Sales Processes, Branch Processes, Head Office Processes, Finance Areas (Travel bills, reimbursement claims), HR processes.
Ensuring timely conduct of investigations on various allegations including whistle blower complaints.
Driving standardization, automation & consolidation through re-engineering and process improvement initiatives for Fraud Risk Management Function.
Establishing collaborative relationship with regulators, peer banks, insurance companies and fraud risk industry forums to help detect & mitigate fraud.
Providing support in conduct of proceedings of the Fraud Risk Management Committee and implementing governance actions finalized in/by the Committee.
Encouraging & promoting an active training and learning environment to facilitate excellence in risk management, risk awareness & behaviour.
Conducting awareness programmes in the organization through training, workshops and other proactive initiatives for continuous education and improvement of employees on compliance policies.

May 10 – May 2012 - Intarvo Technologies, DGM – Accounts Receivable (Credit, Billing, Collections)

Significant Accomplishments:
Examine collection status on a weekly basis and keep track on status of outstanding receivables, underlying processes for billing and revenue recognition.
Verify all billing data to ensure existence, completeness and accuracy of revenues.
Performed reconciliation of accounts with customers and reviewed credit evaluation/credit limit review for existing customers on monthly basis.

Jul’07 – Nov’09 - G E Capital, Mumbai, Regional Collections Manager & Compliance Champion – West & South (Credit Cards) India.

Significant Accomplishments:
Direct reportees 5 and indirect 135.
Spearheaded the entire gamut of Collections (SBI Cards) across the Western Region including Maharashtra, Goa, Gujarat, Karnataka and Madhya Pradesh.
Ensured 60+ products flow at 47% in the year 2009 as compared to SBI OP of 57% and 49% in the year 2008.
Reduced the loss rate and maintained at 18% as compared to SBI at 22%.
Achieved highest recovery rate as a zone at 0.59% in 2008.
Ensured vendor consolidation from 52 to 38 vendors.
Designed Vendor Engagement Project to reduce the vendor billing TAT from 90 days to 45 days.
Acquired lowest cost of collection as a zone at 15%.
Played a key role as a member of Project Team, which developed software on Billing, Issuance of Identity Cards to feet on street and Collection Management System for Credit Cards.

Current location: Maharashtra, India - View on map
Nationality: Indian
Preferred Sector of Employment:  Banking Insurance and Financial Services, General Management, IT and Technology
Spoken languages: english, Hindi, marathi
Location I am interested in working: Anywhere