Freelance Insurance Underwriter – Claims & Non-Disclosure Specialist

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About Fund Wapas

Fund Wapas helps customers recover money stuck in insurance policies. We handle cases like claim rejections, unclaimed amounts, and underwriting disputes, ensuring fair evaluation and proper settlements.

Role Overview

We are looking for experienced insurance underwriters who specialize in claims review and non-disclosure cases. The role involves analyzing rejected claims and identifying whether the rejection is valid or can be challenged.

Key Responsibilities1. Claims Review

• Analyze rejected insurance claims
• Check if claim decisions follow underwriting guidelines
• Identify gaps between policy issuance and claim rejection

2. Non-Disclosure Analysis

• Review cases of non-disclosure or misrepresentation
• Check if the non-disclosed information is material
• Assess whether non-disclosure was intentional or unintentional
• Evaluate claim decisions as per IRDAI guidelines

3. Medical Assessment

• Review medical records and treatment history
• Identify pre-existing diseases (PED)
• Check waiting periods and condition timelines

4. Documentation Review

• Review proposal forms, policy documents, and claim files
• Identify discrepancies in disclosed vs actual information

5. Recommendation

• Provide a clear opinion:
• Valid rejection
• Wrongful rejection
• Suggest next steps:
• Reopen claim
• Appeal or escalation
• Refund possibility

6. Team Support

• Guide internal team on underwriting and claims
• Support in resolving complex cases

Required Skills

• Strong knowledge of health insurance underwriting
• Understanding of claim settlement and rejection process
• Experience in non-disclosure cases
• Ability to analyze medical and policy documents
• Good analytical and decision-making skills

Preferred Experience

• Experience with insurance companies, TPAs, or brokers
• Background in underwriting or claims handling
• Knowledge of IRDAI guidelines and claim regulations 

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