Job Description

Summary of role



The role involves building robust fraud detection frameworks, managing investigations through empanelled risk agencies, engaging with law enforcement and business teams, and driving awareness across teams.



Key Responsibilities



Develop and implement fraud risk frameworks across customer and distributors life cycle .

Monitor transactions, claims and sales practices to identify red flags and fraud patterns

Lead and manage investigations of suspected fraud cases through empanelled risk agencies, ensuring timely closure with quality reporting.

Evaluate and monitor performance of risk agencies to ensure adherence to defined SLAs and investigation quality standards.

Drive vendor staff training programs to improve competency, investigation skills, and compliance with fraud risk protocols.

Collaborate with internal stakeholders (underwriting, claims, operations, audit, compliance) to strengthen process controls.

Liaise with law enforcement agencies and industry bodies for complaint filling and resolution.

Conduct fraud awareness and sensitisation training across distribution channels and operations teams.

Provide root-cause analysis of fraud incidents and recommend process/policy improvements.



Regards



Dinesh Gandhi



From Shah Aastha /HR SC/ICICIPRU/Mum Sent 20 August 2025 1508

To Dinesh Gandhi /Opsc/ICICIPRU/Mum Cc Sunaina Bhat /HR SC/ICICIPRU/Mum Subject Ops Risk JD



Dear Dinesh,



As discussed, please find below the current JD for Ops Risk-



Purpose



To identify preventive ways to avoid any risk occurrence To decrease fraud and operational risk in the state by efficiently identify the emerging risk and putting appropriate measures To coordinate and perform investigation on various cases allotted & report within timelines Proactively detect problems or gaps in different processes, ensure mitigation, and loop closure To effectively manage risk agencies and to ensure that their competency skills are upgraded as against evolving fraud trends Learning and ground sensing to be shared with the stakeholders for root cause analysis

Accountability



Effective use of risk agency network and ensuring closure of cases within stipulated timelines without compromising on quality Ensure issues are picked up in a proactive manner & necessary corrections are made Create network across the industry to identify nexus / racket Proactively engage with law enforcement agencies for imparting knowledge and filing complaint.

Imparting risk awareness/sensitization trainings across various branch locations / departments.