1. SAMIMOHD SHAFI HAMDULE
Mobile: +91-9920120319 / +91-8291392475 || E-Mail: hamdulesami@yahoo.com
Address: 373/C/7 Lawrence Nivas Hall Road, Village Kurla, West Mumbai – 400070
Professional Profile
 An astute & dedicated insurance professional with more than 10 years of experience investigating and
processing insurance claims.
 Currently associated with Since May ‘07 with Capita India Pvt. Ltd., as Process Leader; handling Life &
Pension services for Capita Life & Pension Services, India.
 Expertise in claims management & financial settlement of US Healthcare domain & UK Industrial Injury
claims; Excel in analyzing damages/causes, interpreting policies and negotiating payment solutions.
 Effectively manage multiple, high-priority projects and take pride in providing exemplary customer service.
 Handled key positions like Process Associate, Senior Insurance Executive and Business Development
Executive in renowned multi-national companies like Wipro BPO, Capita, etc.
Core Competencies
Claims Handling and InvestigationsClaims Handling and Investigations Risk Assessment and MitigationRisk Assessment and Mitigation FinancialFinancial
SettlementsSettlements
Healthcare Domain/ Injury ClaimsHealthcare Domain/ Injury Claims Evaluation of Liability ExposureEvaluation of Liability Exposure ProcessProcess
EnhancementEnhancement
Claims Reports/DocumentationClaims Reports/Documentation Confidential Records ManagementConfidential Records Management Team ManagementTeam Management
Customer ServiceCustomer Service Trainings/ Audits/RCATrainings/ Audits/RCA Policy InterpretationPolicy Interpretation
Career Contour
Since May ‘07 with Capita India Pvt. Ltd., as Process Leader
Capita Offshore Services led the evolution of BPO in U.K. and caters to a variety of clients ranging from Financial
Services providers, UK Public Offices to Insurances companies. It provides long term contracts across local &
central govt., education, and private sector & also towards health sector services in the U.K.
Growth Path:
Since Nov ‘12 Process Leader
Mar ‘09 to Oct ‘12 Senior Executive – Capita Life & Pension Services
May ‘07 to Feb ‘09 Claims Adjuster
Key Deliverables:
Serving as Process leader for Deutsche bank Life & Pension Services: A project of Deutsche bank Life & Pension
Policies in UK, dealing with the general servicing of Abbey Life Policies
 Ensure appropriate numbers of Quality Audits on completed cases are conducted on a timely basis and
assist in maintaining the team quality as per Quality Framework.
 Under taking root cause analysis of complaints and breaches and develop effective measures, recommend
and facilitate the implementation of process improvement initiatives to improve efficiency.
 Regular Analysis of Queries/Quality errors to identify trends and bridge gaps and increase scope of
processes.
 Audit work streams to ensure compliance with process and quality standards & internal and reports resolve
queries or escalations.
 Ensure accurate and in-time reporting on quality, breaches and complaints.
 Filter all the queries/referrals and resolve/address before they are sent to UK.
 Ensure process training and accreditation for new joiners/existing team members are conducted as per
training calendar/recruitment/requirement.
 Actively participate with the Technical team to identify and cascade process/product updates between UK
and India. Conduct the required process/product knowledge enhancement session.

2.  Ensure any process changes/Updates are reflected in the procedure guide and same is sent for TA for the
final signoff.
 Responsible for their individual performance of process and contribution to team performance targets,
ensuring they are doing the right thing within the right time for the customer.
 Involved in ORIGO allocation and report and report any escalation to the respective team managers or the
manager.
 Look after the team and SLA in the absence of Team manager and ensure team have met daily target.
Notable Attainments:
 Reduced number of complaints and breaches for the last quarter of 2016 by identifying the error through
RCA and provided the process improvement plan.
 Successful brought the ORIGO SLA down to day 10 from Day 12 which was appreciated by the Onshore
management team as well as from Offshore
 Received Best Performer and Process Leader Award for Second quarter of 2013 & First quarter of 2014&
2015.
 Acknowledged for updating team/ process with the recent budget changes taking place in UK
 Worked as a part of training team in Bournemouth for Migration of Vintage Scheme Policies in 2015 of
Abbey life and trained a team for the same back home.
 Successfully implemented the engage one project with the help of onshore team and after further analysis
of data for a month Pre and post implementation was able to provide benefit release of three FTE’s.
As Senior Executive
Served as Senior Executive for Deutsche bank Life & Pension Services: A project of Deutsche bank Life & Pension
Policies in UK, dealing with the general servicing of Abbey Life Policies
 Settled the pensions claims made by client, analyzed the forms and set up the annuity after paying any tax
free lump sum; constantly involved in quality audits and provided feedback to executives.
 Updated process, developed technical changes assuring quality assessment of the claims; Trained executives
in Deutsche Bank Life & Pension project for general servicing of the Abbey life policies (Retirements).
As Claims Adjuster
Served as Claims Adjuster for Coal Health: A project of Department of Business Enterprise and Regulatory Reforms
(DBERR), dealing with the industrial diseases benefit claims
 Articulated and executed transactions ranging from back office data processing to complex functions
covering multiple industry sectors.
 Authenticated documents submitted by miners/claimant/legal solicitors; conducted audits for employment
details of the miners involved in different coalmines under National Coal board and British Coal board.
 Financial settlement of industrial diseases benefits claims for the miners caused due to coal dust exposure
while working in the coal mining industry.
 Maintained the updates for the process and develop technical changes assuring quality assessment of the
claims; referred the legal solicitors for any missing information relating to the claim.
Notable Attainments:
 Received ‘Performer Award’ in the year 2008, 2009, 2010, 2011 and 2012 for maintaining quality at work
and assisting colleagues on the floor.
 Worked as a part of training team in Bournemouth for Migration of Hill Samuel, Occupational and Target life
policy in 2009 for Retirements process of Abbey Life and trained a team for the same back home.
Jul ‘06 to May ‘07 with Wipro BPO, as Associate (Insurance Claims), CBD Belapur
Key Deliverables:
 Handled a Project of U.B.H. Process (United Behavioural Health). Processing the claims according to the
benefits stated by the U.B.H.
 Financial settlement of health insurance claims for a US based insurance company [United Health Group].
 Liaise with policyholders/providers to progress claims in accordance with policies/procedures set by client.

3. Notable Attainments:
 Contributed in the area of quality checks and authorization of payments.
 Built insurance business with respect to prospecting, identify customers' needs, profiling and suggest
insurance solutions for order closures.
Jul ‘04 to May ‘06 with Evergreen Developers, as Business Development Executive
Managed the Business Development planning process through Real Estate Agents, assessed current projects &
implemented competent business strategies to market a wide range of products to accomplish sales & profit
targets.
Professional Enhancements (Certifications/ Trainings)
 SAP R/3 ECC 6.0 Sales & Distribution
Topics Covered:
Organizational structure Creation of Material Master & Customer Master
Record
Condition Technique as used in Pricing Pricing Procedure Determination
Sales Document “Order” Types Special Sales Document types
cash Sales and rush Sales process Consignment Stock Process
Deliveries and Invoicing Invoice and Billing Processes
 Advance Diploma in Computer Hardware and Networking form Jet King Institute
 Certification in CF1 UK financial services, regulation and ethics.
 Certificate in FA2 UK Pensions Administration.
 Industrial project training at Carrier Aircon Ltd. (Project: 'Achieving Competitive Excellence' by driving
continuous improvement in products & services that deals with benefits of the customer).
Academia
 SAP (Sales & Distribution) from Sysplex in 2005.
 MBA (Marketing) from Rai Business School, Rai University in 2004 with 63%.
 BA (Sociology) from KJ Somaiya College, Mumbai University in 2001 with 50%.
 12th
from Maharashtra State board of Secondary and Higher Secondary Education in 1998 with 57.83%.
 10th
from Maharashtra State board of Secondary and Higher Secondary Education in 1996 with 43.3%.
Personal Details
Date of Birth: 14th
October 1981 || Languages Known: English, Hindi, Marathi and Kokani
References: Available upon request