Nagamah Subramaniam
Summary
Experienced insurance professional with 20 years in claims management, specializing in medical, life, PA, and general insurance. Currently a Case Manager at FMOS, handling insurance disputes across medical, life, PA, travel, and takaful products. Skilled in dispute resolution, mediation, and investigations, ensuring fair outcomes. Experienced in UATs, system enhancements, and training. Led a team as Sports Club President, organizing company-wide events. Holds a Biomedicine degree, AMII Level certification, and is an Accredited Mediator (MIMC), strengthening expertise in claims and mediation.
Overview
20
20
years of professional experience
8
8
years of post-secondary education
3
3
Languages
Work History
Case Manager
Financial Market Ombudsman Services
Kuala Lumpur
03.2021 - Current
- I specialize in managing insurance-related disputes involving medical, life, PA, travel, and takaful products, ensuring fair and impartial resolutions between consumers and financial service providers
- My approach focuses on active listening, impartiality, and constructive dialogue to guide parties toward mutually beneficial outcomes
- I believe in resolving disputes efficiently while maintaining fairness and transparency throughout the process
- Key Responsibilities:
- Assessing dispute eligibility and conducting thorough investigations
- Facilitating mediation, conciliation, and negotiation to encourage open discussions
- Clarifying interests and helping parties find common ground
- Issuing recommendations when no agreement is reached
- Managing the case process, including gathering information and escalating cases to the Ombudsman when necessary
- I am passionate about helping parties navigate disputes effectively and continuously improving processes to enhance dispute resolution in the insurance industry
Senior Claims Executive
AmGeneral Insurance Berhad
Kuala Lumpur, Kuala Lumpur
11.2014 - 03.2021
- Experienced in claims assessment, policy interpretation, and dispute resolution, ensuring accurate and timely processing. Skilled in investigating claims, issuing coverage letters, managing reserves, and handling high-value escalations, including litigation oversight. Adept at stakeholder communication, maintaining organized follow-ups, and contributing to system enhancements and process improvements.
- Key contributions include standardizing claim letters (Aug 2017) for consistency, enhancing customer engagement through SMS updates, and collaborating on FAQ development for better product understanding. Additionally, conducted training sessions for agents and branches, improving overall claims handling efficiency.
Claims Executive
HSBC Amanah Takaful Berhad
Kuala Lumpur, Kuala Lumpur
10.2013 - 11.2014
- Experienced in medical and life insurance claims assessment, ensuring accurate processing based on policy terms, conditions, and SOPs. Skilled in verifying diagnoses and bills for coverage eligibility, processing life and medical claims—including investment-linked products under takaful—while ensuring SLA compliance. Additionally, contributed to system enhancement projects to improve claims processing efficiency.
Claims Executive
QBE INSURANCE (M) BHD
Kuala Lumpur
01.2011 - 10.2013
- Experienced in medical, personal accident (PA), and workmen compensation claims processing, ensuring accurate assessment and compliance with policy terms and SLAs. Skilled in verifying diagnoses, medical bills, and benefits, managing investment-linked takaful claims, and conducting client training on claims procedures. Additionally, contributed to system enhancements for improved efficiency.
Claims Executive
MCIS ZURICH INSURANCE BERHAD
Kuala Lumpur, Kuala Lumpur
10.2008 - 01.2011
- Experienced in medical claims assessment and customer engagement, ensuring accurate processing and policy compliance. Skilled in verifying diagnoses, managing policyholder inquiries, processing hospital payments, and ensuring timely settlements. Liaised with stakeholders to clarify coverage, handled recoveries, and conducted training sessions on medical claims procedures.
Claims Executive
Mediexpress [M] Sdn Bhd
Kuala Lumpur, Kuala Lumpur
05.2005 - 01.2008
- Started my career in claims assessment and customer service at a TPA, managing medical claims and policyholder inquiries. Experienced in verifying coverage, assessing diagnoses and bills for approvals, processing hospital payments, and coordinating with agents, doctors, and hospital staff. Also skilled in call center operations, handling complex inquiries and dispute resolution.
Education
Advanced Mediation Skills Training Course -
Malaysian International Mediation Centre
Kuala Lumpur 03.2023 - 06.2023
AMII Level 1 - Insurance
Asian Institute of Insurance
Kuala Lumpur 01.2019 - 12.2022
Bachelor of Medical Science - Biomedicine
Kolej University Teknology & Pengurusan Malaysia
Kuala Lumpur 08.2004 - 12.2006
Higher Secondary/Pre-U/"A" Level -
Sek Men Tinggi Setapak
Kuala Lumpur 01.2001 - 12.2002
Skills
Timeline
Advanced Mediation Skills Training Course -
Malaysian International Mediation Centre
03.2023 - 06.2023
Case Manager
Financial Market Ombudsman Services
03.2021 - Current
AMII Level 1 - Insurance
Asian Institute of Insurance
01.2019 - 12.2022
Senior Claims Executive
AmGeneral Insurance Berhad
11.2014 - 03.2021
Claims Executive
HSBC Amanah Takaful Berhad
10.2013 - 11.2014
Claims Executive
QBE INSURANCE (M) BHD
01.2011 - 10.2013
Claims Executive
MCIS ZURICH INSURANCE BERHAD
10.2008 - 01.2011
Claims Executive
Mediexpress [M] Sdn Bhd
05.2005 - 01.2008
Bachelor of Medical Science - Biomedicine
Kolej University Teknology & Pengurusan Malaysia
08.2004 - 12.2006
Higher Secondary/Pre-U/"A" Level -
Sek Men Tinggi Setapak
01.2001 - 12.2002
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