Overall Responsibility:
The job holder will be responsible for processing and managing insurance claims, ensuring accurate and timely resolutions while upholding company policies and procedures. This involves evaluating claims, investigating incidents, communicating with parties involved, and managing all aspects of the claim process from initial report to final settlement. The role will be responsible for fulfilling promises and obligations of risks assumed by the company on behalf of its clients. The position will also detect fraudulent claims to minimize claims costs and keeping loss ratios low.
Key Responsibilities:
Initial reserving of new claims.
Analyse claims and decide whether they are covered by policy.
Make recommendations for the settlement of claims.
Inform clients if claims are accepted and how they will be allocated.
Analysing and authenticating service provider's reports/ recommendations and preparing repair authority letters to garages as well as preparing courtesy car letters.
Appointment of Loss adjusters and investigators to investigate suspicious claims within stipulated timelines.
Issuing of discharge vouchers for approved offers and letter of offers.
Checking claims payment vouchers and dispatching the same as well as reviewing of files after payment is done.
Make sure all enquiries and payments are dealt with quickly.
Process service provider payments.
Third party recoveries
Contacts arising from the Job (Key Relationships)
Internal: All Staff and intermediaries
External: All Claims Service Providers, Customers and intermediaries
Skills and Competencies Required
Excellent communication and interpersonal skills;
Excellent planning and organization skills;
Ability to work under pressure;
Excellent problem solving and decision-making skills;
Knowledgeable with industry's rules and regulations; and
Results driven and customer focused
Understanding of the insurance industry, particularly the area they work in, such as fire, life, accident or marine insurance
Understanding of relevant laws
Knowledge & Work Experience
Minimum 2 years' work experience in claims handling, underwriting experience is an added advantage
Academic and Professional Qualifications required
Degree in Actuarial Science/Statistics or Business-Related field
Diploma in Insurance (IIK) or ongoing