Purpose for the Job
The position holder will handle allocated clients claims, the insurance claim process for all general insurance claims in motor, property, liability and work injury claims at both personal and commercial lines.
Duties and Responsiblities
Claims Advisory and Advocacy:
Review and analyze client claims, applications and adjustments and determine whether a client is covered under their insurance policy and that the claim has been properly adjudicated and processed within reasonable timelines.
Research, craft and draft appropriate professional and technical responses to claims issues.
Give the client a competent insurance policy and claim expert's opinion based on sufficient knowledge and analyses of the relevant facts.
Meet clients and concerned stakeholders over complaints and dispute resolution.
Client Account, Claims Relationships:
Handle claims for the allocated client accounts and ensure that all claims made by clients on their insurance policies are dealt with prudently, processed efficiently and that payments for valid claims are made to policyholders quickly; and that all claims are settled and concluded within reasonable a time.
Coordination of all services that may be required by policyholders following an accident or incident and the insurance partners and actors involved therein.
Handling of customer complaints in regard to the claims from the portfolio of accounts and by escalation from direct reports.
Maintaining Claims Records, Data and Claims Reporting:
Properly handle client information and storage of claims documents received and ensure the claim files are kept always updated.
Accurately capture claims data in the Core Claims Systems and ensure the claims data is up to date and correct at all times.
Prepare monthly reports for clients and for management highlighting claims trends.
Complaints & Issues handling:
Handling of customer complaints in regard to the claims from the portfolio of accounts and by escalation from direct reports.
Meeting clients and concerned stakeholders in the ground over complaints and dispute resolution.
Key Result Areas
Client Retention at 100%.
Claims life cycle lead time at 25-30days (simple claims) or complex claims at 90-180days.
Real time claims information.
Claims closure rate at 115% (Closed/New) for the year.
Customer satisfaction Index of 85% and net promoter score of 60%.
Compliance with processes, policies and procedures at 100%.
Key Competencies
Knowledge of various insurance products, claim processes and in handling all general insurance products including:
Negotiation skills.
Interpersonal skills.
Attention to details.
Knowledge And Skills Required
Adept in general insurance claims with an experience of atleast 3 years in a busy general insurance claims environment.
Excellent communicator in both verbal and written English.
Strong analytical and risk management capability.
Excellent computer skills.
Good organizational skills, agile, resourceful and collaborative.
Problem solver/solution oriented.
Team player.
Professional and Academic Qualifications
Bachelor's Degree from a recognized university (in a Business /Legal Studies -related discipline).
Diploma in ACII/AIIK.
End Date 11th August 2026