JOB PURPOSE
The Team Leader - Claims will assist the Claims & Legal Manager in the management of the Claims section of Claims & Legal department. The work entails review of motor and non-motor claims, co- ordination of assessment and or adjustment of losses, ensuring that appropriate reserves are held for all claims, determination of compensation due to insureds in line with the policy terms, review of payments to ensure that they are in line with the approved terms, work allocation and co- ordination of the claims team, preparation of management reports, IRA monthly reporting and co- ordination of salvage disposals.
Main Responsibilities
Claims Administration
Evaluate and assess the information provided in the claim's documents received.
Assist in the maintenance of the overall claims handling systems.
Respond to correspondence on claims.
Maintain claim files, such as records of settled claims and an inventory of claims requiring detailed analysis.
Ensure follow up on various reports to avoid delay in claims settlement.
Appoint loss adjusters, investigators, and assessors.
Verify and analyze data used in settling claims to ensure that claims are valid and that settlements are made according to company practices and procedures.
Investigate and review claims for coverage and/or liability.
Ensure that claims handling is conducted in compliance with applicable statutes, regulations, and company policy.
Liaise with the loss adjusters, investigators, assessors, and doctors when reviewing claims to be paid.
Ensure timely updates to clients on the progress of their claims and timely response to enquiries. Coordinate salvage tendering process.
Claims Settlement
Analyze claims presented.
Recommend claims to be approved and/ or declined
Prepare approval and repair authority
Review service providers fees/invoices and ensure compliance with service level agreements and the prevailing tax requirements.
Follow up the settlement of relevant claims including payments due to insured's and service providers.
Ensure that claims are processed and paid in a timely and accurate manner.
Follow up on recovery with other parties to make good the claims presented.
Ensure timely issuance of third-party demand letters and update in the third-party recovery register where third party are to blame.
Customer Relationship Management
Resolve complaints/disagreements with service providers amicably to maintain a good working relationship.
Respond to correspondence, relating to claims handling emanating from brokers, clients, agents etc.
Interact with agents and claimants, meet them in person.
Point out areas for clarification on documentation provided and investigate doubtful entries. Ensure the accurate and timely preparation and processing of all claims and payment transactions.
Generate comprehensive monthly, quarterly, and annual claims reports which are to be used for internal analysis by the various departments, the management and used for evaluation of the Company's financial status.
Assist in preparation of monthly reports to the management on the department's performance or on any other issue affecting the claims department
Behavioral Competencies
Demonstrate prudent ethical practices.
Good interpersonal and public relation skills
Ability to maintain a high level of accuracy in preparing and entering information in the core business systems.
Technical know-how and experience in analysis of data.
Excellent written and verbal communication skills.
Good negotiation skills and strong analytical skills
Ability to facilitate decision making process.
Academic Background & Relevant Qualifications
Bachelor's Degree In Finance, Actuarial Science, Economics or in any other relevant field.
Diploma In Insurance
(Seven) years in claims management with at least 2 (two) of the years being a Senior Claims Officer or Supervisory Level.