This position entails working with a multi and cross-disciplinary team in fast-paced processing, demanding environment, and clientele. The job holder is an integral member of the Claims Leadership Team. The job holder assists the Head of Claims and Claims Team in meeting departmental goals, assisting with special projects, and making technical recommendations.
Duties and Responsibilities:
Direct management of staff of up to 3 Account Handlers and their claim files.
Analyse file plans and approve action plans for Team members in accordance with best practices.
Complete 10-day diary reviews on all new claims and maintains active diaries of all claims in the unit.
Document the claim file of all activities taken (both in the physical file and in the system).
Work with the Account Handlers throughout the life of the claim.
Manage the Claims Value Chain and frequently communicate with all appropriate parties involved with the claim, including complaints and dispute resolution.
Actively execute appropriate claims activities to ensure consistent delivery of quality claims service.
Compliance with the Company Procedures, Claims Standard Operating Procedures (SOPs), Broking Manual and Laid out Best Practices, state laws and regulations (including Treating Customers Fairly (TCF) Principles) regarding claim handling.
Shared responsibility for department strategy, which includes planning and ongoing management of the claims unit overseen.
Reviews the claim file and the insurance policy to determine coverage and thereby advising the insured party accordingly.
Reviews insurance forms and documents for accuracy and completeness. Calls or writes to the insured party or others involved to secure missing information.
Promptly negotiates settlements, making sure that the settlement reflects the actual claimant losses while also being certain that the insurer is protected from invalid claims.
Effectively manages the performance of direct reportees by providing daily leadership and support; is available for staff coaching, feedback, questions, concerns, and communicate clear goals and expectations.
Creates, maintains and tracks unit reports in relation to the department and individual performance.
Any other tasks and assignment as requested.
Knowledge and Skills Required:
The job holder must possess:
Bachelor’s degree from an accredited university, preferably in Bcom (Insurance), Business related field, Economics, Mathematics, or Statistics.
A Diploma in insurance qualification (Diploma in CII or Local Diploma from the College of Insurance and
processing towards attaining ACII).
At least 5 years of post-qualification insurance practice and experience.
Hands on experience having worked in a busy claims department in an Insurance company.
Knowledge in all insurance and general insurance products.
Competencies and Attributes:
Integrity.
Positive attitude, self-motivated, self-driven and able to work with minimal supervision.
Good negotiation and networking skills.
Passionate, confident, energetic, and proactive.
Organisational and analytical skills.
Interpersonal and communication skills.
Flexibility and adaptability.
