Job Purpose:

The role holder will be responsible for the processing and payment of general insurance claims.

Key responsibilities:

• Review documents and pertinent requirements regarding an insurance claim.
• Ensure that the insurance claim made by the claimant is complete in form and complies with the documentary requirements of an insurance claim for non-motor.
• Advice claimants regarding basic matters about their insurance coverage in relation to the insurance claim.
• Respond to both internal and external claims inquiries concerning benefits, claims process, service providers, and the filing/completion of proper forms.
• Record all claims transactions including appointment of Loss Adjusters, investigators and surveyors.
• Prepare claims registers for claims meetings and update the various claims reports.
• Prepare initial claim letter and mail to insured, along with appropriate forms for completion.
• Track and follow up on receipt of necessary forms.
• Delegated Authority: As per the approved Delegated Authority Matrix as per SODA.
• Process payments to insured’s and service providers as per SLA.
• Maintain adequate initial reserves as per reserve guidelines and participate in the monthly, quarterly and annual reserves reviews.
• Ensure that claims, appointment and payments are processed within the set TATs and claim files duly updated.
• Ensure that initial demand letter is prepared, sent out on all recovery matters and the recovery register updated.
• Prompt settlement of invoices and negotiation with service providers to realize Savings as per set targets.
• Record and update all required registers or company data across all necessary system.
• Initiate and pursue recovery under motor, XOL, FacRe or any other recovery.
• Adhere to claims manual procedures and processes.
• Perform any other duties as may be assigned from time to time.

Requirements

Knowledge, experience and qualifications required:

• Bachelors of degree or commerce (insurance option preferred).
• Progress in professional qualification in Insurance (ACII, FLMI or AIIK).
• 2-3 years’ experience in insurance claims processing.
• Knowledge and experience in the insurance sector.

Technical/ Functional competencies:

• Knowledge of insurance regulatory requirements.
• Knowledge of insurance products.
• Sales and marketing management skills.