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.
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.
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