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/documents.
  • 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 files duly updated.
  • Ensure that initial demand letter is prepared, sent out on all recovery matters and 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, pursue recover under motor, XOL, FacRe or any other recovery.
  • Adhere to claims manual procedures and process.  
  • 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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