Senior Executive, Claims (Accident & Health - PA)

Responsibilities

  • Handling, Processing, Recommend Settlement of claims in accordance with policy contract, company policy and procedures.
  • Compliance of all the claims processes, procedures and guidelines as stipulated in the Claims Operation Manual and/or instructions.
  • Provide quality, prompt and efficient claims service to meet Customer satisfaction
  • Review/follow up on all outstanding claims on regular basis to ensure claims reserve are adequate and status updated.
  • Maintain a low pending ratio of outstanding claims (prompt disposal of claims to reduce number of outstanding claims.)
  • Assist superior to handle major large losses / event losses / complicated / litigated claims i.e. preparation of Major Loss Advice (MLR), preliminary loss / development and settlement loss / cash calls advices to co/reinsurers on timely manner.
  • Keep Reinsurance and Finance advised of any material claims as set in the claim manual / procedures and work with Reinsurance to effect recoveries.
  • Keep ratio of outstanding claims at healthy level.
  • Highlight to supervisors and/or HODs of any deficiency in policy coverage and adverse claims trends to facilitate corrective and appropriate action.

Requirements

  • Tertiary or Professional qualification in Insurance.
  • 4-5 years in Accident & Health claims handling.
  • Sound knowledge and experience in all aspects of Claims.
  • Strong product knowledge.
  • Team player with good track record
  • Good communication skills.
  • Strong analytical skills and business acumen.