Senior Claims Analyst
Directline Assurance Company Ltd;
Total years of experience :7 years, 1 Months
Job Purpose;
I am responsible for assisting the Claims Manager in the supervision of both technical and non-technical staff in claims department.
Duties and Responsibilities:
•Team supervision for optimal performance.
•Offering technical support to Claims team.
•Handle customer complaints/concerns from the insured or intermediaries.
•Responding to client queries that require technical response.
•Analyzing claims performance and reporting to Claims Manager.
•Working closely with cross functional teams to ensure claims processes are efficient.
•Providing advice on management of claims and the processes involved.
•Processing new insurance claims notifications and monitoring the progress.
•Collecting accurate information and documents to proceed with a claim.
•Review the relevant claim guidelines and template documents to conform to the policy and best practices.
•Investigating potentially fraudulent claims.
•Ensuring fair and timely settlement of valid claims.
•Building relationships with loss adjusters, forensic investigators and advocates as well as other legal/claims professionals.
•Handling any complaints associated with claims.
•Seeking legal recovery of monies paid out where our insureds are not to blame.
•Maintaining good broker/Agents relations.
•Ensuring that claim costs are kept to the bare minimum.
•Adhering to legal requirements, industry regulations and customer quality standards set by the company.
•Preparation of periodic performance reports of the departmental staff.
•Prepare relevant departmental and management reports when required.
•Any other duties that maybe assigned from time to time.
Duties and Responsibilities:
Issuance of Underwriting Documentation:
• Carrying out the issuance of Debits, Credits and policy documents for business accepted as per the agreed terms with the insured and in line with set departmental service standards.
Risk Management:
• Evaluation of risks as per risk appetite, the reinsurance treaty and underwriting manual.
• Reviewing loss-making accounts and providing risk improvement measures.
• Ensuring assessment of risks accepted are done as guided by the underwriting manual.
• Processing of quotations within the agreed time frames and maintaining a register.
• Closely monitoring all quotations to brokers, agents and direct clients for closure.
Service Delivery and Customer Experience
• Reviewing and following up on outstanding premiums from brokers, agents and direct clients. This is in line with the company’s credit policy.
• Ensuring policy documents, quotations and all required documents are issued and delivered to clients as per the service level agreements.
• Ensuring all customers are attended to whenever they need service from the underwriting team and ensuring all queries from customers are attended to timeously within the company service charter.
• Attending to all incoming mail and instructions and responding to them promptly.
Management of the Renewal Process:
• Ensuring the retention of existing business as per renewal retention targets and also ensuring that the monthly renewal notices are processed, issued, dispatched and followed through as guided by the underwriting manual.
Accountable Documents:
• Ensuring proper documentation and accountability for all accountable documents including certificates/stickers of motor insurance.
• Ensure frequent motor certificate reconciliation and monthly reports on the same.
Compliance:
• Ensure Statutory and regulatory guidelines are adhered to when offering quotations, issuing policies and placing reinsurance.
• Ensuring prescribed underwriting guidelines are adhered to as per company policy and underwriting manual.
• Supporting the underwriting manager in preparing regulatory reports as per the set timeframes.
Reinsurance Processing:
• Ensuring timely and correct reinsurance allocations for all policies handled or reviewed for all businesses as per treaty provisions and regulatory direction.
Credit Control:
• Ensuring that the credit policy is adhered to at all times at issuance of covers and also assisting in managing premium payment arrangements and ensuring follow-up and periodic reporting.
Duties and Responsibilities:
• Ensured the timely registration of motor claims and acknowledgment and made appropriate reserve amounts in the system for each claim.
• Following up on the claim documentation from insured/intermediaries and appointed external assessors and followed up on the reports.
• Scrutinized all the assessment reports submitted by the external assessors and recommended the next cause of action.
• Frequently updated clients on the status of their claims and appointed investigators in cases of third-party injuries/property damage where necessary.
• Raised payment vouchers and ensured that all assessors conducted themselves professionally and ethically and made recommendations where the action was warranted.
• Recommended for a second assessment on accident vehicles whenever necessary.
• Ensured that garages adhered to the repair timelines at all times and the preparation of requisite claim reports.
• Negotiated with repairers for extra discounts given lowering the repair costs and also exercising exemplary customer service.
• Performed any other duty as may be allocated by the management from time to time
Duties and Responsibilities:
• Registered and processed all reported claims and appoint relevant service providers where applicable and advised the clients on the required claim supporting documents.
• Initiated claim recoveries and accurately posted, maintained and reviewed claims reserves continuously. • Received and acknowledged all customer correspondences and resolved customer complaints and disputes swiftly fairly and diplomatically.
• Raised payment requisition within the set standard of the company.
• Promptly and efficiently attended to customer queries and complaints and continuously recommended system enhancement for improved services.
• Prepared various claims analysis reports for clients and management consumption.
• Performed any other duties as may be allocated by management from time to time
Second Class Upper Division