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Job Summary
Responsible for the administration of all insurance claims and associated queries. This involves considerable contact with insurers, loss adjusters, solicitors, claimants or their representatives, relevant business units including CRDB Bank Departments and Branches. It involves dealing with claimants’ claims issues and be able to generate correspondence on contentious issues and provide reports and advice to management where necessary.
Key responsibilities:
- Provision of an efficient and effective insurance claims service includes ensuring that all claims related matters are dealt with within the timescales imposed by the agency.
- Provision of specialist advice and support for all business units and CRDB Bank on claims related matters, including the organization’s risk management process.
- Ensuring that all business units are aware of the insurance claims processes within their activities.
- Development, implementation, and monitoring of claim unit strategy to achieve the company objectives.
- Develop and implement various policies and procedures for claims.
- Development of specific SLA with the insurer for claims serving.
- Monitoring of SLA with the Insurance companies for adherence and providing the deviation reports to the management and also provide recommended action for deviation.
- Provide services to all business requirements and ensure optimal handling of all claims and follow-up all issues and provide training for all business units.
- Evaluate all business units and CRDB Bank claims and administer all documentation integrity and manage communication to Insurers and monitor all claims to ensure timely closure.
- Analyze all claims to ensure optimal quality and prepare reports for the Management, business units, and CRDB Bank.
- Examine all claims and identify all risks and ensure the processing of all claims as per Agency policy.
- Administering claim management to ensure the customer is treated fairly and receives excellent service in accordance with industry and company guidelines.
- Follow up and updating the CRDB Group Legal Department on the status of the Court claims cases against the Agency.
- Maintaining the computerized claims/loss recording system and developing information with particular regard to allowing proper risk analysis to be undertaken
- Provision of professional advice to business units, and CRDB Bank members on all aspects of insurance claim practice and law, including preparation of reports and advice notes as required
- Ensuring the customer is treated fairly and that the customer receives excellent service in accordance with industry and Agency guidelines.
- Training Insurance Zonal/Focal/Sales on Insurance processes and requirements for improving claims TAT and claims service.
- Periodic update of claims trends in the market.
- Adoption of innovative changes in the claims process and the best practices from the local and global markets.
- Development and implementation of a digitized claims platform for client self-servicing.
- Advising the Bancassurance Agency on proper underwriting and underwriting gaps.
- Adhering to legal requirements, industry regulations and customer quality standards set by the company.
- Conducting monthly claims meetings with the Insurer for claims service review and SLA adherence.
- Managing clients visits and reports as they deem fit for improving the Department service.
- Oversee and coordinate with the team to ensure job targets are met and the clients are adequately serviced.
- Set performance standards, manage and motivate the team to achieve high productivity.
- Any additional responsibility is given by the supervisor and the management from time to time.
Experience, Knowledge and Skills Requirements
- Bachelor Degree in Insurance or any other related field from an accredited institution.
- Minimum of 5 years of experience in insurance claims.
- In-depth understanding of legal regulations.
- Excellent analytical and problem-solving skills.
- Customer service background.
- Ability to organize, document, and control both digital and physical data.
- Possess thorough knowledge of the claims process and service-related process.
- Possess knowledge of competitor activity through participation in and cultivation of intra-industry contacts.
- Sound analytical, presentation, communication and interpersonal skills.
- High computer literacy especially in the use of Microsoft packages.
