Working closely with Colleagues and expert service providers, the Claims Handler will be responsible for the identification, investigation, handling, negotiation and ultimate resolution of claims to protect the interests of our policyholders.
Reporting to the Claims Operations Manager they will be involved in the delivery of claims departmental goals and collaborate with investigation and consultant service providers.
Delivery of Objectives:
- Proactive, informed, prudent management of your portfolio of claims.
- Timely delivery of personal objectives and assigned work items.
- Proactive and efficient liaison with external associated resources.
- Prompt and efficient management of portfolio tasks, work flow items and keen adherence to deadlines.
Operate with Integrity:
- Be honest, ethical, sincere and principled
Identify and escalate issues and achieve your outcomes with a high degree of probity and integrity.
- Reviewed referred cases for specific risk or fraud profile elements
- Determine and devise an appropriate file strategy particularly on suspect / claims groupings
- Investigate, negotiate or defend claims to a successful outcome within agreed authority limits
- Identify and build case defence on suspect claims to facilitate Section 26 defences and where possible appropriate referral to relevant authorities
- Liaison and co-operation with dedicated external anti-fraud consulting resources
- There should be a specific focus on identification, through MI and analysis of developing trends, patterns and associations within the claim’s portfolio.
- Continually seeking improvements in process efficiency and client service.
- Delivering fraud savings aligned to the business anti-fraud objectives and targets
- Prepare for and adopt robust defensive positions on claims to be defended
- Meet all MCC/CPD requirements annually
- Proactively manage a portfolio of claims from referral or assignment to conclusion and through the District and Circuit Litigation process if required
- Arrange and attend liability and settlement consultations, where necessary
- Monitoring provisions and ensuring cost effective and timely resolution of claims
- Prioritise work and meet all targets
- Work as part of a team internally but also externally with select retained expert advisors.
- Ensure compliance with all regulatory, governance and quality standards
- Carry out any other duties as required by Claims Management.
Demonstrate Business acumen:
- Maintain and apply market knowledge and learnings from the general insurance claims and anti-fraud trends and activities within the marketplace.
- Maintain a keen awareness of claims handling protocols, processes and awards, the book of quantum and judicial trends, particularly as they may apply to IPB and influence future potential of your portfolio.
- Ensure detailed knowledge of the general insurance regulatory environment is evidenced in every aspect of your role and case management.
- Deliver industry leading claims handling, negotiation and resolution with a particular and specialised focus on anti-fraud investigation and handling.
Experience & Technical Skills:
- MCC qualified, CIP minimum.
- Relevant professional and /or 3rdlevel qualification.
- 5+ years’ experience within claims in the General Insurance Industry
- 3+ years’ experience as a dedicated claims anti-fraud specialist and networked within this environment
- Detailed accumulated knowledge of fraud techniques and methodologies, historical, current and emerging
- Expertise in Litigation Processes to Circuit Court level
- Detailed experience in counter fraud techniques employed to maximise identification and defence against such fraud techniques and methodologies, including use of I2, Verisk or other comparable software
- Demonstrable aptitude and determination in pursuit, detection and combatting of fraud
- Deep knowledge and experience of Public Liability claims handling
- Broad knowledge of Employers Liability, Motor and Property claim technical requirements, regulatory and operational requirements
- Exemplary negotiation and claims settlement skill set
- Strong written and verbal communication skills.
- Highly computer literate, web savvy and highly aware of public domain social media
- An excellent administrator with a pedantic eye for detail in managing claim files
- Be flexible, self-motivated with strong organisational skills.
- Results driven, and goal focussed.
- Have the ability to deliver in a changing environment.
- Ability to work well under pressure
- Be customer focussed and committed to quality.