CLAIMS OFFICER (MATERNITY COVER) at APA Insurance

KEY PRIMARY RESPONSIBILITIES

• Providing advice on making a claim and the processes involved

• Processing new insurance claims notifications

• Collecting accurate information and documents to proceed with a claim

• Analyzing a claim made by a policymaker

• Contacting service providers a network of approved professionals and arranging     for them to make repairs on the policyholder's property

• Monitoring the progress of a claim

• Investigating potentially fraudulent claims

• Identifying reasons why full payment may not be made

• Ensuring fair settlement of a valid claim

• Building relationships with loss adjusters, forensic accountants and solicitors, as well as other legal/claims professionals

• Ensuring the customer is treated fairly and that the customer receives excellent service in accordance with industry and company guidelines

• Handling any complaints associated with a claim

• Initiating legal recovery of monies paid out

• Maintaining good broker relations

• Keeping cost at a bare minimum

• Adhering to legal requirements, industry regulations and customer quality standards set by the company.

Liaison with other departments

• Ensuring premiums are settled prior to claim processing.

• Liaising with the underwriting department for policy terms and endorsements.

• Advising on loss making/non performing brokers.

Customer service

• Ensuring that all enquiries by clients and or stakeholders are responded to promptly and appropriately.

• Ensuring that discharge vouchers are dispatched and settled as per the guidelines.

• Ensuring that records in respect of claims processed are available and maintained correctly for effectiveness in responding to policyholders’ queries.

• Regular briefing to the departmental manager and making consultations.

Administrative functions

• Assisting and training new staff on work procedures and company policies to ensure effective client service

• Participating and contributing in meetings, discussions and consultations with other team members to ensure that all hindrances to job performance are addressed in good time.

• Entering claims data to the system

ACADEMIC QUALIFICATIONS

• Bachelor’s degree in relevant field

JOB SKILLS AND REQUIREMENTS

• Team Player
• Negotiation Skills 
• Interpersonal Skills
• Interpersonal and Communication skills
• Integrity

• ACII/AIIK

At least 4 years relevant experience in Insurance