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Old Mutual
Banking + 2 more
Description
C. KNOWLEDGE & EXPERIENCE
- Insurance technical Knowledge
- Professional certification in Loss Adjusting, Insurance or Claims Management (IIK,CILA)
- Bachelor’s degree in a business-related field
- At least 3 years of experience in claims handling or loss adjustment.
D. QUALIFICATIONS
- Business related Bachelor’s degree
- Insurance professional qualification (IIK or CII)
- Professional certification in Insurance Loss Adjusting (CILA)
- Proficiency in data analysis tools and software (e.g., Excel, Power BI).
Responsibilities
1. Claims Assessment and Adjustment
- Timely assess the extent of loss into claims to determine extent of liability
- Prepare detailed loss adjustment reports, including the calculation of indemnities and decision on your claim
- Recommend process improvements to enhance efficiency and effectiveness in claims management.
- Negotiate settlements to achieve fair outcomes for both the insured and the company.
- Advise the risk recommendations to be taken on policies if needed
- Review policy terms and conditions to ensure claims fall within coverage.
- Coordinate with clients, witnesses, service providers, and other stakeholders to collect evidence and support documentation.
- Review and provide quality assurance for external loss adjustment reports
- Review and recommend reserves especially for large losses
- Follow up large losses with external loss adjusters
- Visit scene of incidents for large losses
- Provide expert advice on technical and financial aspects of claims.
- Identify potential fraudulent claims and escalate for further review.
- Implement measures to minimize risk exposure and reduce claims leakage.
- Maintain professional communication with clients, brokers, and third-party service providers.
- Maintain accurate and up-to-date records of claims assessments and settlements.
- Contribute to audits and reviews by providing relevant documentation and insights.
- Participate in training and development programs to enhance technical skills and knowledge.
2. Quality Assurance
- Review the quality the Loss adjustment report from the external loss adjusters
- Conduct performance review from the external adjusters.
- Prepare monthly report on the status of all claims under adjustment.
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