Internal Loss Adjuster - GI Claims

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).
  

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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