Key Responsibilities: Receive reports on new claims and ensure they are promptly registered and handled in accordance with our Customer Service Charter. Ensure all claims are handled professionally within the terms and conditions of policies issued. Ensure settlement offers and payments are processed promptly in line with set targets. Evaluate and settle claims in accordance with delegated authority, to effect fair and prompt disposal of cases and to contribute to a reduced loss ratio. Continuously monitor turnaround time of claims and benefits settlement and take or suggest corrective measures where there are gaps in claim process. Initiate and actualize claims cost management measures within the Treating Customer Fairly (TCF) guidelines. Appoint service providers such as assessors, investigators and loss adjusters. Oversee the preparation of claims statistical reports within the stipulated time. Verify and analyse data used in settling claims to ensure that claims are valid and that settlements are made according to company practices and procedures. Advice claimants regarding basic matters about their insurance coverage in relation to the insurance claims. Confer with legal counsel on claims requiring litigation. Undertake portfolio analysis and risk recommendation reporting to underwriting department. Review reports from service providers and make appropriate recommendations on payment and any further action. Preparation of weekly and monthly claims reports for presentation to the Manager for review. Continuous review of claims reserves to ensure they are adequate at all times. Deal with general correspondences. Maintain a high level of service to customers at all points of contact such as telephone calls, emails, letters or personal visits. Prompt attention to complaints. Ensure compliance with SLAs by all stakeholders and initiate corrective action for any breach. Conduct training for intermediaries as may be necessary for them to understand our products. Be instrumental in implementing strategic objectives. Supervise all direct reports to ensure productive use of time and maintenance of discipline. Appraise, train and develop staff for more challenging roles. Ensure accurate data capture including tagging of service providers. Participate in the scheduled quarterly reviews of files. Embrace governance requirements with respect to KYC/AML/Data protection requirements per governing Acts. Qualifications: Bachelor’s Degree in Business Management, Insurance, Economics or Related Discipline. Progress towards Diploma in Insurance (ACII or AIIK), (at least 5 papers or equivalent). Experience: 6-8 years’ experience in claims management in the insurance industry.
