Senior Complex Claims Adjuster Casualty
- Insurance ,
What you need to know:
To handle the Casualty portfolio of claims from coverage enquiry through legal liability assessment (where relevant) and quantum analysis, to timely and accurate resolution; ensuring mitigation of indemnity and expense exposure while communicating developments and outcomes as necessary to all key internal andexternal stakeholders.
To provide training and be a technical referral point for other team members. As appropriate act as deputy for Team Manager.
Duties and Responsibilities
1. Functional Responsibilities:
- Managing key claims handling enquiry; coverage determination, quantum analysis and legal liability assessment, where appropriate for high value complex claims
- Ensuring effective vendor and litigation management on Complex claims within a personal allocation, including demonstrable savings
- Reporting key claims messages to their Team Manager and to internal stakeholders
- Broader internal / external stakeholder communication where required, as casualty technical claims expert and thought leader
- Delivery of technical training to colleagues and external contacts as appropriate
- Assist in continuous improvement across the region through support for the Quality Assurance / Regional Audit processes (potentially assisting Team Manager to complete monthly quality assurance reviews?)
- Ensure adherence to best practice procedures for casualty Complex claims, consistent with global best practice.
- Handle higher level of complexity claims Complex losses within authority limits
- Timely, accurate and customer focused claim resolution, minimising indemnity exposure and mitigating vendor and legal expense
- Effective communication and management of key advanced Complex claims and Casualty portfolio messages to internal stakeholders and customers/clients.
- Financial control through consistent reserve and other financial transaction discipline
- Accurate and consistent policy interpretation
What we’re looking for:
- Excellent communication skills, both written & verbal
- Good presentation skills and file knowledge
- Time management – ability to manage & prioritise workload and diary management
- Ability to contribute effectively within a team environment and with internal/external stakeholders at all levels
- Ability to assist with technical training to team claim handlers as required
- Ability to influence claims and non claims stakeholders to effectively direct claims strategy
- Well developed/Advanced expertise and knowledge in Casualty most technically complex claims topics (as listed over page).
- Policy language skills enabling accurate and consistent policy wording interpretation
- Advanced and thorough knowledge of legal / regulatory and litigation / procedural requirements for their line of business
- Experience in negotiation, mediation, arbitration and ADR skills on higher value complex claims
- Experience in effectively following up on recommendations from technical claims audits and continuous file handling improvement