Senior Claims Specialist, A&H
5 months ago
The primary objective of this position is to direct, monitor, assess and handle claims and claim-related issues arising under Accidental and Health business classes and some International Personal Lines claims.
This position is accountable for the following: -
Claims Service Claims Quality Expense Management Legal advice as required on claims Provision of claims analysis, trendsProvide training and technical referral point for internal & external stakeholders
Areas of Responsibility
Claims Service
Work within local and regional on operating processes and claim handling procedures to ensure that quality claim service is rendered to all customers in accordance with Chubb Claims Philosophy. Effectively assist Consumer Claims Lead to manage A&H claims underwritten or reported in Singapore against policy terms and conditions, claims best practices guidelines, statutory and company guidelines, local operating procedures and claims management guidelines. Evaluate the cost effectiveness of claims handling procedures. Recommend improvements to reach optimum performance and service standards. Attend to claim enquiries and feedback, maintain positive relationship with all customers, brokers, service providers etc, Claims costs containment and loss dollar management – accurate interpretation of policy coverage, close liaisons with underwriters and internal colleagues to manage accounts and on risk improvement and suspicious claims, claims data and loss trend analysis. Contribute to discussions with business units for products developments and loss control. Ensure that Consumer Claims Lead and appropriate Underwriters, as required, are made aware on a timely basis of specific claims issues or trends which may impact underwriting decisions. Use external resources in accordance with the CHUBB guidelines and philosophies. This includes the engagement of appropriate service providers where required and management of such providers and cases towards the timely and effective resolution of the matter.Claims Quality
Manage and handle claims to finality within designated Settlement Authority and Chubb Claims Management Guidelines, including timely action, appropriate investigation, regular case reviews and proper evaluation are taken in all claims. Ensure that loss reserves are set and maintained in accordance with Chubb guidelines, timely updates of claims data made into systems and correctness of systems and file records, Comply with Chubb quality review program guidelines and ensure corrective action is complemented as necessary. Complete Reserve Reconciliation and Advocacy reviews in accordance with CHUBB guidelines.Expense Management
Provide input to, and in association with Consumer Claims Lead to monitor and control department operating budget (UCE) by ensuring departmental controls are prudently applied and Chubb interests are protected at all times. Manage and monitor Allocated Claim Expense (ACE) and adhere to all Chubb controls and guidelines.Others
Maximize recoveries from insurers, salvage dispositions, subrogation or other recovery proceedings through close monitoring. Ensure timely advices, relevant supporting documents and responses to enquiries are provided to coinsurers / reinsurers to settle their share promptly. Provide and/or assist with the provision of statistical analysis and operational reports. As required, to provide Claims Representation/Support including visitations, meetings, presentations, etc. with Underwriters and/or Business Unit. As required, assist in claims related projects including UAT etc, and other projects/assignments or tasks, as assigned. To meet or exceed the expectations/objectives set on the individual’s and the Team’s yearly goal setting.Skills and Experience:
Advanced expertise and knowledge in A&H claims handling. Excellent communication and internal personal skills. Ability to effectively manage all internal and external stakeholders. Advanced knowledge of legal, regulatory & procedural requirements on A&H claims handling. Ability to organize work effectively and methodically. Highly adaptable to change in a fast-paced environment. Ability to assist with technical training to team claim handlers as required. This would include training / presentations to internal / external stakeholders. Experience in negotiation, mediation and arbitration skills on high complexity claims. Ability to develop and implement appropriate claims management strategies and plans and design efficient claim operating program and coordinate with Consumer Claims Lead to facilitate same.Ability to analyze all claims to ensure optimal quality and prepare reports for Consumer Claims Lead, various business units and provide reports to all clients and management.
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