Senior Claims Consultant

2 weeks ago

Brisbane, Queensland, Australia Auto & General Australia Full time

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Brief Description

As a Technical Motor Claims consultant, you will be dealing predominantly with claims where there is a level of complexity, non-disclosure, policy exclusions and where conditions of cover have not been met so require further review.

Motor Claims experience essential
Investigation experience highly desirable
Demonstrated insurance claims knowledge
Exceptional customer service skills

Ability to develop strong relationships at all levels with both internal and external stakeholders coupled with a high level of emotional intelligence.

Broad ability to drive for results, focus on outcomes and well-developed negotiation skills.

Summary

You will be responsible for.

Managing a portfolio of complicated or unusual motor claims files.
End to end management of a portfolio of complex, high value and sensitive claims.
Reviewing each referred claim for acceptance in line with the ICA, PDS and prior to internal dispute resolution or Ombudsman determination.
Manage existing claims to provide support to customers within policy entitlements, organisation of repairs & management throughout the claims life.
Accurate reserving, claims validations, manage claims costs, and negotiate with a variety of stakeholders.
Identifying and raising potential risks or compliance issues to Management
Perform detailed review of retained claims and complete a Day-1 review of all claims.
Stay up to date on regulatory changed in the insurance industry that is relevant.
Engaging with customers on the phone and via email.
Reviewing, verifying, and issuing documentation to customer.
Relationship with the customer through claims processing, claims service and compensation service.
Build and maintain relationships with internal and external stakeholders such as forensic experts, underwriters, and customer dispute resolution team.
Seek additional information to validate events.
Accurately underwrite claims and make determinations on cover.
Review duty of care application by customer and apply reasonable care assessment as a key part of decision making.
Liaise with assessing team and suppliers to get the customers back into their pre-claim condition.
Constantly manage claims towards finalisation.
Liaising with external stakeholders to coordinate claim finalisation.
Communicate processes and next steps clearly verbally and/or in writing to customer.
Make sure customer understand their claim entitlement and the claim process.
Identify vulnerability experience by the customer and ensure support services offered.
Effectively listen and understand the needs of the customer and what is important to them to enable efficient momentum on claims where vulnerability have been identified.
If required recommend to Team leader to amend BAU process to accommodate vulnerability.
If required initiate fast-track claim process.
Provide great customer service whilst remaining rational and emotionally impartial to the outcome.
Demonstrating excellent motor claims processing skills and experience to benefit the customer and the Technical Motor claims team.
Complies with all applicable regulations related to the Motor product and Technical Motor claims processes.
Responsible to communicate with customers and other stake holders on claim related matters.
Be pro-active in supporting your team whilst also working independently.
Take ownership of their learning and be open to feedback, be solution focused and enjoy new challenges.
Assist TMC Team Leader and/or Head of Fraud & Claims investigations with additional projects or tasks where required.

Seniority level

Seniority levelMid-Senior level

Employment type

Employment typeFull-time

Job function

Job functionFinance and Sales
IndustriesInsurance

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