Head of Technical Claims

2 months ago

Sydney, Australia Australian Reinsurance Pool Corporation Full time

**ARPC Position Description**

**Function**:Claims **Classification broadband**:EL2

**Location**:Sydney **Security clearance**:Baseline

**Role Reports to **(role title)**:Chief Claims Officer

**Direct Reports **(role titles)**:Nil

**Purpose of the role **(Why the role exists; how the role contributes to the ARPC’s strategic objectives)
The purpose of this role is to serve as a technical authority in reinsurance claims for terrorism and cyclone risk with
responsibility to ensure compliance with legislation and contract law, provide technical assistance to key stakeholders,
ensure alignment with industry best practice and development/overseeing all aspects of claims leakage/fraud
prevention, detection, and recovery. The role will be a responsible knowledge expert, enhancing the capability of the
Claims team and will be involved in Claims related strategic initiatives as they arise.

**Key Accountabilities** (Key activities, tasks, and outcomes to be achieved)***

Leadership of reinsurance claims practices
Establish and maintain appropriate technical claims reinsurance policies, procedures, and processes.
Establish and maintain working practices which serve to provide assurance that ARPC will routinely comply with

contractual, regulatory, and legislative requirements and obligations.
Identify risks in policy frameworks and working practices and design and implement mitigation strategies.
Provide detailed assistance to stakeholders to promote their compliance with the Act and the ARPC Reinsurance

Agreement
Provide technical support and advice in relation to claims related disputes.

Advisory to ARPC teams for both Cyclone and Terrorism Reinsurance
Support and provide council to the CCO where required.
Serve as the authoritative technical expert on legislative operations, the intersection and interrelation between

legal definitions in contract law and function as the primary internal point of reference for reinsurance claims
related matters.

Provide high level professional guidance and comprehensive technical information to the stakeholders in relation
to reinsurance offered by ARPC.

Development / Overseeing Reinsurance Claims Leakage and Fraud
Detection and Prevention: Develop, implement, and continuously enhance claims leakage and fraud detection

strategies and initiatives to reduce the risk of increased claims costs due to leakage and mitigate fraudulent
claims. Collaborate with cross functional teams to strengthen anti-fraud measures.

Investigation and Analysis: Conduct in -depth analysis of claims data and patterns, as well as internal
benchmarking of insurers, to identify high risk claims and potential fraud. Lead the investigation of suspicious
claims, using advanced tools and techniques where required.

Recovery: For identified frauds liaise with appropriate parties to take action on recovery.
Policy Development: Develop a framework to identify and assess fraud risks. Create and maintain policies and

procedures related to fraud detection reporting and prevention. Ensure compliance with industry regulations and
standards.

Collaboration: Collaborate with claims and underwriting teams as well as other departments to share information
and improve claims leakage and fraud prevention efforts. Partnership with the Commonwealth Fraud Prevention
Centre for a whole of government approach to fraud detection and management working together on fraud
countermeasures and reporting.

Quality Assurance: Ensure the quality and accuracy of claims audit and fraud investigations, maintaining a high
standard of work while adhering to deadlines.

Engagement with internal and external stakeholders
Take a lead role in fostering stakeholder understanding of the relevant legislation for the Cyclone and Terrorism

Reinsurance Pools

***

Provide detailed assistance to stakeholders to promote their compliance with the Act and the ARPC Reinsurance
Agreement.

Represent ARPC at relevant industry forums which may involve presentations, government reports and articles.
Work with Underwriting, particularly the Head of Technical Underwriting, on disputes or retrocession claims

recoveries should they arise

Other
Participate in ARPC Corporate projects as and when opportunities arise.
Champion risk culture values and a strong advocate for good customer outcomes
Promote continuous improvement to ARPC’s products and services having regard to product assessments, IT

solution and business efficiencies.
Identify, communicate, and solve issues within ARPC that arise in the administration of the TCI Act
Draft Board papers on claims matters and present at Board level as required. Develop and maintain a commercial

understanding of the markets in which ARPC operates to contribute to short, medium, and long-term business
planning and development.

Role model ARPC’s Values and Code of Conduct and Capabilities set out in the ARPC’s Capability Framework.

**Working Relationships **(Key stakeholders, clients, customers, suppliers,

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