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Claims Assessor
2 months ago
About the Role:
The Claims Assessor is accountable for accurately assessing property damage and determining claim quantum and scope under the relevant Policy Document Schedule (PDS). Through their customer interactions, and support for Client Managers, Claims Assessors deliver exceptional service, providing customers with peace of mind during the claims process.
Key Responsibilities:
- Deliver professional and exceptional service when completing on-site and desktop assessments, interacting with customers on the Client Manager's request – creating, accepting and rejecting the scope of work for claims – in line with the relevant PDS and Suncorp's service excellence standards and principles.
- Proactively communicate clear and accurate advice, solutions, timeframes and claim progress to stakeholders, including Customers, Client Managers, Repairers and Suppliers.
- Support the Client Manager to identify customer resolution strategies to minimise customer escalations.
- Identify customers experiencing vulnerability and take appropriate action to ensure the customer is supported.
- Build effective and trusted relationships with stakeholders to meet customer and business needs; and support best practice claims outcomes.
- Respond to customer and stakeholder requests within expected or agreed timeframes.
Effective Claims Assessment:
- Assess the property loss or damage, determine policy coverage (claim quantum, scope & schedule) and determine reserve within delegation levels.
- Determine an appropriate claim fulfilment method that balances customer needs with business outcomes.
- Clearly document all decisions made and reasons, including ownership details, reserve changes and acceptance/rejection of claims.
- Contribute to claims cost control via following the panel selection process, reviewing quotes & refining with repairers where necessary, and early identification of potential recovery action.
- Assess the quality of the repairs via Quality Assurance processes and frameworks.
- Maintain current PDS knowledge to enable accurate coverage decisions and deliver fair and reasonable costs.
- Follow and implement the Assessing & Repair strategy for working loss and events.
Proactive Risk Management & Compliance:
- Proactively identify potential risks and mitigate where possible to avoid unnecessary escalation of a claim.
- Identify potentially fraudulent activity and immediately report anything suspicious to your leader.
- Identify unacceptable underwriting risks from on-site assessments and report these to your leader.
- Ensure compliance with all internal policies, procedures, legislative and external requirements (e.g., General Insurance Code of Practice, Privacy, IDR processes).
Positive Contribution:
- Identify insights and performance feedback on the repairers via dedicated feedback mechanisms and report these to your leader.
- Identify any process or customer experience improvements and share these with your leader. Where appropriate, also share these improvements with your peers and stakeholders.
- Stay abreast of new repair techniques and stay current with industry standards and share with peers.
- Actively support others during major events and catastrophes, in line with the Event Response Plan.
- Take ownership for learning and development to uplift skills and capabilities.
- Role model the Suncorp Our Compass Behaviours and Code of Conduct.
- Positively contribute to team and take action to enhance own and others' safety and wellbeing.
