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Principal Claims Consultant

3 weeks ago

Mcmahons Point, Australia B & K Consulting Full time

**The Client**

We are currently working exclusively with a prestigious, well-respected leading Life Insurer who has both the stability of an established financial entity dating back to late 19th Century, and the feel of an energetic "mature start-up", which is a great mix to have in a business. Further, they are backed by one of APAC's largest Insurance companies, and they pride themselves on delivering exceptional service and products to their customers, across a multitude of insurance channels.

They are a trusted financial partner to millions of Australians across both the Retail, and Group Life, insurance industries.

**The Role**

This role exists to provide high-level technical expertise and coaching to a team of specialised Case Management professionals providing oversight and guidance on the management of complex income protection claims.

You will help to assist in the identification of claims requiring clarification and potential investigation, inconsistencies or inaccuracies in evidence requiring an in-depth review of the claim(s), and the over-arching case management process.

The actual claim investigation and gathering of evidence also requires a sound understanding of the relevant legal test in the policy, and will require strong analytical skills, and a strategic mindset.

**Accountabilities will include;**
- Provide oversight and manage a complex portfolio of Income Protection Claims to ensure the customer experience is aligned with our clients claims philosophy.
- Build rapport with customers over the phone by maintaining regular contact, identifying appropriate added support services, and liaising with the Recovery Specialists to support customers
- Manage all stakeholders expectations to support a seamless customer experience.
- Assess claims against policy terms and explain complex decisions with logical and clear rationale
- Instruct third parties to provide claim assessment support as appropriate to the claim situation and use claim providers in line with an appropriate cost benefit analysis.
- Manage claims within appropriate risk and governance frameworks
- Coach and mentor the team in support of the Team Manager
- Provide honest and constructive feedback to case managers, and help to upskill where necessary
- Ensure sound technical claims oversight to influence the duration of each claim
- Maintain strong working relationships and interactions and ensure each claim has the right level of oversight and expertise

**Required experience**:

- 12-15+ years of insurance claims experience, including knowledge of legislation and regulations affecting the life insurance industry, in particular, LICOP and LICOPv2 (essential)
- Expert in complex Income Protection claims assessment, analysis and complex strategy (essential)
- Cert IV Life Insurance Accreditation (essential)
- Australian Insurance Institute (desirable)
- Tertiary qualifications (desirable)

**Note**: