Accident & Health Claims Examiner

4 days ago


Sydney, Australia Chubb Full time

**Your Role**

The primary purpose of this role is to produce a high-quality work product on Accident & Health or Combined Insurance claims through prompt and professional contact with customers and brokers and through the effective investigation, reserving and adjustment of claims incurred by insureds.

**Your Responsibilities**:

- Manage a portfolio of claims for Accident & Health and /or Combined Insurance claims as allocated and assist processing other Retail claims as required.
- Assess claims in accordance with Chubb’s service level and quality requirements and the General Insurance Code of Practice. This includes determining coverage, reserving within timeframes, making payments, responding to customer queries, providing updates, and requesting additional information as needed to manage a claim.
- Communication by telephone and written correspondence to brokers, claimants and others as required.
- Take part in Claim Department and companywide training as required.
- Respond to enquiries and escalations of matters from underwriters, brokers and customers, and work with underwriters, the Compliance Department and other departments of the company as needed.
- Where applicable, review income replacement claims for payment of periodic benefits at lodgement stage and at key points in the claim cycle and develop strategies for claim management and successful return to work of the claimant where possible.
- Participate in claims meetings with internal and external stakeholders as required.
- Manage Emergency Assistance cases end to end as allocated.
- Facilitate payment of claims costs and service provider fees including reconciliation and liaison with Chubb Business Services overseas and the service providers.
- Provide advice, instructions and coaching to Chubb Business Services overseas and outsourced service providers as required on claims within delegated authority limit.
- Monitor performance and processes of service providers to make recommendations in respect of process and contract compliance, escalating breaches to Claims Management.
- Assist in daily payment, audit, and other administrative tasks as required.
- General assistance within the Claims Department and adoption of other duties in response to altered business needs and staff changes.
- Tertiary Qualified or 2-3 years similar work experience
- Investigation techniques
- Strong written and verbal communication skills
- Understanding of insurance contracts
- Understanding of legal requirements and regulations
- Damage and/or loss evaluation
- Negotiation skills
- Organisational skills
- Reserving skills (desirable)
- Capable of participating in audits
- 1st and/or 3rd party fraud (desirable)

**Requirements**:

- Fluency in Japanese is essential.

Chubb is committed to equal employment and celebrates individual differences by creating a workplace environment in which everyone feels welcomed, respected and valued. We offer you the opportunity to work as part of a dynamic and agile environment where continuous development is encouraged throughout your career, both locally and globally. Some additional benefits offered include a flexible working approach via our “My One Thing” initiative, education assistance, dress for your day every Friday, promotion of health and wellbeing (including discounted health insurance, daily breakfast and fresh fruit), and the option to enrol into the Chubb Limited discounted stock purchasing scheme.



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