A&H Claims Examiner

1 week ago

Perth, Western Australia Chubb Full time $60,000 - $100,000 per year
Job Description:Your RoleYour 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, broker sand customers, and work with underwriters, the Compliance Department and other departments of the company as needed.
  • Proactively apply claims policies and procedures including Chubb's policy in relation fraud, salvage, cost containment and complaints.
  • Where applicable, review income replacement claims for payment of periodic benefits at lodgment 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.
  • 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 over seas 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.
Qualifications:
  • Tertiary Qualified or 2-3 years similar work experience
  • Investigation techniques
  • Claims Experience
  • Strong written and verbal communication skills
  • Understanding of insurance contracts
  • Understanding of legal requirements and regulations
  • Damage and/or loss evaluation
  • Negotiation skills
  • Reserving skills (desirable)
  • Capable of participating in audits
  • 1st and/or 3rd party fraud (desirable)


Chubb

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