Claims Examiner, SPL

1. Processing new claims in accordance to the latest Claims Best Practice or SOP document(s), with guidance of updated Letter of Authority granted.

• a) Issue acknowledgement note to Insured/intermediaries/marketers.
• b) Appointment of adjusters if necessary.
• c) Ensure prompt and accurate claim registration within 5 working days.
• i. Ensure Claims file creation (i.e. in Workview)
• ii. Reserves created in the Financial Systems ( PolisyAsia & Meridian)
• iii. Ensure all correspondences & docs being filed (i.e. in Workview)
• d) Follow-up for initial report from adjuster/surveyor/expert.
• e) CABFAC/CABCO Claims recoveries on outward placement

• Ensure PLA, RLA and SLAs sent to all follow insurers i.e. CAB & NONCAB within 7 working days.

f) Timely issuance of PLAs, RLAs and SLAs to treaty reinsurers (where necessary)

1. Monitoring the progress of claims

• a) Follow up with adjuster/surveyor/expert for the status of the claims including timely update the provision of reserve.
• b) Follow-up with adjusters for their Preliminary Report/Status Report/Final Report.
• c) Issue reminder to Insured/intermediaries/marketers on outstanding docs/information required.
• d) Diary/Pend the outstanding files for monitoring purposes.

1. Claim processing

• a) Fast Track Claims (internal handling) – immediate attendance to claims to reach claim settlement within 3-5 working days.
• b) Non-Fast Track Claims (external handling) - claim approval within 7 working days upon receipt of adjuster’s reports / last info or docs required.
• c) Ensuring fair and expeditious settlement of a valid claim in accordance to policy conditions, statutory requirement and Claims Best Practice.
• d) Communicate claims decision (offer or denial) to Insured / intermediaries/ marketers.
• e) Accurate claims payment including maintaining record of banking details & other related documents as required.
• f) Ensure all correspondences & docs being filed (i.e. in Workview)
• g) Ensure consistency in file status at Workview and PolisyAsia & Meridian

1. Handling of complaints i.e.

• a) To monitor and manage complaints and disputes.
• b) To evaluate complaints so as to reduce the occurrence of systematic and recurring problems of service-related issues.

1. Attending internal and external phone calls on claims related enquiry from claimants, Business Units & intermediaries.
2. Timely submission of periodic and ad hoc requests for data, analysis and reporting i.e. large loss report to management, monthly XOL report, PIAM Quarterly report etc.
3. Conduct file review – minimum once a year.
4. Others

• a) Vendor management – compliance of service standard
• b) Fraud Management – fraud identification & management
• c) Subrogation Recovery – early action to be taken.

• Preferably with at least 3 years experience in handling non-motor claims
• A degree and preferably with professional insurance qualifications