Senior Claims Adjuster *Master*

Location Malaysia
Discipline Others
Job reference 163506
Salary 10000.0
Consultant name Mohamad Hafiz bin Mat Noor
Contact email [email protected]
Contact no. +60320870000
Contact name Mohamad Hafiz bin Mat Noor
Contact email [email protected]
Contact no. +60320870000
Senior Claim Adjuster
Salary: RM10,000

Purpose
  • This role is to assess, handle, negotiate, adjust and settle claims ensuring successful resolution. The role also involves offering advice to other adjusters within the team, and if required the Adjuster will deputise for Adjuster(s), the Assistant Claims Manager(s) and/or Head of Reinsurance Claims in their absence.
  • Either 5 to 8 years Reinsurance Claims experience, preferably in CAT & Risk Excess of Loss, Stop Loss and Proportional Treaty Claims, or 5 to 8 years of Large Commercial Insurance Claims, preferably experience with adjudicating large commercial casualty claims for global insurers that involve complex coverage and quantum investigations, disputes, and settlement authority between £100K and £1M.
  • The candidate must also be willing to learn and run with other classes of claims, for example Marine (Hull, Cargo & Liability), Aviation, and Property and Casualty.
  • It is preferred if the candidate has experience with subscription markets and/or co-insurance and broker intermediated claims.
  • Relevant insurance qualifications and/or insurance degrees preferred. Interest in studying towards CII qualifications. We want a Team player who will fit into our team and pace of work.
  1. Candidate must be able to adjust a portfolio of claims across different classes and quantum value bands, independently and together with our Claims Team based our of our Kuala Lumpur office – currently comprised of six (6).

Dimensions

The role involves claims adjustment for all underwriting years where client are in an agreement/Lead party, this includes the technical assessment of claims, formation and implementation of strategies for the successful resolution of these matters. The successful candidate must:
    • Have an eye for accuracy and detail
    • Be able to work at a fast pace, take pressure in their stride and effectively prioritise
    • Be organised and efficient in thinking
    • Be able to pick up our work processes quickly across our various applications including (but not limited to) Excel, Subscribe (Underwriting application), TRAX (Claims Management application)
    • Be willing to take on any new challenges, learn and be flexible in approach and thinking
    • Have a positive attitude and outlook to work and colleagues

Key Result Areas.

Claims Adjusting

To adjust own portfolio of claims within Specialty Risk business unit in accordance with agreed authority limits and in line with client claims procedures.

    • To ensure that all claims are adjusted in accordance with the appropriate Lloyd’s claims scheme(s).
    • To ensure that claims presented, either by way of paper or electronic submission, are handled promptly, efficiently and within agreed service levels.
    • To manage and adjust simple/complex claims through to resolution in accordance with QA requirements with special attention to detail and accuracy at all times.
    • To appoint and monitor the use of claims service providers in accordance with the Group policy. In addition to supply input into the procurement of service provider networks, including feedback as to provider service quality.
    • To manage providers and develop strategy for claim resolution.
    • Liaise with brokers, co-insurers, reinsures and Xchanging on claims related issues, including the coordination of claims management with the following market and Xchanging Claims Services.
    • To be responsible for the maintenance and usage of the Workflow system and to ensure that the claim records are accurate and up to date, in accordance with claims procedures. When required provide input into future development and enhancements of the system.
    • Work in conjunction with Claims Adjusters / Technicians, Assistant Claims Managers, Claims Managers and representatives of the Underwriting teams to ensure smooth operation of business and effective communication is in place through all areas of the business.
    • Dispute Resolution To represent client and the market at mediations, arbitrations and settlement negotiation, individually or in conjunction with MS Amlin staff and or other appointed representatives.
    • To ensure that all avenues for recovery or subrogation are investigated evaluated and pursued during the lifespan of the claim.


Internal Liaisons

To maintain and develop relationships with other areas within the Group, including the following:

    • Management
    • Operations
    • Underwriters
    • Group Legal
    • Claims Teams
    • Reinsurance Recoveries Team
    • Finance

To assist on any internal working group or committee as required by client.


External Liaisons

To maintain and develop relationships with key third parties including the following;

    • Brokers
    • Surveyors
    • Adjusters / Assessors
    • Lawyers
    • Clients
    • Xchanging Claims Services
    • Co-insurers/Reinsurers.

 

To meet regularly with brokers and service providers where required to discuss existing claims or contract developments.

To either conduct or accompany senior members of staff in carrying out client visits to discuss claim developments, conduct reviews, discuss current claims trends and issues and maintain or develop relationships.


The Operating Environment and Context of the Job

Client is one of the major leaders of business in the Lloyd’s market. The underwriters and claims personnel operate in a highly regulated business that monitors the business they write, the manner is which it is written and the control environment. Internal controls and procedures are in place to ensure that client’s underwriting and claims management conforms to Lloyd’s licences and national and international regulations and that the client’s interests are protected by ensuring that financial and operating risk is identified and controlled.

The role of the Senior Claims Adjuster is to assess, handle, negotiate, adjust and settle claims on classes of business where client are an agreement party, operating under agreed authority levels and in conjunction with the client Claims procedure manual.

To be able to receive a new claim, analyse the claim , do a ground up assessment , come up with a reserve , to present findings, request for authority to reserve where it exceeds handler’s claims authority, make payments diary files, follow up, liaise with brokers acknowledging receipt of claim and reserving rights where necessary. Open/Close claim files.

In addition to the stated facets of the role the Senior Claims Adjuster is also responsible for

    • Working with and supporting the Head of Reinsurance Claims and the Assistant Claims Manager (based in KL) in the implementation of the Asia Claims strategy.
    • Able to manage the end to end claims process which includes administrative processes related to adjustment activities using various applications.
    • Preparation of market intelligence reports and scorecards produced by the Claims Team on a monthly basis for circulation to key stakeholders across the business


Key Competencies:

Generic

    • High computer literacy
    • Data entry into Excel, Subscribe, TRAX and other applications as well as any manual Excel sheets that are required to be maintained – training will be provided
    • Must be well versed in excel – experience in managing and developing Excel based workbooks to support claims activities advantageous
    • Compliance with procedures

Role Specific

    • Class specific (Property, Engineering, Casualty and Maritime (Hull, Cargo, Liability etc), insurance/reinsurance knowledge
    • Qualified to handle Reinsurance claims (Proportional & Non-Proportional) as well as Direct/Facultative Property, Engineering, Casualty and Maritime (Hull, Cargo, Liability etc) with training to be provided, as needed
    • English language
    • Judgement and decision making capability
    • Evaluation and analysis

Commercial Awareness

    • Negotiation skills
    • Eye for detail and accuracy
    • Makes self available to help others to solve technical problems
    • Reporting skills – able to write in a clear and concise manner to various stakeholders

Behavioural

    • Proactive and self driven – takes the initiative to attend to tasks before being asked to or compelled to by events/urgency
    • Effective time management skills - Iis able to cope with multiple tasks and problems concurrently, prioritise and liaise with relevant stakeholders to manage expectations
    • Strong attention to detail - spots connections, trends or discrepancies in information that are not obvious
    • Strong interpersonal skills - cultivates and maintains a network of contacts to share information and encourage co-operation within the team, business and externally
    • Able to complete work in a fast, efficient, accurate manner, independently and with team where the task is group-based
    • Builds a positive professional reputation in the business and market
    • Stands up for what they believe in when dealing with difficult/complex situations – seeks out feedback and plans best response to situation
    • Enthusiastically takes on new ideas and shares their own
    • Nurtures and values relationships within own team and across function
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Key Interfaces:

 

The role interfaces with the Underwriting teams, Claims Teams (Claims Manager(s), Assistant Claims Manager(s), Claims Adjuster(s)/Technician(s)), Finance Teams (Accounts Payable, Credit Control and Technical Accounting), External Teams (Cedent(s), Broker(s) and other claims related third party providers).