Job Purpose: The main task of the role is to settle claims, in accordance with the segregation of duties principle. The Senior Claims Adjuster is responsible for processing claims received (settlement), managing a portfolio of claims and maintaining an appropriate service level. He/she denies, settles, or authorizes payments to routine claims based on coverage, appraisal, and verifiable information. Responsibilities also include corresponding with policyholders, brokers and agents and preparing report of findings of an investigation.

Key Responsibilities/What You Do:

• Require, if necessary, missing documents/ information directly to the policyholders/ brokers,
• Inform the policyholders/ brokers of the status of the claim (assessed, settled)
• Handle possible appeals (complaints) from the policyholders/ brokers
• Liaise with Collections to assess policyholders’ collection efforts and compliancy with obligations under policy
• Answer Collections requests/ authorizations
• Answer policyholders / brokers questions in a professional and customer friendly manner
• Close claims file following closing of Collections file.
• Handle objections to claims through negotiations with policyholders and any other stakeholders
• Resolve claims issues which may have a major impact on claims settlements and business retention
• Develop and maintain good relationships with policy holders and brokers by understanding their business and responding promptly to their questions
• Send claims for collection to the lawyer and follow up and negotiate with the lawyer
• Make all claims settlements, according to the Terms and Conditions of the insurance policy/contract
• Discuss with trustee and file Proofs of Claim

KEY REQUIREMENTS/WHAT YOU BRING:

• Bachelor’s Degree in Business Administration or a relevant field.
• 5-10 years’ experience in claims settlement with insurance company
• Excellent communication skills in French and English, both spoken and written
• Knowledge of Claims and Collections processes and systems
• Knowledge of Quality Standards, C&C operational guidelines
• Ability to identify mandatory documents per type of claims / collection
• Strong interpersonal and communication skills.
• Comfortable with numbers; strong analytical skills.
• Strong attention to detail.
• Ability to determine the appropriate course of action in settling claims
• Result oriented & Team player
• Customer centric
• Business expertise
• Strong knowledge of policies, contract law and local insolvency
• Strong knowledge of claims settlement processes and systems
• Strong knowledge of collections process
• Strong knowledge of quality standards and claims and collection operational guidelines

• Require, if necessary, missing documents/ information directly to the policyholders/ brokers,
• Inform the policyholders/ brokers of the status of the claim (assessed, settled)
• Handle possible appeals (complaints) from the policyholders/ brokers
• Liaise with Collections to assess policyholders’ collection efforts and compliancy with obligations under policy
• Answer Collections requests/ authorizations
• Answer policyholders / brokers questions in a professional and customer friendly manner
• Close claims file following closing of Collections file.
• Handle objections to claims through negotiations with policyholders and any other stakeholders
• Resolve claims issues which may have a major impact on claims settlements and business retention
• Develop and maintain good relationships with policy holders and brokers by understanding their business and responding promptly to their questions
• Send claims for collection to the lawyer and follow up and negotiate with the lawyer
• Make all claims settlements, according to the Terms and Conditions of the insurance policy/contract
• Discuss with trustee and file Proofs of Clai