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Claims Adjuster (Delegated Authority)

Massenhove Recruitment
Job LocationLondon
EducationNot Mentioned
Salary£35,000 - £45,000 per annum
IndustryNot Mentioned
Functional AreaNot Mentioned
Job TypeContract, full-time

Job Description

Job Purpose:To monitor, review and reconcile claims bordereaux which are managed under a delegated authority. To desktop adjust own portfolio of cases notified, from first advice through to settlement within designated Branch authority, in accordance with the claims handling manual. The cases are varied and may include both lead and follow claims to a high technical level.Key Result Areas:

  • To ensure claims bordereaux and reconciliation information is presented on a timely basis by TPA’s in accordance with KPI’s.
  • To review and reconcile claims data presented in Excel format to ensure claims are presented in the correct policy period; are reserved correctly and are managed within the TPA delegated authority.
  • To undertake an initial evaluation of cause of loss on individual claims to determine whether a claim is covered and what further information may be required.
  • To decide the Company’s response to claims, based on correct interpretation of policy and underwriting documentation; investigating, negotiating and settling claims within statutory and company guidelines. This includes coverage analysis and policy determination.
  • To assist in the process for setting accurate, realistic and timely claim reserves to enable management to assess the company exposure.
  • To liaise variously with clients, loss adjusters, solicitors, experts, brokers, MGA’s and TPA’s as appropriate for claims service and investigation.
  • To liaise variously with underwriters & risk managers, finance, Management, Head Office and with network (Servicing and/or Producing offices) as and when relevant for informational, procedural or authority reasons
  • To maintain accurate records for auditing and regulatory purposes, preparing reports as necessary.
  • To ensure accurate entry of claims data into Company systems to enable precise reporting on the nature and financial impact of the claims portfolio and to assist in the preparation of MI.
  • To proactively participate in projects or other initiatives designed to improve the effectiveness or efficiency of the department.
  • To undertake any other tasks as requested by the Claims Manager and Claims Director, in order that the team achieve its objectives.
    • Specific Job Related Skills & Competencies:
  • CII qualified (Diploma Level) or equivalent experience.
  • Experienced user of Excel & Word
  • Good understanding of delegated authority arrangements and procedures, the claims process and terminologies used.
  • Good understanding of insurance and the terminologies used, across all lines of business.
  • Awareness and understanding about underwriting policy construction; able to read underwriting files and understand the importance of claims data for the underwriting process.
  • Able to evaluate information from a variety of sources and solve problems.
  • Good decision-making skills; able to consider the costs and benefits of various decisions and choose the appropriate one.
  • Good communication and interpersonal skills; comfortable with phone & face to face discussions with underwriters, brokers & other technical colleagues; confident in negotiation and networking scenarios
  • Accuracy and attention to detail
  • Able to organise own workload effectively to meet service standards
  • Deadline focused; able to work under pressure to meet tight deadlines
  • Good systems knowledge, experience of using various company bespoke systems to interrogate data
    • Required skills
  • Insurance
  • Claims Handling
  • MS Excel
  • Claims Adjusting
  • Claims Bordereaux

    • Keyskills :
    Insurance Claims Handling MS Excel Claims Adjusting Claims Bdereaux

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