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Claims Role

Function Purpose

The Claims Function in our insurance broking company is designed to facilitate the efficient and accurate processing of insurance claims. This function aims to ensure timely resolution of claims, maintain client satisfaction, and uphold the credibility of the organization by adhering to ethical and legal standards.

Role Purpose

The purpose of the Claims Role is to effectively manage the claims process for clients, ensuring a smooth and fair settlement of claims. The role involves reviewing and validating claims, liaising with insurers, advocating for clients' interests, and guiding them through the claims process to achieve a satisfactory outcome.

Key Expectations of the Role

• Claims Processing and Documentation :
• Accurately review and process claims in adherence to established protocols and guidelines.
• Ensure all necessary documentation is collected and maintained for each claim, including client statements, accident reports, and relevant records.
• Client Advocacy and Communication :
• Act as the main point of contact for clients during the claims process, providing timely updates and information.
• Advocate for clients' interests and rights, ensuring a fair and just settlement of claims.
• Guide clients on document compliance and solutions for addressing queries of surveyor and insurer to expedite settlement of claims.
• Settlement or Compromised Settlement :
• Engage in substantiating the claim to the insurers to secure optimal claim settlements for clients.
• Ensure that settlements are fair and appropriate, considering policy terms, legal requirements, and clients' expectations.
• Conflict Resolution and Customer Service :
• Address client concerns, disputes, and inquiries related to claims in a professional and timely manner.
• Facilitate conflict resolution and maintain positive client relationships throughout the claims process.

Competencies Required for the Role

Personal Qualifications