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Kuala Lumpur

    Senior Executive, Claims - Kuala Lumpur, Malaysia - General Insurance

    General Insurance
    General Insurance Kuala Lumpur, Malaysia

    Found in: Talent MY C2 - 2 days ago

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    Description
  • Handle, process and recommend settlement of claims diligently in accordance with policy contract, company policy and procedures.
  • Approving claims within the department benchmark/turnaround time and within authority limit.
  • To ensure claims appeal from any parties/complaints are attended and respond within the benchmark set by the department.
  • Provide quality, prompt and claims courteous service to meet customer satisfaction and cultivate the culture of Customer Service Excellence.
  • To ensure outstanding claim files are reviewed yearly and ensure claim reserves are adequate with status updated.
  • To authorize payments.
  • To handle incoming enquiries from internal or external parties via emails, phone calls and letters.
  • To provide advice, sound judgment and recommendation on cases that surpass the authority of an Executive. Provide advice with appropriate referrals/escalations as and when needed.
  • To authorize, deny and determine extent of insurer's liability on case of discharge that surpasses the authority of an Executive.
  • To ensure claims recommendations and decisions are complied with legal requirements, industry regulations, company policies and professional codes.
  • Highlight to supervisors and/or HODs of any deficiency in policy coverage and adverse claims trends to facilitate corrective and appropriate action.
  • Identifying potential fraud and make appropriate referrals.
  • Participate in projects, meetings, UAT initiatives, system enhancements and assignments as and when the need arises.
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