Job Description

:Claim evaluationReviewing and assessing claims to determine their validity and coverage under the financial lines insurance policies.InvestigationConducting investigations and gathering necessary information, such as policy documentation, claim forms, incident reports, and any supporting evidence, to help determine the authenticity of the claim.Policy interpretationAnalyzing policy terms and conditions to determine if the claim falls within the coverage limits specified in the insurance policy.CommunicationInteracting with policyholders, brokers, and other relevant parties to gather necessary information and clarify coverage details.DocumentationMaintaining accurate and comprehensive claims records, including correspondence, reports, and other relevant documents.Claims negotiationNegotiating settlement agreements with policyholders or their representatives, ensuring fair and equitable resolutions.Fraud identificationIdentifying and investigating potential fraudulent or exaggerated claims and working closely with internal investigation teams, legal counsel, and law enforcement if necessary.Subrogation Recovery identificationIdentifying and investigating potential subrogation recovery and working closely with internal investigation teams, legal counsel, and law enforcement if necessary.ComplianceAdhering to regulatory and legal requirements and ensuring compliance with company policies and procedures.ReportingPreparing and presenting claim summaries and reports to management, providing insights on claim trends,Continuous improvementSuggesting and implementing process improvements to enhance claim handling efficiency and customer satisfaction.Qualifications:SkillsKnowledge: Solid understanding of financial lines insurance policies, terms, and conditions. Familiarity with relevant legal and regulatory frameworks is advantageous.
Analytical skills: Ability to evaluate claims, analyze policy coverage, and review complex financial and legal documents.
Communication: Excellent verbal and written communication skills to interact with policyholders, brokers, and internal stakeholders.
Attention to detail: Strong attention to detail to ensure accurate claim assessment and documentation.
Problem-solving: Ability to handle complex claims and make informed decisions in a timely manner.
Knowledge: Solid understanding of financial lines insurance policies, terms, and conditions. Familiarity with relevant legal and regulatory frameworks is advantageous.
Analytical skills: Ability to evaluate claims, analyze policy coverage, and review complex financial and legal documents.
Communication: Excellent verbal and written communication skills to interact with policyholders, brokers, and internal stakeholders.
Attention to detail: Strong attention to detail to ensure accurate claim assessment and documentation.
Problem-solving: Ability to handle complex claims and make informed decisions in a timely manner.
ExperiencePrior experience in claims management or insurance-related roles, preferably in financial lines insurance, is highly desirable.QualificationsA bachelor\'s degree in law, finance, insurance, business administration, professional insurance qualifications or a related field is typically required.

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