Senior Executive, Claims

Found in: Talent MY C2 - 1 week ago


Kuala Lumpur, Malaysia General Insurance Full time

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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