Major Claims Manager

4 days ago


Kuala Lumpur, Kuala Lumpur, Malaysia Allianz Popular SL. Full time

What if you were empowered to make a positive impact?

To process claims and to ensure that the departmental strategic initiatives, contributing to the overall achievement of the Company's mission and business plan is continuously met. To provide optimal service to both internal/external customers that the moment of truth experience is realized. To conduct thorough investigation (mainly internal investigation) on claims cases to establish non-disclosure/pre-existing.

You'll be responsible for:

  • Assessment and approval of Major claims & PA claims within the defined approval authority limit set and committed service level. To make recommendation for cases above limit to Superior.
  • Review processes to propose new guidelines, rules & requirements, procedures and system enhancement for operational efficiency and effectiveness.
  • Constantly monitor and review pending claims and appeals within the committed service level and make appropriate revised decision if it is within the authority limit.
  • Handle enquiries and provide quality customer service to clients and agents including investigating into customer/agent's complaints on delay in claims assessment.
  • Conduct closed file and open file audit review of junior assessors.
  • Liaison with Consultant Doctor and other Insurers to determine validity and liability of the Company.
  • Support other sections within the dept. to ensure efficiency.
  • Assist Superior in the monitoring of Daily TAT, Penders' File and work performance towards the objectives and goals of the dept.
  • Assist to provide training for junior staff and contract staff.
  • Clearing of Suspense Account and UMA reporting.
  • Conduct Agency Workshop.
  • Involve in BCP, DRP testing.
  • Adherence to Insurance Act 1996, AMLA, Standard Operating Procedures, Bank Negara Malaysia guidelines and Office Procedures.
  • Handles correspondence, draft, type and send:
    • simple general correspondence to customers.
    • standard letter to customers, doctors etc. for further information.
    • standard approval and rejection letter.
  • Ensure accurate and timely report submission to Accounts Department and any other relevant parties.
  • Undertake any other job-related functions as and when directed or instructed by immediate superior or any other person as may be designated by the Company.
  • To assess, review cases for higher approval amounts.
  • To manage the Major Team with subordinates.
  • To take part actively in system enhancement issues including but not limited to User Requirement preparation, to fine-tune the current claim processes to an optimum process to achieve a better Turn-Around Time.
  • To take part in Product Implementation Committee (PIC) meeting and to work towards getting system readiness for new product launching including but not limited to product specification review, to prepare the system readiness, to raise the needed enhancement, provide claims processing material/guideline and to make sure the system is ready for the new product launching.
  • To constantly look for ways to improve the current process and to raise the needed enhancement to simplify and improve productivity.
  • To conduct monthly updates to the team on the latest guidelines, new products, etc.
  • To maintain and update the claims manual on a yearly basis.
  • Any task that is not mentioned above as long as it is to support the team in day-to-day operations.
  • Ability to leverage AI tools like ChatGPT for data analysis and generating actionable insights.

Important to your success:

  • Bachelor's Degree in Insurance, Business, or a related field.
  • At least 5 years of experience in claims assessment, preferably in the insurance industry, with a proven track record in handling Major Claims & PA claims.
  • Experience in a leadership or supervisory role, particularly managing a team of junior assessors, is an advantage.
  • Comprehensive understanding of the Insurance Act 1996, AMLA, Bank Negara Malaysia guidelines, and standard operating procedures.

Let's care for tomorrow. For challenging business as usual.

Disclaimer: Thank you for your interest in joining our team. Due to the high volume of applications we receive, we are unable to provide individual feedback to every applicant. If you do not hear from us within 14 days of submitting your application, please assume that you have not been selected for this position.

Important: All updates regarding your application status will be communicated via email. Please ensure you frequently check your email for updates and further instructions.

Allianz Group is one of the most trusted insurance and asset management companies in the world. Caring for our employees, their ambitions, dreams and challenges, is what makes us a unique employer. Together we can build an environment where everyone feels empowered and has the confidence to explore, to grow and to shape a better future for our customers and the world around us.
We at Allianz believe in a diverse and inclusive workforce and are proud to be an equal opportunity employer. We encourage you to bring your whole self to work, no matter where you are from, what you look like, who you love or what you believe in.
We therefore welcome applications regardless of ethnicity or cultural background, age, gender, nationality, religion, disability or sexual orientation.
Great to have you on board. Let's care for tomorrow.

#J-18808-Ljbffr

  • Kuala Lumpur, Kuala Lumpur, Malaysia Allianz Popular SL. Full time

    Career Opportunity: Senior Claim SpecialistAllianz Popular SL seeks an experienced Senior Claim Specialist to join our team. The ideal candidate will possess strong analytical and communication skills, as well as excellent problem-solving abilities.In this key role, you will be responsible for conducting thorough investigations on claims cases, assessing and...


  • Kuala Lumpur, Kuala Lumpur, Malaysia Prudential Hong Kong Limited Full time

    Assistant Manager, Major ClaimsAssistant Manager, Major ClaimsApply locations Kuala Lumpur (Takaful) time type Full time posted on Posted Yesterday job requisition id 25010328Prudential's purpose is to be partners for every life and protectors for every future. Our purpose encourages everything we do by creating a culture in which diversity is celebrated and...


  • Kuala Lumpur, Kuala Lumpur, Malaysia Allianz Popular SL. Full time

    At Allianz Popular SL, we are looking for a talented individual to fill the role of Insurance Claims Manager. In this position, you will be responsible for ensuring that our customers receive optimal service and that claims are processed efficiently.The successful candidate will have a Bachelor's Degree in Insurance, Business, or a related field, as well as...


  • Kuala Lumpur, Kuala Lumpur, Malaysia Allianz Popular SL. Full time

    We are seeking an experienced Insurance Claims Manager to join our team. The ideal candidate will have a deep understanding of the insurance industry, excellent analytical and communication skills, and the ability to work effectively in a fast-paced environment.As a member of our team, you will be responsible for ensuring that claims are processed...


  • Kuala Lumpur, Kuala Lumpur, Malaysia Prudential Hong Kong Limited Full time

    Assistant Manager, Customer Promise Job SummaryThe incumbent is responsible for providing efficient and effective support to the company's goals by meeting and exceeding expectations on operational processes. Key responsibilities include adhering to our claims workflow in relation to major, accident and hospitalization claims procedure, assessing and...


  • Kuala Lumpur, Kuala Lumpur, Malaysia Prudential Hong Kong Limited Full time

    Assistant Manager, Customer Promise - Medical Reimbursement & AccidentThe incumbent is responsible for providing efficient and effective support to the company's goals by meeting and exceeding expectations on operational processes. The complexity of the insurance business requires the incumbent to acquire a thorough knowledge of different insurance products...


  • Kuala Lumpur, Kuala Lumpur, Malaysia Allianz Popular SL. Full time

    We are looking for an experienced Claims Assessment Leader to join our team. The ideal candidate will have a strong background in insurance claims, excellent leadership skills, and the ability to motivate and inspire a team of professionals.In this role, you will be responsible for conducting thorough investigations on claims cases, assessing and approving...

  • Major Claims Manager

    3 hours ago


    Kuala Lumpur, Kuala Lumpur, Malaysia Allianz Popular SL. Full time

    Let's care for tomorrow. For your ambitions. Your dreams. Your challenges. Join team Allianz and discover endless career opportunities.Since 1890, all around the globe, we at Allianz have been working hard to secure people's lives and give our customers courage for what's ahead. We are a diverse community of experts delivering outstanding insurance and asset...

  • Claims Manager

    7 days ago


    Kuala Lumpur, Kuala Lumpur, Malaysia Prudential Hong Kong Limited Full time

    As a key member of our team, you will be responsible for delivering exceptional customer experience and ensuring the efficient and effective management of claims.Company OverviewPrudential Hong Kong Limited is a leading insurance company that provides innovative products and services to meet the evolving needs of our customers. We are committed to being...


  • Kuala Lumpur, Kuala Lumpur, Malaysia Sedgwick Claims Management Services Ltd Full time

    Key ResponsibilitiesThe ideal candidate will have:Proficiency in computer skills, including Microsoft Office.Strong time management abilities.Excellent communication skills, both oral and written.Ability to communicate in Mandarin to assist Chinese-speaking customers; proficiency in other dialects is a plus.The successful candidate will also have the...

  • Executive, Claims

    3 days ago


    Kuala Lumpur, Kuala Lumpur, Malaysia Prudential Hong Kong Limited Full time

    Executive, Claims (Production) page is loadedExecutive, Claims (Production)Apply locations Kuala Lumpur (Takaful) time type Full time posted on Posted 30+ Days Ago job requisition id 24060183Prudential's purpose is to be partners for every life and protectors for every future. Our purpose encourages everything we do by creating a culture in which diversity...


  • Kuala Lumpur, Kuala Lumpur, Malaysia Generali Group Full time

    Claims Support Services Job DescriptionWe are seeking an experienced Claims Operations Manager to join our team at the Generali Group. The successful candidate will be responsible for managing the claims support services function, including handling incoming emails, attending to first notifications of loss, and providing timely and accurate responses to...


  • Kuala Lumpur, Kuala Lumpur, Malaysia Allianz Popular SL. Full time

    We are seeking an experienced Claims Services Manager to join our team at Allianz General Insurance Company. As a key member of our leadership team, you will play a critical role in overseeing the Motor Own Damage Claims unit and ensuring that we deliver exceptional service to our customers.The ideal candidate will have a strong background in claims...


  • Kuala Lumpur, Kuala Lumpur, Malaysia Prudential Hong Kong Limited Full time

    About UsAt Prudential Hong Kong Limited, we strive to create a workplace that values diversity and promotes inclusivity. Our goal is to empower our employees to excel in their roles and contribute to the success of our organization.Our company culture is built on the principles of collaboration, innovation, and customer-centricity. We believe in fostering a...


  • Kuala Lumpur, Kuala Lumpur, Malaysia Businesslist Full time

    Job Summary:We are seeking a highly skilled Claims Management Specialist to join our team at Businesslist. As an Insurance and Travel Claims Specialist, you will be responsible for receiving, validating, and managing new claims.Key Responsibilities:Manage new claims from receipt to resolutionReview and approve claims within authority limitsConduct...


  • Kuala Lumpur, Kuala Lumpur, Malaysia Prudential Hong Kong Limited Full time

    As a Claims Investigation Manager at Prudential Hong Kong Limited, you will play a vital role in supporting the company's goals by conducting efficient and effective claims investigations.Your key responsibilities will include:Conducting and driving claims investigation of suspicious, early, and fraudulent claims;Carrying out claims due diligence and...


  • Kuala Lumpur, Kuala Lumpur, Malaysia Zurich 56 Company Ltd Full time

    Job OverviewZurich 56 Company Ltd is seeking an experienced Senior Claims Specialist to join its team. As a key member of the claims department, you will be responsible for handling single and multi-party personal or commercial line claims of moderate to high exposure and complexity.Key ResponsibilitiesDocument Claims File:Accurately capturing and updating...


  • Kuala Lumpur, Kuala Lumpur, Malaysia Malaysian Reinsurance Berhad Full time

    Job OverviewMalaysian Reinsurance Berhad is seeking a Claims Management Specialist to join our team. As a key member of our claims department, you will be responsible for managing the claims process, ensuring timely and accurate resolution of claims, and maintaining high levels of customer satisfaction.Key ResponsibilitiesManage the claims process from...


  • Kuala Lumpur, Kuala Lumpur, Malaysia Allianz Popular SL. Full time

    Key Performance IndicatorsResponsibilitiesThe ideal candidate will handle claims to completion within designated Settlement Authority and Company Guidelines, ensuring timely actions and regular case reviews. They will conduct thorough investigations to assess claim validity and extent, appoint independent surveyors and investigators, communicate with...


  • Kuala Lumpur, Kuala Lumpur, Malaysia Prudential Assurance Malaysia Berhad Full time

    This role at Prudential Assurance Malaysia Berhad offers the opportunity to work in a fast-paced environment that values diversity and promotes inclusivity.Key Tasks and ResponsibilitiesMain Job Responsibilities:Follow claim handling procedures for hospitalization claims.Determine and justify claims based on policy terms and conditions.Authorize claims...