Executive, Customer Promise

2 weeks ago

Kuala Lumpur, Malaysia Prudential plc Full time

Prudential's purpose is to help people get the most out of life. We will deliver our purpose by creating a culture in which diversity is celebrated and inclusion assured, for our colleagues, customers, and partners. We provide a platform for our people to do their best work and make an impact to the business, and in exchange, we support our people's career ambitions. We pledge to make Prudential a place where you can Connect, Grow and Succeed.
- Claims Examination
- Claims Recommendation
- Claims Approval within authority limit
- Adhering to our claims workflow in relation to major, accident and hospitalization claims procedure
- Assess and provide justifiable claims according to policy terms and conditions to our valued policy holders
- Approving claims within the department benchmark/turnaround time and authority limit
- Recommend for claim approval/repudiation
- To ensure claims appeal from any parties are attended and respond within the benchmark set by the department
- To ensure and monitor claims processing benchmark and turnaround time
- To closely follow up on out-standing cases
- To correspondences on and day to day operation functions of the department and coordinates with other departments
- To handle queries from other insurance companies via ICVS and ensure the respond within the benchmark set by ISM
- To prepare correspondences both internally (sales advisor and other departments) and externally (policyholders, employer, private investigator, OFS/BNM and repudiation letter.
- Updating and submission of reports as required by management within the agreed service standards
- Liaise with Prudential Malaysia’s IT division to troubleshoot issues / cases encountered in the day to day operations.
- Continuously review and update/document the administrative rules and processes for effective and efficient operation of the sections.
- Continuously attend / involve with training for personal and career development.
- To review and provide opinion from medical perspective eg medical conditions, treatments, conformity to contract definition etc
- Undertake projects / other work and duties allocated by management as and when required

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