Executive, Customer Promise

2 weeks ago

Kuala Lumpur, Malaysia Prudential plc Full time

Prudential’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 inclusion assured, for our people, customers, and partners. We provide a platform for our people to do their best work and make an impact to the business, and 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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