The primary purpose of this role is to produce a high quality work product on technical complex Fine Arts & Specie and marine claims through immediate contact and the effective investigation, reserving and adjustment of claims incurred by insureds or third parties.
Major duties/responsibilities are detailed in the individual's annual goals. The goals may include items such as:
Coach and mentor Claims Examiners in your technical field.
Analyse first report to determine nature of loss, coverage provided and scope of injury/damage.
Conduct investigations of all aspects of reported claims including potential fraud. Secure and/or file all supporting documentation and verify same for accuracy, relationship and completeness.
Establish accurate and timely reserves.
Seek technical assistance in handling claims exceeding delegated authority.
Maintain an active diary. Monitor same to achieve timely development of the file and timely disposition of the claim.
Promptly and properly document all developments claims documentation system
Exercise good judgement in reaching final disposition of claim by evaluating nature of loss, damage, coverage provided and applicable limits.
Effectively negotiate compromise settlements where appropriate.
Effectively communicate with the following: Claim Department, Customer Services, Risk Control, Underwriting Departments, brokers, insureds, counsel, third parties and/or their legal representatives.
Recognise subrogation where applicable & forward the claim to the subrogation team.
Adhere to Insurance Contracts Act and all other relevant statutory rules and regulations.
Effectively control the use, work product and expense of outside vendors.
Any other duties as required by the Claims Manager
Accountable for taking all practical measures to insure that the workplace is safe and without risk to health.
Experience & Skills Required:
Tertiary qualified, law degree preferred.
Written and verbal communication related to claims handling.
Familiar with the Marine Insurance Act & the Insurance Contracts Act.
Damage and/or loss evaluation.
Good negotiation skills.
Able to demonstrate effective case management.
Able to professionally & effectively communicate with brokers and clients