- Prepare appropriate coverage letters to be submitted to and approved by claims management
- Complete a highly detailed investigation on each claim in a timely manner and fully document the file with pertinent information
- Uncovered fraudulent claims scheme; provided evidence leading to the recovery of thousands of dollars in insurance overpayments.
- Effectively manage multiple, high-priority projects and take pride in providing exemplary customer service.
- Maintain good faith in investigation process to resolve claims for the insurer.
- Maintain pdpa at all times (personal data protection act).
- Notify insurer on the type of claim being submitted against their insurance (own damage & third party).
- Keeping records in excel sheets for tracking purposes.
- Investigate and process insurance claims filed by policyholders
- Handle letter of demands from workshop and law firm.
- Claims finalization, provide proper information to workshop.
- Accurately and timely review injury settlement demands
- Provide excellent customer service to policyholders while explaining the litigation process
- Assist defense counsel throughout litigation while continuing to maintain open negotiations with plaintiff counsel
- Issue pay-out amounts.
sr. claims examiner
- Manage a portfolio of claims for Accident & Health and /or Combined Insurance claims as allocated and assist processing other Retail claims as required.
- Assess claims in accordance with Chubb’s service level and quality requirements and the General Insurance Code of Practice. This includes determining coverage, reserving within timeframes, making payments, responding to customer queries, providing updates, and requesting additional information as needed to manage a claim.
- Communication by telephone and written correspondence to brokers, claimants and others as required.
- Take part in Claim Department and company-wide training as required.
- Respond to enquiries and escalations of matters from underwriters, brokers and customers, and work with underwriters, the Compliance Department and other departments of the company as needed.
- Proactively apply claims policies and procedures including Chubb’s policy in relation fraud, salvage, cost containment and complaints.
- Where applicable, review income replacement claims for payment of periodic benefits at lodgement stage and at key points in the claim cycle and develop strategies for claim management and successful return to work of the claimant where possible.
- Allocation of funds/Receipt Reconciliation.
- Liaising with the clients for outstanding invoices.
- Debt Analysis, for quick collection of funds from clients
- Processing of client accounts according to treaty agreement
- Generating statement of account and sending it to clients for agreement,
- Reinsurance accounting including Financial settlement with clients according to treaty terms and agreements
- Credit Control Activity prior to payments to clients, Additional ad hoc requirements