Claims Examiner, Personal Accident
Kuala Lumpur, MALAYSIA
Job description
Job Summary
To perform the following activities in processing specialty claims:
- Claims Processing & Assessment
- Claims Settlement
- Claims Recovery
- Claims Services
- Functional business analyst
Key Responsibilities
- Obtain necessary claims documents from insured, solicitors, underwriters, agents, brokers, etc.
- Appoint independent adjusters for investigations, solicitors for summon cases & medical specialists.
- Confirm coverage and assess claims based on documents / reports that support claims, i.e. medical, police
- report, adjuster report etc.
- Offer settlement to insured.
- Handle complaints from local authorities, insured & agents.
- Conduct negotiation & attend court when necessary for selected contested cases.
- Prepare repudiation letter for cases where the Policy Liability is not apparent.
- Take action to recover claims by way of subrogation.
- Attend to claims query from customer, agents, brokers, branches and claims hub.
- Provide claims input in product development
- Identifying processes which can be automated and perform enhancement in Merimen /OPUS.
Requirements
- Able to work independently and as a team player.
- Good communication and writting skills.
- Ability to leverage AI tools like ChatGPT to simplify tasks at work
- Willing to learn and interested in handling and process in Claims.