JOB DETAILS:

Purpose          :           Responsible for overseeing the end-to-end claims process from claim notification to final settlement: ensuring timely, fair, and accurate claims handling in accordance with company policies, regulatory requirements, and service standards.

The role requires strong technical expertise, analytical ability, and leadership in managing

claims operations and supporting departmental strategy.

Key Result Areas:

1. Receive, assess, and verify claim notifications to confirm validity of cover in line with company policies.
2. Register claims, obtain and review supporting documentation, and ensure completeness of claim files.
3. Recommend and liaise with assessors and service providers, review reports, and advise on claim outcomes ensuring alignment with policy terms and conditions.

1. Prepare claim adjustments and recommendations for approval by the Claims Committee in line with internal policies.
2. Communicate claim decisions and provide clear justifications to clients and intermediaries professionally and transparently.
3. Prepare discharge vouchers, payment requisitions, and follow up on approved payments in line with company procedures.
4. Monitor recoveries, salvage disposal, and third-party claims management.
5. Advise on underwriting of bonds in line with guidelines and best practices.
6. Prepare periodic loss advices for reinsurance and submit periodic claims reports for management review.
7. Provide technical advice on claims trends, risks, and policy improvements.

1. Ensure compliance with all claims management policies, regulatory requirements, and internal control measures.

1. Perform any other professional duties that may be assigned from time to time.

Key Performance Indicators (KPIs)

• Timely processing and settlement of claims within agreed turnaround times.
• Accuracy and completeness of claims documentation.
• Quality of claims assessments and adherence to policy terms.
• Reduction in claim leakages and fraudulent claims.
• Compliance with internal audit and regulatory standards.

Job Qualifications and Experience:

• Bachelor’s degree in Actuarial Science, Business Administration, Risk Management, or a related field.
• A professional qualification in Insurance is an added advantage
• At least four (4) years of relevant experience in claims management in a reputable insurance company.

Job skills and abilities:

• Strong knowledge of insurance principles, policy wordings, and claims management processes.
• Excellent analytical, negotiation, and decision-making skills.
• Proficiency in insurance software systems and MS Office applications.
• High integrity, professionalism, and attention to detail.
• Excellent communication and interpersonal skills.
• Sound understanding of regulatory requirements and reinsurance practices.
• Must be able to work under pressure and meet deadlines, while maintaining a positive attitude and providing exemplary customer service
• Ability to work independently and to carry out assignments to completion within parameters of instructions given, prescribed routines, and standard accepted practices