AddressMedical Indemnity Claims Specialist Over View : Global Tier 1 is an underwriting agency operating in the niche healthcare sector, covering indemnity insurance for medical practitioners, healthcare practices, day surgeries and allied health. Primary purpose of the position To support the team and clients through the management of their claims, providing expert advice every step of the way. The role is also responsible for assisting in the accurate maintenance, entry, and reporting of claims data, file management, and document production. Key accountabilities This role is required to:
Manage and Oversee Claims: Perform all claims management services on behalf of Underwriters in respect of claims under specified insurance policies. This includes reviewing and investigating all claims, establishing reserves for indemnity and expenses, and adjusting these reserves periodically. Manage the daily handling of claims by attending to incoming claims, existing claims, insured claim queries and managing them internally to ensure a streamlined and efficient process. Appoint and Coordinate with External Parties: Appoint adjusters, appraisers, engineers, assessors, or other necessary parties to evaluate claims. Also, appoint solicitors for insureds, where appropriate, in consultation with Underwriters
File and Documentation Management: Establish and maintain appropriately documented claim files for all claims and incidents. Ensure accurate, timely, and comprehensive documentation throughout the claims process.
Coverage Issues:Directly submit issues of coverage, including proposed denials or reservations of rights, to Underwriters for instructions as required, including appointing coverage counsel.
Reporting and Bordereaux: Provide monthly bordereaux in an agreed format listing all outstanding claims, paid claims, and expenses, or note any no-claims activity. Deliver precise and accurate reporting of claims data. Ensure meticulous file management and the production of exact documents, facilitating clarity and transparency in claims handling.
Administrative: Perform all necessary administrative tasks related to claims management. This includes ensuring prompt notification of complaints to Underwriters and compliance with laws and regulations regarding claims settling practices and complaints handling.
Legal and Regulatory Compliance: Stay informed and comply with all current laws and regulations governing the conduct of claims. This includes regulations and requirements pertaining to Lloyds, claims settling practices, financial crimes, and sanctions.
Underwriters' Relationship and Coordination: Work closely with Underwriters to ensure that their regulatory obligations are met and that claims or complaints are handled effectively and timely. Actively contribute to the success of the company by enhancing relationships between underwriters and clients, fostering trust and long-term partnerships.
Subrogation and Recovery Efforts: Pursue possibilities of subrogation, contribution, indemnity, recovery, and salvage on behalf of Underwriters, consulting with Underwriters when the cost of pursuit may outweigh potential recovery.
Service Standards and Quality Assurance: Comply with service standards or conditions set by Underwriters, ensuring proper, effective, and timely handling of claims or complaints.
Support the Team and Clients: Provide critical support to the internal team and clients, including brokers, through effective claims management. Ensure high standards of service and communication are maintained at all times. Required Skills and Experience Extensive experience in claims management within an insurance or underwriting environment. Strong understanding of the Australian insurance regulatory landscape, including knowledge of relevant laws and regulations. Proven ability to manage complex claims and coordinate with various stakeholders Excellent communication, negotiation, and interpersonal skills. High level of organisational and documentation skills. Understanding of Lloyds’ insurance market. If you are interested in progressing your career with this role please submit your application through the link below. Alternatively if you would like to discuss this role in confidence in more detail then please contact: *********@andersenpartnership.com
