The Claims Assistant reports to the Claims Officer and Assistant Manager, Non-Motor Claims and is responsible for end-to-end processing of designated Personal Accident (PA) Claims and other related tasks as assigned. This includes validating documents, evaluating Claims, coordinating with the assureds and/or intermediaries, and ensuring timely and accurate claim resolution in compliance with the company standards.
Key Results Areas/Duties And Responsibilities
I. Claims Processing
- Validate and check correctness of documents received from claimants or intermediaries.
- Encode reported PA claims in Genweb and set up loss reserves.
- Evaluate claims and make recommendations on compensability.
- Assign claims to independent adjusters when necessary.
- Compute probable liability and prepare in-house reports.
II. Compliance, Documentation, and Investigation
- Maintain accurate records of all PA claims and organize / upload relevant documents in the system.
- Ensure adherence to policy coverages and regulatory requirements.
- Develop investigation plans and gather necessary documents and information.
- Prepare reports and updates for management as needed.
- Keep updated with insurance product knowledge.
III. Customer Service and Coordination
- Communicate effectively with adjusters, claimants / insured parties, intermediaries and others to determine liability and coverage.
- Attend to inquiries related to assigned accounts and provide accurate information.
- Provide assistance and clarification on claim-related inquiries.
- Perform other tasks related to Non-Motor Lines or as required by the immediate superior from time to time.
