01Overview
Function Purpose
To manage and administer reinsurance claims efficiently by ensuring timely notification, assessment, processing, recovery, and settlement of claims while maintaining compliance with contractual, regulatory, and service standards.
Role Purpose
The Claims Handling professional is responsible for end-to-end management of claims, acting as the key liaison between insurers, reinsurers, brokers and management. The role ensures prompt resolution of claims, minimizes financial exposure, and delivers superior stakeholder service.
Key Expectations of the Role
- Handle the complete lifecycle of reinsurance claims from notification to closure.
- Review claim documentation and verify coverage, policy terms, and treaty conditions.
- Coordinate with insurers, reinsurers & brokers for claim processing.
- Monitor claim reserves, recoveries, and settlement timelines.
- Follow up on outstanding claims, recoveries, and documentation requirements.
- Prepare claim bordereaux, management reports, and claim status updates.
- Analyze claim trends and provide insights on loss experience and portfolio performance.
- Ensure compliance with policy wordings, treaty agreements, regulatory requirements, and internal processes.
- Support audits, reconciliations, and regulatory reporting related to claims.
- Maintain accurate claim records and documentation in claims management systems.
- Build and maintain solid relationships with c insurers, and reinsurers to ensure effective claims service.
Competencies Required for the Role
- Experience & Expertise in handling Group Personel Accident claims
- Strong knowledge of reinsurance claims processes.
- Understanding of policy wordings, treaty structures, and coverage interpretation.
- Analytical and problem-solving skills.
- Strong negotiation and stakeholder management abilities.
- Excellent communication and relationship management skills.
- Attention to detail and documentation accuracy.
- Ability to manage multiple claims and meet deadlines.
- Knowledge of claims accounting, recoveries, and reserve management.
- Proficiency in Microsoft Excel, Power Point, and claims management systems.
- Understanding of regulatory and compliance requirements within the insurance industry.
Personal Qualifications
Educational Background:
- Graduate in Insurance, Commerce, Finance, Business Administration, or a related field.
- Professional qualifications such as III, AIII, FIII, CII, or equivalent insurance certifications preferred.
Experience:
- 8-10 years of experience in reinsurance claims handling preferable in GPA claims.
- Hands-on experience managing Group personal accident, property, engineering, marine, casualty, or specialty claims.
- Experience in coordinating with insurers, reinsurers and broker for claim settlement and recovery processes.
- Exposure to large and complex claims would be an added advantage.
Confidentiality and Ethics:
- Upholds high standards of confidentiality, ethics, and integrity in handling sensitive information and interactions.
Technology Proficiency:
- Proficient in using office productivity software (Microsoft Office, Google Workspace) and calendar management tools .
