Senior Executive - Unstructured Claims

Senior Executive – Unstructured Claims

Union Assurance is a leading corporate and one of the fastest growing entities in the Life Insurance industry backed by the strength and stability of John Keells Holdings PLC, one of Sri Lanka's largest conglomerates.

The Job Role:

The person will be assisting in prompt, effective, and fair settlement of all valid unstructured claims as per the limits established in the delegation of authority, providing a speedy and efficient service in settling claims and proper follow up on all pending claims at Union Assurance.

Principle Accountabilities:

• Managing all administration aspects of the claim including collecting accurate information and documents to proceed with a claim to enable achievement of business goals
• Processing all the unstructured claims including critical illness, disability, death etc. within the given delegation (financial) authority limits and ensure that the policy conditions are met
• Processing claims that route out of automatic adjudication, within current turnaround standard
• Ensuring accurate processing and completion of unstructured claims
• Monitor and track the progress of a claim
• Maintain key records like working files, email for reference and audit purpose
• Comprehend and respond to customer inquiries and resolve issues as per guidelines and stipulated SLAs
• Periodically liaise with sales team to understand business requirement and deliver accordingly
• Provide exceptional customer service to all stakeholders
• Investigate potentially fraudulent claims and highlight it to leadership
• Adhere to legal requirements, industry regulations and customer.
• Contribute to and drive continuous process improvement.

Qualifications and Experience

• Minimum 03-05 years’ experience in Life Insurance industry.
• CIP - SLII or Part / Full Qualification in Dip -CII / AIII is essential
• Experience in a Life Policyholder Servicing Department will be an added advantage.
• Good understanding and knowledge about competitor products and practices, trends & developments in the life insurance market in Sri Lanka
• Fair understanding on regulatory framework of Insurance industry
• Very Good knowledge on life underwriting (medical & financial), diseases, medical procedures and their impact to longevity and disability, medical tests and their interpretations.
• Fair knowledge on reinsurance arrangements. 
• Broad knowledge in Microsoft office applications
• Ability to work under minimum supervision, multi-task and work under pressure
• A self-motivated individual as well as a team player