Senior Claims Adjuster – Casualty Healthcare
Job Summary
Duties and Responsibilities:
- Management a portfolio of Lloyds and Company Casualty and Healthcare claims to include setting up new claims if necessary.
- Manage and handle claims that fall outside any Delegated Authority.
- Take ownership of policy declinatures and avoidances not to be left with the TPAs
- Reserve in accordance with our claims philosophy
- Negotiate and settle claims within specified authority and recommend reserves beyond authority to appropriate management as necessary
- Review and maintain your caseload (i.e. reviewing incoming claim correspondence formulating responses maintaining an up-to-date diary) in accordance with current internal claims procedures an comply with key performance indicators.
- Adhere to internal procedures (i.e. declinatures large losses complaints fraud etc.)
- Assist with coordination of and carrying out of TPA audits if necessary.
- Carry out aged file/static claims reviews as required
- Proactively manage vendors such as loss adjusters TPAs defence counsel and monitoring counsel
- Demonstrate ability to drive good claims outcomes (i.e. representing AW interests at market meetings mediations JSMs and any other client meetings)
- Develop good relationships internally with all departments you come in contact with
- Develop an understanding of what senior management want and appropriate messaging
- Work with Underwriters to provide updates evaluate exposures attend client meetings where required and assist with development of policy wordings and other contractual documents where required
- Assist with the mentoring of more junior members of the Team
- Assist with Lloyds and Company reporting requirements.
- Assist with special projects as required.
Person Specification;
- University degree preferred.
- Insurance related courses or certificates are an advantage.
- Good working knowledge of the Lloyds claims system ECF2.
- Good working knowledge of the Claims Portal.
- Good understanding of Casualty and Medical Malpractice policy wordings.
- Experience of managing bordereau and monitoring files on binder business.
- Experience of handling multi-jurisdictional claims in particular Canada Ireland Australia and Italy.
- Experience of managing TPAs.
- Knowledge of UK Corporate market would be beneficial.
- Working knowledge of the Microsoft Office Suite.
- Strong business writing skills.
- The ability to work well in a team environment.
- Excellent organisational skills and the ability to work on multiple tasks concurrently
Required Experience:
Senior IC
Key Skills
About Company
Allied World Assurance Company Holdings assures its clients that everything is well insured. In the US its insurance products include general property/casualty coverage as well as specialty products such as environmental, health care, and professional liability coverage targeted to sm ... View more