Chief Manager - Legal and Non-Legal Claims at Kenindia Assurance Company Limited

Main Purpose of the Job - (Job Summary)

Overall responsibility for the general business claims ( legal and non legal) including supervision of claims processes and timely settlement of the claim within TAT, analyzing the claims movement with respect to individual portfolio, brokers, agents and clients. Monitoring and supervising the services of the service providers such as loss adjusters, advocates, investigators, garages and medical service providers and coming up with strategies to control the claims/claims cost in line with the overall business strategy and objectives.

Main Responsibilities

• Formulating and leading in the implementation of the general business legal and non legal claims, policies, guidelines and procedures in the process and payment of liability claims in line with business strategy and objectives.
• Ensuring the proper management of claims at both the individual and portfolio level to optimize expenditure and achieve high levels of satisfaction to all stakeholders through high quality claims management and conflict resolution.
• Ensure that appeals lodged are monitored and periodical statements submitted on funds held in joint accounts.
• Setting up of the panel of external advocates; the terms of reference; performance and evaluation criteria and continuously monitoring their performance to ensure achievement of the company objectives.
• Analyzing & authorizing for approval of claim settlement proposals by both external advocates and internal legal officers for payment by the company to ensure that all required documents and excess payable guidelines are complied with.
• Implementing plans and initiatives to increase customer satisfaction and retention through formulating, documenting and executing claims strategies.
• Advising Reinsurance and Finance departments of any material claims as set out in our business treaties, protocols and procedures and liaising with Reinsurance and Legal departments for effective recoveries.
• Collating the analyzed reports of potential or existing insureds claims experience and claim trends that have the potential of impacting on profit and loss account of the company.
• Approving and/or recommending claims for settlement/ repudiation in line with the terms and conditions of the insurance policies and financial authority, and having a thorough knowledge of industry regulations /changes for compliance and the company’s claims and underwriting control standards.
• Overseeing the management and monitoring of claims portfolio’s for optimal performance by conducting regular reviews as required by the Company’s claims controls and standards.
• Ensuring compliance with regulatory and statutory requirements and advising management on the legislative changes in the industry and making reports on areas of compliance.
• Approving, monitoring and reporting of the general business legal claims budgetary allocations.
• Developing, preparing and reviewing manuals for claims, loss adjusters and service level agreements.
• Contributing towards the business development strategy by attending Broker/ client meetings to articulate the Company’s claims’ philosophy handling and customer excellence.
• Maintaining the status reports of all outstanding files and ensure that the appropriate claims reserves are adequately maintained to safeguard the company’s financial status.
• And any other duties assigned

Job Specifications

Academic Qualifications

• Undergraduate degree in any business related field

Professional Qualifications

• Diploma in Insurance (AIIK or ACII)

Key Job Skills (specific to the job)

• Excellent researching skills
• Work Management skills
• Administrative Skills
• Excellent customer service skills
• Negotiation skills
• Analytical skills
• Time management skills
• Good communication skills
• Insurance Skills (special Category)
• Fraud detection
• Insurance policies analysis
• Claims Management
• Basic underwriting

General Skills

• Interpersonal skills
• Customer Service
• IT skills (fluency)

Our Competencies/Behaviours

• Integrity
• Reliability
• Transparency
• Professionalism
• Teamwork
• Quality

Relevant Experience

• At least 10 years of relevant experience