Internal Loss Adjuster - GI Claims at Old Mutual Kenya

KEY RESPONSIBILITIES

 Claims Assessment and Adjustment

• Timely assess the extent of loss into claims to determine extent of liability
• Prepare detailed loss adjustment reports, including the calculation of indemnities and decision on your claim
• Recommend process improvements to enhance efficiency and effectiveness in claims management.
• Negotiate settlements to achieve fair outcomes for both the insured and the company.
• Advise the risk recommendations to be taken on policies if needed
• Review policy terms and conditions to ensure claims fall within coverage.
• Coordinate with clients, witnesses, service providers, and other stakeholders to collect evidence and support documentation.
• Review and provide quality assurance for external loss adjustment reports
• Review and recommend reserves especially for large losses
• Follow up large losses with external loss adjusters
• Visit scene of incidents for large losses
• Provide expert advice on technical and financial aspects of claims.
• Identify potential fraudulent claims and escalate for further review.
• Implement measures to minimize risk exposure and reduce claims leakage.
• Maintain professional communication with clients, brokers, and third-party service providers.
• Maintain accurate and up-to-date records of claims assessments and settlements.
• Contribute to audits and reviews by providing relevant documentation and insights.
• Participate in training and development programs to enhance technical skills and knowledge.

Quality Assurance

• Review the quality the Loss adjustment report from the external loss adjusters
• Conduct performance review from the external adjusters.
• Prepare monthly report on the status of all claims under adjustment.

SKILLS AND COMPETENCIES

• Computer literate
• Team oriented.
• Strong analytical and investigative skills
• Excellent negotiation and communication skills
• High attention to detail and ability to multitask
• Confidentiality on sensitive information
• Detail-oriented with a focus on accuracy.
• Excellent communication and interpersonal abilities.
• Stakeholders’ management Commitment.
• Ability to work independently and collaboratively in a team-oriented environment.
• Integrity, professionalism, and strong ethical standards.

KNOWLEDGE & EXPERIENCE

• Insurance technical Knowledge
• Professional certification in Loss Adjusting, Insurance or  Claims Management (IIK,CILA)
• Bachelor’s degree in a business-related field
• At least 3 years of experience in claims handling or loss adjustment.

QUALIFICATIONS

• Business related Bachelor’s degree
• Insurance professional qualification (IIK or CII)
• Professional certification in Insurance Loss Adjusting (CILA)
• Proficiency in data analysis tools and software (e.g., Excel, Power BI).