Directline Assurance Company Limited – Deputy Claims Manager (TPPD / OD).

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We are looking for a motivated and qualified professional to fill the position of Deputy Claims Manager (TPPD / OD).

Overall Purpose of the Job: The role holder will ensure superior customer experience at all levels of interrelations through identification, evaluation of key records & facts, advise on claim resolution strategy, client defense strategy, program analysis and evaluation of quantum.

Key Roles and Responsibilities

Management and Co-ordination

  • Assist the Claims Manager in supervision and management of the Claims Department
  • Supervise the assigned staff within the Claims Department and ensuring that the highest quality of service is rendered to the company and the staff comply with the company policies and guidelines
  • Be the link between the claims department and other departments
  • Participate in the recruitment and training of quality members of staff in the Claims department

Claim and Incident Management

  • Thorough and detailed analysis of claim documents to enable early fraud detection and ensure that the fraudulent claims are effectively addressed within the company’s policies and guidelines.
  • Maintain a proper and accurate reserves on claims and incidents and ensure that all Journal vouchers are forwarded to the Accounts department within 24 hours of approving them.
  • Maintain a proper update of the system data and documentation of the claims and incidents and ensure that the files submitted by the Claims officers are approved within 24 hours of posting.
  • Ensure that negotiation and settlement of claims is completed within 30 days from the date of approval and that such settlement is within the least amounts possible
  • Ensure that correspondences from the insured, intermediaries, claimants and their advocates are responded to within 72 hours from the date they are received.
  • Ensure that proper factual and legal research required for achievement of the strategy on the claims is conducted
  • Engaging with third party service providers where necessary to build evidence on liability, medical injury disputes etc
  • Where execution of court judgements has commenced, to firstly have our advocates immediately instructed to file the appropriate pleadings and secondly, deal with the auctioneers to protect the insured’s interests as well as the business interests of the Company. This has to be done within 24 hours of receipt of the court warrants and insured updated on the measures taken and copies of the warrants availed to the Managing Director and
  • General Manager Claims for information and follow up.
  • Ensure that recoveries from the insured and third parties is achieved
  • Prepare and review the relevant claim guidelines and template documents to conform to the policy and best practices.
  • Liaise with the Company’s re-insurers and provide the requisite documentation to facilitate timely recovery of the recoveries due
  • Handle customer complaints from the insured or intermediaries and instil confidence in the company’s claim process

Reports

  • Preparing reports to the Claims and Risk Committees on the legal implications of adopting proposed policies and strategies on the management of claims
  • Preparation of monthly performance reports of the departmental staff
  • Preparation of monthly Claim Reports for internal and external use
  • Preparing relevant claim and incident reports for presentation to the relevant Board Committees.
  • Preparing necessary returns on the Claims portfolio to the Industry Regulators Leadership.

General Duties

  • Review of the Claims IT system and workflow and making recommendations on modification
  • Conducting legal and other forms of relevant training
  • Providing advice on the legal effects of proposed changes on policy documents and preparing responses to consulting documents
  • Review and approve Company contracts and agreements and identifying opportunities for efficiencies and improvements.
  • Monitoring changes in relevant legislation and the regulatory environment, and advising the company on the impact of such changes
  • Attending court to represent the Company as a witness or any other capacity as may be approved by the Company
  • Participate and offer valuable advice to the Company and Departmental Committees which you are nominated or elected to
  • Represent the Company in meetings with Industry Stakeholders and proving the Company with the requisite reports from such meetings
  • Signing the relevant and authorized documents on behalf of the Company
  • Maintain highest level confidentiality concerning the sensitive, strategic and integral legal and other information, data, decisions and developments taking place at the company.
  • Any other duties that maybe assigned from time to time.

Person Specifications

Academic Qualifications

  • University degree from an institution recognized by Commission for Higher Education
  • Minimum Overall Grade of C+ in KCSE

Professional Qualifications

  • Certificate of Insurance (COP)
  • AIIK Diploma/CII Diploma or any insurance related qualification will be an added advantage

Experience

  • At least 3 years’ experience in Claims management preferably within an Insurance Company OR Intermediary.
  • Experience in dealing with PSV will be an added advantage.

Skills and Attributes

  • High level of integrity; Able to maintain utmost confidentiality of information in their possession
  • Excellent communication and presentation skills
  • Excellent interpersonal and negotiation skills
  • Excellent Client relationship skills
  • Have great attention to detail

Application Instructions

If you qualify for the above advertised role, kindly send us a detailed CV and Application Letter clearly demonstrating your fit as per the roles & responsibilities and the person specifications (academic/professional qualifications, experience, skills & attributes) listed above.

Applications that do not conform to the Application Instructions will not be considered.

Kindly send your application documents to human.resource@directline.co.ke to reach us on or before 5.00pm Friday, 21st February 2020.

We are looking for a motivated and qualified professional to fill the position of Deputy Claims Manager (TPPD / OD).

Overall Purpose of the Job: The role holder will ensure superior customer experience at all levels of interrelations through identification, evaluation of key records & facts, advise on claim resolution strategy, client defense strategy, program analysis and evaluation of quantum.

Key Roles and Responsibilities

Management and Co-ordination

  • Assist the Claims Manager in supervision and management of the Claims Department
  • Supervise the assigned staff within the Claims Department and ensuring that the highest quality of service is rendered to the company and the staff comply with the company policies and guidelines
  • Be the link between the claims department and other departments
  • Participate in the recruitment and training of quality members of staff in the Claims department

Claim and Incident Management

  • Thorough and detailed analysis of claim documents to enable early fraud detection and ensure that the fraudulent claims are effectively addressed within the company’s policies and guidelines.
  • Maintain a proper and accurate reserves on claims and incidents and ensure that all Journal vouchers are forwarded to the Accounts department within 24 hours of approving them.
  • Maintain a proper update of the system data and documentation of the claims and incidents and ensure that the files submitted by the Claims officers are approved within 24 hours of posting.
  • Ensure that negotiation and settlement of claims is completed within 30 days from the date of approval and that such settlement is within the least amounts possible
  • Ensure that correspondences from the insured, intermediaries, claimants and their advocates are responded to within 72 hours from the date they are received.
  • Ensure that proper factual and legal research required for achievement of the strategy on the claims is conducted
  • Engaging with third party service providers where necessary to build evidence on liability, medical injury disputes etc
  • Where execution of court judgements has commenced, to firstly have our advocates immediately instructed to file the appropriate pleadings and secondly, deal with the auctioneers to protect the insured’s interests as well as the business interests of the Company. This has to be done within 24 hours of receipt of the court warrants and insured updated on the measures taken and copies of the warrants availed to the Managing Director and
  • General Manager Claims for information and follow up.
  • Ensure that recoveries from the insured and third parties is achieved
  • Prepare and review the relevant claim guidelines and template documents to conform to the policy and best practices.
  • Liaise with the Company’s re-insurers and provide the requisite documentation to facilitate timely recovery of the recoveries due
  • Handle customer complaints from the insured or intermediaries and instil confidence in the company’s claim process

Reports

  • Preparing reports to the Claims and Risk Committees on the legal implications of adopting proposed policies and strategies on the management of claims
  • Preparation of monthly performance reports of the departmental staff
  • Preparation of monthly Claim Reports for internal and external use
  • Preparing relevant claim and incident reports for presentation to the relevant Board Committees.
  • Preparing necessary returns on the Claims portfolio to the Industry Regulators Leadership.

General Duties

  • Review of the Claims IT system and workflow and making recommendations on modification
  • Conducting legal and other forms of relevant training
  • Providing advice on the legal effects of proposed changes on policy documents and preparing responses to consulting documents
  • Review and approve Company contracts and agreements and identifying opportunities for efficiencies and improvements.
  • Monitoring changes in relevant legislation and the regulatory environment, and advising the company on the impact of such changes
  • Attending court to represent the Company as a witness or any other capacity as may be approved by the Company
  • Participate and offer valuable advice to the Company and Departmental Committees which you are nominated or elected to
  • Represent the Company in meetings with Industry Stakeholders and proving the Company with the requisite reports from such meetings
  • Signing the relevant and authorized documents on behalf of the Company
  • Maintain highest level confidentiality concerning the sensitive, strategic and integral legal and other information, data, decisions and developments taking place at the company.
  • Any other duties that maybe assigned from time to time.

Person Specifications

Academic Qualifications

  • University degree from an institution recognized by Commission for Higher Education
  • Minimum Overall Grade of C+ in KCSE

Professional Qualifications

  • Certificate of Insurance (COP)
  • AIIK Diploma/CII Diploma or any insurance related qualification will be an added advantage

Experience

  • At least 3 years’ experience in Claims management preferably within an Insurance Company OR Intermediary.
  • Experience in dealing with PSV will be an added advantage.

Skills and Attributes

  • High level of integrity; Able to maintain utmost confidentiality of information in their possession
  • Excellent communication and presentation skills
  • Excellent interpersonal and negotiation skills
  • Excellent Client relationship skills
  • Have great attention to detail

Application Instructions

If you qualify for the above advertised role, kindly send us a detailed CV and Application Letter clearly demonstrating your fit as per the roles & responsibilities and the person specifications (academic/professional qualifications, experience, skills & attributes) listed above.

Applications that do not conform to the Application Instructions will not be considered.

Kindly send your application documents to human.resource@directline.co.ke to reach us on or before 5.00pm Friday, 21st February 2020.

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