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Claims Assessor

Date Posted: Dec 12, 2017

Location: Brighton, BNH, GB, 0

Company: MetLife

THE ROLE:  

 

To contribute to the proactive management of claims administered by MetLife, providing reassurance to customers through service excellence and accuracy of work, whilst developing and maintaining strong relationships with internal and external customers.

  

Key Responsibilities:

  • Responsible for the timely and accurate assessment, decision making, settlement and communication of Employee Benefits and Individual Protection claims from beginning to end within agreed authority and service levels. These claims will be from our accident, life, income protection, and critical illness insurance products.
  • Providing exceptional levels of customers service to policyholders, clients and intermediaries in a professional and friendly manner.
  • Managing the claims relationship for all customers within agreed portfolio.
  • Ensuring all aspects of the claims function, including complaints are dealt with in accordance with all compliance, FCA, TCF and legal requirements.
  • Identifying and investigating potential non-disclosure claims.
  • Identifying and investigating potential fraudulent claims.
  • Liaising with the Chief Medical Officer, underwriters and external service providers to ensure all appropriate information is obtained to assist in the assessment and ongoing management of claims.
  • Maintaining a good working relationship with Reinsurers in order to maximise recovery from reinsurance contracts.
  • Participation on claims project and change work as and when required.

 

CANDIDATE QUALIFICATIONS:

 

Business Knowledge/Technical Skills:

  • Experience in handling Employee Benefits claims to include: Income Protection, Critical Illness, Accident & Health or Life.
  • Experience can be solely from a Direct Insurer or from a combination of Direct Insurer and Reinsurer.
  • Confidence in communicating claim decisions via the telephone and in writing.
  • Technical ability with claim assessment and decision making.
  • Knowledge of Medical or Scheme Underwriting would be beneficial.
  • Experience quality checking and decision approval on the work of others.

 

Leadership Competencies:

  • Creates Partnerships - Authentically builds trusted relationships and collaborates across both internal MetLife teams and external customers to successfully drive business objectives.
  • Seizes Opportunity - Seeks new opportunities and ways to create balanced business growth while improving operational capabilities.
  • Models our Values - Creates a culture that promotes the company’s values and standards through role modeling, accountability and ownership of decisions and behaviours.
  • Focuses on Customers - Promotes customer centricity and ensures focus on creating great customer experiences for all claimants, policyholders and Intermediaries.
  • Drives Results - Sets own goals and is accountable for continuously driving improved performance  whilst ensuring high standards of quality in claim assessment.