SENIOUR CLAIMS ADJUSTER | 30189

Emerald Group; Greater London, Birmingham, Worthing; Hybrid; GBP 65,000 - 95,000; Full time

Job summary

Emerald Group in London/Birmingham/Worthing is seeking a Senior Claims Specialist to manage life and non-life (re)insurances liabilities. You will handle high value, complex claims with autonomy, determine coverage, and reserve within SLAs. You will mentor peers while keeping abreast of industry developments.

Required GCSEs in Maths and English, and ideally CII/CILA or a degree. Experience with mesothelioma and reserves over £250k is highly valued.

Qualifications

• GCSE Maths and English Grade C or above or equivalent.
• CII/CILA or bachelor’s degree preferred.
• Experience handling mesothelioma and other high value disease claims with reserves over £250k.
• Strong analytical skills and autonomous work style.

Responsibilities

• Handle a substantial volume of high value and highly complex claims with minimum guidance.
• Analyze coverage to verify policy obligations and determine loss eligibility.
• Establish reserves within SLAs and review throughout the claims cycle.
• Negotiate settlements within authority or via referrals for higher value claims.
• Mentor junior claims professionals and share technical knowledge.

Skills

High value claims

Complex claims handling

Negotiation

Analytical skills

Autonomous working

Self-motivation

Education

GCSE Maths & English C or above

CII/CILA or bachelor’s degree preferred

Job description

You will acquire life and non-life (re)insurance liabilities and provide risk transfer solutions, for businesses seeking to improve their Return on Equity, capital position, and profitability profile You will have an ability to full caseload of technically complex high value claims; comfortable with making and supporting own decisions; with a moderate level of guidance and direction.

• Location: London/Birmingham/Worthing - Hybrid
• Category: Claims
• Type: Permanent

Key responsibilities including however, not limited to the following:

• Able to handle substantial volume of high value and highly complex claims; comfortable with making and supporting own decisions; with a minimal level of guidance and direction
• Use judgment to determine policy verification and coverage determination by analysing applicable coverage for claims and determining whether the loss falls within the coverage
• Establish timely reserves outlined in SLAs and perform ongoing review throughout claims cycle within authority limit by estimating and validating value of claims
• Negotiate settlement of claim by establishing appropriate negotiation strategy and utilizing available tools and resources within your own authority limits, or within the referral structure for claims above your authority
• Serve as a technical resource by mentoring lower-level claims professionals and sharing technical knowledge related to specific Line of Business expertise
• Maintain professional and technical knowledge by participating in educational opportunities, staying current with industry trends, establishing personal networks and participating in professional societies
• Prime emphasis will be on ensuring all valid policy obligations are appropriately met, Customers are treated Fairly and requirements under applicable Conduct obligations are discharged
• Required – GCSE Maths and English Grade C or above or equivalent
• Preferred but not essential – CII/CILA/bachelor’s degree (or equivalent), some mentoring experience
• Required – Experience of handling mesothelioma and other high value disease claims with reserves over £250k
• Strong analytical skills
• Ability to settle claims within agreed guidelines and to think outside the box
• Self-motivated with the ability to work autonomously
• Takes responsibility for managing own development