Claims Officer (Commercial / Employees' Compensation)

Zurich Insurance; Hong Kong; On-site; HKD 300,000 - 520,000; Full time

Job summary

A leading insurance firm is seeking a Claims Officer in Hong Kong to manage Employees’ Compensation claims focusing on liability and investigations. You will report to the Claims Manager and build relationships with stakeholders to ensure effective claims service. Required qualifications include a degree and over 2 years of claims management experience. Strong negotiation skills and fluency in English and Chinese are essential. This role offers a dynamic work environment where innovative thinking is valued.

Qualifications

• Degree holder, preferably in Insurance, Business Administration, or Legal.
• Over 2 years EC claims management experience.
• Strong negotiation skills in both written and verbal formats.
• Over 2 years EC claims management experience is a must.
• Experience in managing legal claims is highly preferred.
• Knowledge of the Employees’ Compensation Ordinance.
• Strong command of written and spoken English & Chinese (including Cantonese & Mandarin).
• Negotiation skill, both written and verbal.
• Candidates with less experience can be considered as Claims Assistant.

Responsibilities

• Handle EC claims with focus on liability and global settlement.
• Review and finalize claims ensuring settlement at optimum levels.
• Build relationships with stakeholders to conclude claims quickly.
• Strong ability to understand barriers for return to work and strategies to deal with return-to-work issues
• Review, resolve and proactively finalize claims within authority limits ensuring settlement at an optimum level
• Take proactive approach in monitoring employees’ compensation claims in order to minimize claims settlement
• Handle EC litigated claims by taking responsibility to resolve all enquiries from both customer and external contacts to ensure delivery of a focused claims service
• Ensure claims procedures, documentation is adhered to the group claims management requirement and best practice
• Build up relationship with all stakeholders and achieve compromised settlement to conclude the case at the earliest time and avoid litigation
• Develop a claim case strategy to ensure appropriate reserves are assigned, in which investigations are conducted and appropriate suppliers are engaged
• Provide quality customer service to clients & meet with clients for claims review meeting
• Acquire and efficiently organize the relevant evidence and information to accurately assess the value of the litigated claim and to recognize potential fraud/recovery indicators
• Identify all potential recovery and fraud cases
• Assist Claims Manager to monitor and conduct assessment of the performance of external loss adjuster whose services form part of claims services
• Set and monitor reserve adequately and timely and ensure the authoritative level laid down are complied with
• Report to claims management team on adverse trend of development of claims
• Report to claims management team for clients with adverse claims experience
• Perform any other duties, task-oriented or claims related as may be delegated by Claims Manager

Skills

Negotiation skills

Knowledge of Employees' Compensation Ordinance

Understanding legislation and legal liability

Knowledge of claims agreements

Fluent in English and Chinese (Cantonese & Mandarin)

Education

Degree holder

Tertiary education in Insurance, Business Administration or Legal

ANZIIF/ACII would be an asset

Job description

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Claims Officer (Commercial / Employees' Compensation))

130653

Job Summary

• Handle Employees’ Compensation (EC) claims with focus on liability, investigation and global settlement
• Drive outcomes on liability, return to work and injury management
• Provide quality and professional claims service to customers
• Strong ability to understand barriers for return to work and strategies to deal with return-to-work issues

Job Accountabilities

• Review, resolve and proactively finalize claims within authority limits ensuring settlement at an optimum level
• Take proactive approach in monitoring employees’ compensation claims in order to minimize claims settlement
• Handle EC litigated claims by taking responsibility to resolve all enquiries from both customer and external contacts to ensure delivery of a focused claims service
• Ensure claims procedures, documentation is adhered to the group claims management requirement and best practice
• Build up relationship with all stakeholders and achieve compromised settlement to conclude the case at the earliest time and avoid litigation
• Develop a claim case strategy to ensure appropriate reserves are assigned, in which investigations are conducted and appropriate suppliers are engaged
• Provide quality customer service to clients & meet with clients for claims review meeting
• Acquire and efficiently organize the relevant evidence and information to accurately assess the value of the litigated claim and to recognize potential fraud/recovery indicators
• Identify all potential recovery and fraud cases
• Assist Claims Manager to monitor and conduct assessment of the performance of external loss adjuster whose services form part of claims services
• Set and monitor reserve adequately and timely and ensure the authoritative level laid down are complied with
• Report to claims management team on adverse trend of development of claims
• Report to claims management team for clients with adverse claims experience
• Perform any other duties, task-oriented or claims related as may be delegated by Claims Manager

Job Qualifications

• Degree holder
• Tertiary education in one of the fields (or more) would be required:
  • Insurance, Business Administration or Legal
• ANZIIF/ACII would be an asset
• Over 2 years EC claims management experience is a must
• Experience in managing legal claims is highly preferred
• Previous handling corporate client would be an asset
• Knowledge in insurance principles
• Litigation knowledge is highly preferred
• Strong knowledge of Employees‘ Compensation Ordinance
• Understand legislation and legal liability
• Interpretation of policy cover
• Understand industry standards and protocol
• Knowledge of claims agreements
• Knowledge of the legal procedure of WC litigated case in Hong Kong
• Good command of written and spoken English & Chinese (including Cantonese & Mandarin)
• Negotiation skill, both written and verbal
• Candidates with less experience can be considered as Claims Assistant

At Zurich, we like to think outside the box and challenge the status quo. We take an optimistic approach by focusing on the positives and constantly asking What can go right?

We are an equal opportunity employer who knows that each employee is unique - that’s what makes our team so great!
Join us as we constantly explore new ways to protect our customers and the planet .

• Location(s): HK - Hong Kong, CN - Guang Zhou, Pazhou