Claims Examiner, Personal Accident

Allianz; Kuala Lumpur; On-site; MYR 60,000 - 90,000; Full time

Job summary

Allianz Malaysia is seeking a proactive Claims Specialist to support processing specialty claims. You will handle document gathering, settlement offers, and subrogation actions, while ensuring coverage and compliance.

The role emphasises collaboration, accurate communication, and leveraging AI tools to streamline claims workflows. Training and development opportunities are available within a dynamic insurance environment.

Qualifications

• Excellent communication and writing skills.
• Able to work independently and as part of a team.
• Ability to leverage AI tools like ChatGPT to simplify tasks at work.
• Willing to learn and interest in handling and processing claims.

Responsibilities

• Obtain necessary claims documents from insured, solicitors, underwriters, agents, brokers, etc.
• Appoint independent adjusters for investigations and solicitors for summon cases & medical specialists.
• Confirm coverage and assess claims based on documents/reports (medical, police, etc).
• Provide settlement offers to insured.
• Handle complaints from local authorities, insured and agents.
• Negotiate and attend court when necessary for selected contested cases.
• Prepare repudiation letters when policy liability is not clear.
• Take action to recover claims via subrogation.
• Address claims queries from customers, agents, brokers, branches and claims hub.
• Provide claims input in product development.
• Identify processes for automation and implement enhancements in Merimen/OPUS.

Skills

Communication

Teamwork

AI tools (ChatGPT)

Willingness to learn

Tools

Merimen

OPUS

Job description

Job Summary

To perform the following activities in processing specialty claims:

• Claims Processing & Assessment
• Claims Settlement
• Claims Recovery
• Claims Services
• Functional business analyst

Key Responsibilities

• Obtain necessary claims documents from insured, solicitors, underwriters, agents, brokers, etc.
• Appoint independent adjusters for investigations, solicitors for summon cases & medical specialists.
• Confirm coverage and assess claims based on documents / reports that support claims, i.e. medical, police
• report, adjuster report etc.
• Offer settlement to insured.
• Handle complaints from local authorities, insured & agents.
• Conduct negotiation & attend court when necessary for selected contested cases.
• Prepare repudiation letter for cases where the Policy Liability is not apparent.
• Take action to recover claims by way of subrogation.
• Attend to claims query from customer, agents, brokers, branches and claims hub.
• Provide claims input in product development
• Identifying processes which can be automated and perform enhancement in Merimen /OPUS.

Requirements

• Able to work independently and as a team player.
• Good communication and writting skills.
• Ability to leverage AI tools like ChatGPT to simplify tasks at work
• Willing to learn and interested in handling and process in Claims.