Claims Examiner, Personal Accident

Allianz; Kuala Lumpur; On-site; Confidential; Full time

Job summary

Allianz in Kuala Lumpur, Malaysia seeks a Claims Analyst to process specialty claims, settlements, recoveries and provide claims services. The role includes coordinating with insured, solicitors, underwriters, and agents, and leveraging AI tools to streamline tasks.

The candidate will work independently and in teams, with emphasis on communication, documentation, and process improvement within the claims function.

Qualifications

• 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.

Responsibilities

• Obtain necessary claims documents from insured, solicitors, underwriters, agents, brokers.
• 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, 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.

Skills

Independent work

Team player

Communication skills

Writting skills

ChatGPT familiarity

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.