Claims Adjuster

Fortune General Insurance Corporation; Pasig; On-site; PHP 279,000 - 390,600; Full time

Job summary

A leading insurance company in the Philippines seeks a claims evaluator to validate submissions, inspect property and vehicle claims, and verify policy details. The role requires strong communication, negotiation skills, and insurance knowledge to determine appropriate payment amounts. Attention to detail and the ability to meet deadlines are essential. Candidates must be open to working overtime as necessary. This position promises an engaging environment for those passionate about insurance and claims assessment.

Qualifications

• Expertise in claims evaluation to assess submitted claims effectively.
• Proficient in Microsoft Word, Excel, and PowerPoint for reporting and analysis.
• Strong communication skills for effective negotiation and coordination.
• High attention to details to ensure accuracy in claims assessment.
• Ability to work overtime as required by workload demands.
• Knowledge of insurance principles and practices.

Responsibilities

• Validate claims submitted to the Company.
• Inspect property and motor car claims, including potential fraud cases.
• Verify policy coverage and details to determine appropriate actions.
• Evaluate and adjust claims for fairness and reasonableness.
• Determine company liability and recommend payment amounts.
• Perform other tasks related to Non-Motor as required.

Skills

Claims Evaluation Expertise

Computer literate (Word, Excel, PowerPoint)

Good communication skills

Attention to details

Negotiation Skills

Insurance knowledge

Job description

Responsibilities

• Validate claims submitted to the Company
• Inspect property and motor car claims, including potential fraud cases. This may include claims nearby provinces, as these will no longer be assigned to an independent adjuster.
• Verify policy coverage, provisions, and related details (e.g. premium payment status, policy validity) to determine appropriate actions
• Evaluate and adjust claims to ensure recommended amounts are fair and reasonable
• Determine the extent of company liability and recommended payment amounts based on actual damage. Recommend claim denials when sufficient grounds exist
• Perform other tasks (related to Non‑Motor) as may be required by the immediate superior from time to time

Job Specifications

• Claims Evaluation Expertise
• Computer literate (Word, Excel, PowerPoint)
• Good communication skills
• Attention to details
• Negotiation Skills
• Willing to go on overtime as and when needed
• Results oriented and mindful of deadlines
• Insurance knowledge