Insurance Claims Adjuster

2 weeks ago

Muntinlupa City, Philippines WHR Global Consulting Full time

The Non-Motor Claims Adjuster assists in the inspection, investigation, evaluation, and settlement of claims under the supervision of more senior claims professionals. The role involves reviewing claims, gathering relevant information, conducting damage assessments, and ensuring that claims adjustment is in accordance with the covering policies, industry standards, and regulatory requirements. The Non-Motor Claims Adjuster plays a key role in ensuring efficient claims management and maintaining high levels of customer service. KEY RESPONSIBILITIES Inspection • Receive request for claims inspection from the Adjustment Supervisor • Conduct initial assessment from the interview of claimant and submitted incident report • Upon confirmation of the Adjustment Supervisor, schedules and finalizes appointment with insured/claimant Proceeds to the site of inspection and conducts physical inspection of damaged property Claims Evaluation & Investigation • Relate the damages observed against the loss details narrated by the insured/claimant • Analyze the loss details and actual damages and validates legitimacy of the claim and prepare preliminary report then submit to the adjustment supervisor and adjustment head for review and approval • Provide or report to Head the vital information, concerns and analysis that needs further investigation and recommends assignment to an external investigator. • Refer and collaborate with the Adjusters and Head for the initial evaluation reports complex claims • Submit to Head the evaluation report with recommendation of settlement offer / compensability Fraud Retention and Reporting • Further investigation of submitted documentations to make sure that overpayment of claims will not occur • Consult with specialists such as lawyers, engineers, architects, and other related professions Identify Fraud cases and collaborate with Fraud Department to establish specific measures that help detect fraud, thus improving the underwriting and financial result Customer Service (Feedback and Collaboration) • Assist claimants and/or agent/broker during claims process which includes providing updates/status of claims • Receive reports/complaints from claimant, agent, and other departments • Submit explanation letter to Head through the Supervisor on what transpire during the claim process that trigger the complaint/s. • Provide assistance to external adjusters during the claim process which includes monitoring and follow-up of documentation and claimants. • Discuss discrepancies on policy interpretation with Head through the Supervisor • Attend meeting/s to discuss the pending claims and how to improve TAT QUALIFICATIONS • Graduate of any 4 yrs bachelor’s degree. • 2 – 5 yrs experience in Non-Motor Claims or having prior experience in a claims department or working with insurance claims can be a significant advantage. • Prior customer service and loss adjustment experience, preferably in an insurance company or adjustment company. • Strong organizational and multitasking skills. • Strong analytical capabilities • Proficient in Microsoft Office Suite (Excel, Word, etc.) and familiarity with claims management software. • Attention to detail and high level of accuracy. • Strong communication skills, both written and verbal. • Ability to handle confidential information with discretion. • Team-oriented and proactive in assisting other claims staff.

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