Non Motor Claims Analyst

2 weeks ago


Pasig, National Capital Region, Philippines Fortune General Insurance Corporation Full time

A.      JOB SUMMARY

The Claims Assistant reports to the Claims Officer and Assistant Manager, Non-Motor Claims and is responsible for end-to-end processing of designated Personal Accident (PA) Claims and other related tasks as assigned. This includes validating documents, evaluating Claims, coordinating with the assureds and/or intermediaries, and ensuring timely and accurate claim resolution in compliance with the company standards.

B.      KEY RESULTS AREAS/DUTIES AND RESPOSIBILITIES

I. Claims Processing

  1. Validate and check correctness of documents received from claimants or intermediaries.

  2. Encode reported PA claims in Genweb and set up loss reserves.

  3. Evaluate claims and make recommendations on compensability.

  4. Assign claims to independent adjusters when necessary.

  5. Compute probable liability and prepare in-house reports.

II. Compliance, Documentation, and Investigation

Maintain accurate records of all PA claims and organize / upload relevant documents in the system.

Ensure adherence to policy coverages and regulatory requirements.

Develop investigation plans and gather necessary documents and information.

Prepare reports and updates for management as needed.

Keep updated with insurance product knowledge.

III. Customer Service and Coordination

Communicate effectively with adjusters, claimants / insured parties, intermediaries and others to determine liability and coverage.

Attend to inquiries related to assigned accounts and provide accurate information.

Provide assistance and clarification on claim-related inquiries.

Perform other tasks related to Non-Motor Lines or as required by the immediate superior from time to time.



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