Claims Ispector

2 days ago

Pasig, National Capital Region, Philippines Cocogen Insurance, Inc. Full time ₱159,000 per year

Job description:

Join our roster of exceptional people

Perks & Benefits:

  • Guaranteed 15 months' pay
  • HMO
  • Medical reimbursements
  • Internal & external trainings
  • Year-round fun & exciting Company Events
  • Employee appreciation
  • Work-life balance

Job Description

  1. Processes, evaluates and prepares settlement checks by performing the following:

  2. Ensures that no red flag indicators (fraud indicators) are noted in the claim being processed, otherwise conduct an investigation and report noted irregularity for appropriate action of superior.

  3. Checks completeness and validity of proof loss documents.
  4. Assigns the adjustment of the loss to an accredited sub-contractor; monitors the regularity of the adjusters report and report any noted deviation on the adjusters handling the assignment, and the unreasonable delay in the submission of such for appropriate action.
  5. Evaluate compensability or deniability based on the proof of loss documents; approves settlement within the authority given, otherwise submit recommendation of settlement for approval. Should the loss be deniable, recommend denial stating the grounds for such recommendations.
  6. Adjusts / amends Loss Reserve and updates Geniisys system re: status of claim; ensures zeroing out loss reserve balances for closed / fully settled claim.
  7. Appraises Insured / Producers with regard to the status / progress of their claim.
  8. Prepares and releases Letter of Authority (LOA) and/or offer letter to the concerned party; negotiates with the concerned party the approved amount of settlement and monitors its acceptance.
  9. Ensures reasonability of the billing statement of subcontractors, and prepares payment request for settlement of bills / cash settlement.
  10. Coordinates / refers the claim file with the Recovery Section if with recovery and ensures proper tagging of the recovery in the system.

  11. Maintains an efficient and accessible file system for claims being processed, and closes claim file in the Geniisys system and boxes it accordingly

  12. Conducts immediate inspection of the damaged properties, when necessary or required by other Processors and prepares timely recommendation report.

  13. In-charge of the on-the-spot cash settlement on petty motor car claims by observing the following.

  14. Ensures that no red flag indicators (fraud indicators) are noted in the claim being processed, otherwise follow the usual claims processing.

  15. Ensures regularity of the insurance policy and the completeness and validity of proof of loss documents submitted, and that the cause of loss is compensable.
  16. Evaluates loss based on actual damage, offers the evaluated amount, if accepted, issues settlement check provided it is within the authority given, otherwise recommends approval and ensures that the corresponding settlement check be approved and released immediately.
  17. Ensures that all claims settled are registered in the Geniisys system and the file is complete and filed properly.

Qualifications

  • Candidate must possess a Bachelor's Degree in Business Administration, Marketing or any related field;
  • Experience in the same role
  • Background in handling Non-Life insurance is an advantage;

Online Application Process

Job Type: Full-time

Pay: From Php15,500.00 per month

Benefits:

  • Additional leave
  • Company Christmas gift
  • Company events
  • Life insurance
  • Opportunities for promotion
  • Paid training
  • Promotion to permanent employee

Education:

  • Bachelor's (Required)

Experience:

  • Claims Inspection: 1 year (Required)

Work Location: Hybrid remote in Pasig