Profession insurance claims manager

Insurance claims managers lead the team of insurance claims officers to ensure they handle insurance claims properly and efficiently. They deal with more complex customer complains and assist with fraudulent cases. Insurance claims managers work with insurance brokers, agents, loss adjusters and customers.

Personality Type

• Enterprising / Conventional

Knowledge

• Principles of insurance

  Understand the principles of insurance, including third party liability, stock and facilities.

• Corporate social responsibility

  The handling or managing of business processes in a responsible and ethical manner considering the economic responsibility towards shareholders as equally important as the responsibility towards environmental and social stakeholders.

• Fraud detection

  The techniques used to identify fraudulous activities.

• Insurance law

  The law and legislation concerning the policies of transferring risks or losses from one party, the insured, to another, the insurer, in exchange for a periodic payment. This includes the regulation of insurance claims and the business of insurance.

• Types of insurance

  The various types of risk or loss transfer policies that exist and their characteristics, such as health insurance, car insurance or life insurance.

• Financial analysis

  The process of assessing the financial possibilities, means, and status of an organisation or individual by analysing financial statements and reports in order to make well informed business or financial decisions.

• Financial management

  The field of finance that concerns the practical process analysis and tools for designating financial resources. It encompasses the structure of businesses, the investment sources, and the value increase of corporations due to managerial decision-making.

• Financial statements

  The set of financial records disclosing the financial position of a company at the end of a set period or of the accounting year. The financial statements consisting of five parts which are the statement of financial position, the statement of comprehensive income, the statement of changes in equity (SOCE), the statement of cash flows and notes.

Skills

• Manage claims process

  Manage the relation with an insurer related to its obligation to receive, investigate and act on a claim filed by an insured.

• Organise a damage assessment

  Organise a damage assessment by indicating an expert to identify and examine the damage, give information and instructions to experts and follow up on the experts, and write a damage report.

• Manage claim files

  Follow up on the progress of a claim file, keep all parties informed of the status of the file, ensure the customer receives the damages owed, treat any problems or complaints from customers, close the file and give information to an authorised person or department when there is suspicion of fraud.

• Lead claim examiners

  Select claim examiners and assign them to cases, assist them and give them advice or information when needed.

• Strive for company growth

  Develop strategies and plans aiming at achieving a sustained company growth, be the company self-owned or somebody else's. Strive with actions to increase revenues and positive cash flows.

• Liaise with managers

  Liaise with managers of other departments ensuring effective service and communication, i.e. sales, planning, purchasing, trading, distribution and technical.

• Follow company standards

  Lead and manage according to the organisation's code of conduct.

• Analyse market financial trends

  Monitor and forecast the tendencies of a financial market to move in a particular direction over time.

• Enforce financial policies

  Read, understand, and enforce the abidance of the financial policies of the company in regards with all the fiscal and accounting proceedings of the organisation.

• Prepare financial auditing reports

  Compile information on audit findings of financial statements and financial management in order to prepare reports, point out improvement possibilities, and confirm governability.

• Advise on financial matters

  Consult, advise, and propose solutions with regards to financial management such as acquiring new assets, incurring in investments, and tax efficiency methods.

• Review insurance process

  Analyse all documentation related to a specific insurance case in order to ensure that the application for insurance or the claims process was handled according to guidelines and regulations, that the case will not pose significant risk to the insurer or whether claims assessment was correct, and to assess the further course of action.

• Handle incoming insurance claims

  Manage, process and evaluate submitted requests for insurance in case a problem, which is covered under an insurance policy, occurs. The claim may or may not be approved, based on assessment of the circumstances.

• Manage staff

  Manage employees and subordinates, working in a team or individually, to maximise their performance and contribution. Schedule their work and activities, give instructions, motivate and direct the workers to meet the company objectives. Monitor and measure how an employee undertakes their responsibilities and how well these activities are executed. Identify areas for improvement and make suggestions to achieve this. Lead a group of people to help them achieve goals and maintain an effective working relationship among staff.

• Conduct financial audits

  Evaluate and monitor the financial health, the operations and financial movements expressed in the financial statements of the company. Revise the financial records to ensure stewardship and governability.

• Plan health and safety procedures

  Set up procedures for maintaining and improving health and safety in the workplace.

Optional knowledge and skills

Source: Sisyphus ODB