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Insurance claims handler: Job description

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Insurance claims handlers ensure that insurance claims are handled efficiently and that payment for valid claims is made to their policyholders. They decide on the extent and validity of a claim, checking for any potential fraudulent activity.

Insurance claims handlers coordinate the services that may be required by policyholders following an accident or incident. This can include arranging and coordinating for approved tradespeople to make homes safe again or organising for replacement goods if a policyholder has been burgled. They may also be involved in large scale accidents and incidents, e.g. a bridge collapse.

As well as communicating with policyholders, insurance claims handlers also liaise with external experts such as loss adjusters and lawyers. They may also become involved in loss adjusting activities (investigating the loss) or in legal discussions about the recovery of money from the party responsible for the loss. Work on complex cases requires experience and expert knowledge.

Typical work activities

Insurance claims handlers are involved in managing a claim from beginning through to settlement. Depending on their level of experience and knowledge, they may be involved in investigating potentially fraudulent claims and undertaking a range of loss adjusting activities.

Typical activities include:

  • providing advice on making a claim and the processes involved;
  • processing new insurance claims notifications;
  • collecting accurate information and documents to proceed with a claim;
  • analysing a claim made by a policymaker;
  • guiding policyholders on how to proceed with the claim;
  • contacting trades people from a network of approved professionals and arranging for them to make repairs on the policyholder's property;
  • monitoring the progress of a claim;
  • investigating potentially fraudulent claims;
  • indentifying reasons why full payment may not be made;
  • ensuring fair settlement of a valid claim;
  • building relationships with loss adjusters, forensic accountants and solicitors, as well as other legal/claims professionals;
  • ensuring the customer is treated fairly and that the customer receives excellent service in accordance with industry and company guidelines;
  • involvement in loss adjusting activities and in legal discussions relating to settlement;
  • seeking legal recovery of monies paid out;
  • managing a team of claims handlers (at managerial level);
  • taking responsibility for productivity and profit;
  • adhering to legal requirements, industry regulations and customer quality standards set by the company.
 
 
AGCAS
Written by AGCAS editors
Date: 
January 2013
 
 

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