Insurance Claims Inspector

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    Insurance claims handlers work on behalf of insurance companies to determine the level and validity of insurance policy claims.

    Inspectors are responsible for assessing or determining liability, negotiating payments and minimizing the number of fraudulent claims. They investigate insurance claims relating to, for example, burglary, motor vehicle accidents, flooding or fire damage to property and in some cases, workplace accidents or work-related illnesses.

     

    Duties

    • 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
    • analyzing 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
    • identifying 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 and claims professionals
    • ensuring the customer is treated fairly and that the customer receives excellent service in accordance with industry and company guidelines
    • handling any complaints associated with a claim
    • 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.

     

    Qualifications

    Although this area of work is open to all graduates, the following degree subjects may increase your chances:

    • business or management
    • economics and accountancy
    • law
    • mathematics,
    • politics, government or public administration.

     

    Skills

    • customer service skills
    • negotiation and decision-making skills
    • communication skills and a confident disposition when dealing with people, often in difficult circumstances
    • organizational and time management skills
    • commercial acumen
    • the ability to think strategically
    • initiative and the ability to adapt quickly to different situations
    • good numeracy and literacy
    • interpersonal skills
    • discernment and the ability to assess a situation objectively
    • attention to detail and sound report-writing skills.

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