Directline Assurance Company Limited
We are looking for a motivated and
qualified professional to fill the position of Deputy
Claims Manager (TPPD / OD).
Overall Purpose of the Job: The role holder will ensure superior customer experience
at all levels of interrelations through identification, evaluation of key
records & facts, advise on claim resolution strategy, client defense
strategy, program analysis and evaluation of quantum.
Key Roles and Responsibilities
Management and Co-ordination
·
Assist the Claims Manager in
supervision and management of the Claims Department
·
Supervise the assigned staff within
the Claims Department and ensuring that the highest quality of service is
rendered to the company and the staff comply with the company policies and
guidelines
·
Be the link between the claims
department and other departments
·
Participate in the recruitment and
training of quality members of staff in the Claims department
Claim and Incident Management
·
Thorough and detailed analysis of
claim documents to enable early fraud detection and ensure that the fraudulent
claims are effectively addressed within the company’s policies and guidelines.
·
Maintain a proper and accurate
reserves on claims and incidents and ensure that all Journal vouchers are
forwarded to the Accounts department within 24 hours of approving them.
·
Maintain a proper update of the
system data and documentation of the claims and incidents and ensure that the
files submitted by the Claims officers are approved within 24 hours of posting.
·
Ensure that negotiation and
settlement of claims is completed within 30 days from the date of approval and
that such settlement is within the least amounts possible
·
Ensure that correspondences from the
insured, intermediaries, claimants and their advocates are responded to within
72 hours from the date they are received.
·
Ensure that proper factual and legal
research required for achievement of the strategy on the claims is conducted
·
Engaging with third party service
providers where necessary to build evidence on liability, medical injury
disputes etc
·
Where execution of court judgements
has commenced, to firstly have our advocates immediately instructed to file the
appropriate pleadings and secondly, deal with the auctioneers to protect the
insured’s interests as well as the business interests of the Company. This has
to be done within 24 hours of receipt of the court warrants and insured updated
on the measures taken and copies of the warrants availed to the Managing
Director and
·
General Manager Claims for
information and follow up.
·
Ensure that recoveries from the
insured and third parties is achieved
·
Prepare and review the relevant claim
guidelines and template documents to conform to the policy and best practices.
·
Liaise with the Company’s re-insurers
and provide the requisite documentation to facilitate timely recovery of the
recoveries due
·
Handle customer complaints from the
insured or intermediaries and instil confidence in the company’s claim process
Reports
·
Preparing reports to the Claims and
Risk Committees on the legal implications of adopting proposed policies and
strategies on the management of claims
·
Preparation of monthly performance
reports of the departmental staff
·
Preparation of monthly Claim Reports
for internal and external use
·
Preparing relevant claim and incident
reports for presentation to the relevant Board Committees.
·
Preparing necessary returns on the
Claims portfolio to the Industry Regulators Leadership.
General Duties
·
Review of the Claims IT system and
workflow and making recommendations on modification
·
Conducting legal and other forms of
relevant training
·
Providing advice on the legal effects
of proposed changes on policy documents and preparing responses to consulting
documents
·
Review and approve Company contracts
and agreements and identifying opportunities for efficiencies and improvements.
·
Monitoring changes in relevant
legislation and the regulatory environment, and advising the company on the
impact of such changes
·
Attending court to represent the
Company as a witness or any other capacity as may be approved by the Company
·
Participate and offer valuable advice
to the Company and Departmental Committees which you are nominated or elected
to
·
Represent the Company in meetings
with Industry Stakeholders and proving the Company with the requisite reports
from such meetings
·
Signing the relevant and authorized
documents on behalf of the Company
·
Maintain highest level
confidentiality concerning the sensitive, strategic and integral legal and
other information, data, decisions and developments taking place at the
company.
·
Any other duties that maybe assigned
from time to time.
Person Specifications
Academic Qualifications
·
University degree from an institution
recognized by Commission for Higher Education
·
Minimum Overall Grade of C+ in KCSE
Professional Qualifications
·
Certificate of Insurance (COP)
·
AIIK Diploma/CII Diploma or any
insurance related qualification will be an added advantage
Experience
·
At least 3 years’ experience in
Claims management preferably within an Insurance Company OR Intermediary.
·
Experience in dealing with PSV will be
an added advantage.
Skills and Attributes
·
High level of integrity; Able to
maintain utmost confidentiality of information in their possession
·
Excellent communication and
presentation skills
·
Excellent interpersonal and
negotiation skills
·
Excellent Client relationship skills
·
Have great attention to detail
We are looking for a motivated and qualified professional
to fill the position of Accident
& Police Liaison Officer.
Overall Purpose of the Job: The Accident & Police Liaison Officer is responsible
for planning and executing investigations into claims and detection of fraud
arising from insured motor vehicle accidents.
Key Roles and Responsibilities
·
Creating and maintaining good and
professional relationships between the Company and the police and other important
sources of accident data in order to facilitate the investigation officers
queries, obtain immediate information regarding major accidents and manage
entry of claimants into the Occurrence Book.
·
Reporting the occurrence of
incidents/accidents to the Company as soon as they occur and visiting the
accident scene, taking photographic evidence of the damages to the vehicle and
injured persons, collecting information in regard to the medical institutions
that are involved in the initial treatment of the injured persons.
·
Conducting investigations and
submitting quality investigation reports in a prescribed format.
·
Managing and reporting the number of
claimants allegedly injured in road traffic accidents involving vehicles
insured by Directline being issued with PAR’s and P3 forms.
·
Gather intelligence information in
regard to accidents and claims trends in the area of coverage.
·
Detecting and reporting fraudulent
claims.
·
Establishing the cause of an incident
and the parties involved, and where applicable ensuring that the police
attribute negligence to the correct parties
·
Establishing the identities of the
parties involved in the incident with the emphasis on injured persons and
witnesses.
·
Obtaining details of the claimants
and claimants statements from the police records in regards to the
circumstances of the accident.
·
Verification of identity cards and
passports.
·
Any other responsibilities will be
communicated to the Officer from time to time.
Person Specifications
Academic Qualifications
·
University degree/Diploma in
Criminology & Security Studies or equivalent from an institution recognized
by Commission for Higher Education
Professional Qualifications
·
Member of relevant professional body
Experience
·
MUST have at least two (2) years’
working experience in the Security/Investigative sector or Kenya Police Force
·
Experience in the insurance industry
and knowledge of Cap 405 will be advantageous
·
Excellent knowledge and understanding
of contemporary risk management principles and practices and reporting
·
Problem solving and Solution oriented
·
Supervisory and leadership skills
managing team/department performance and staff
Skills and Attributes
·
High integrity and ethical level;
·
Able to maintain utmost
confidentiality of information in their possession
·
Excellent analytical skills,
·
Excellent communication,
interpersonal, negotiation and presentation skills
·
Fraud detection skills
·
Self-motivated, confident and
outgoing personality
·
Have great attention to detail and
able to get things done to completion
Application Instructions
If you qualify for the above advertised role, kindly send
us a detailed CV and Application Letter clearly demonstrating your fit as per
the roles & responsibilities and the person specifications
(academic/professional qualifications, experience, skills & attributes)
listed above.
Applications that do not conform to the Application
Instructions will not be considered.
Kindly send your application documents to
human.resource@directline.co.ke to reach us on or before 5.00pm Friday, 21st
February 2020.