- Claims Processing
- Receive, register, and acknowledge claims from clients and intermediaries.
- Verify submitted claims documents for completeness and accuracy.
- Capture claims details into the claims management system promptly.
- Claims Assessment and Documentation
- Assist in assessing the validity of claims by cross-referencing policy terms and conditions.
- Ensure all supporting documents such as police reports, medical reports, or repair estimates are collected and recorded.
- Liaise with service providers (e.g., garages, hospitals) to verify claims information and costs.
- Carry out a thorough claims review process to ensure our reserves are up to date
- Maintain low loss ratios through thorough negotiations and assessments
- Claims Settlement
- Follow up on claims approvals and payments within the stipulated timelines.
- Assist in resolving discrepancies or issues arising from claims processing.
- Prepare claims payment requests and ensure accurate records of payments made.
- Customer Service
- Communicate with claimants and brokers to provide updates on the status of claims.
- Address and escalate client complaints or queries in a timely manner.
- Provide guidance to clients on claims submission requirements and procedures.
- Compliance and Reporting
- Maintain proper filing of claims records for reference and audit purposes.
- Ensure all claims are processed in compliance with company policies, insurance regulations, and service-level agreements.
- Generate and submit periodic claims reports to the Claims Officer.
- Collaboration and Teamwork
- Coordinate with underwriting, risk assessment, and legal teams on claims-related matters.
- Work closely with external assessors, surveyors, and investigators to facilitate claims processing.
- Support other team members during high workloads or tight deadlines.
- Risk and Fraud Management
- Highlight suspicious or fraudulent claims to the Claims Officer for investigation.
- Assist in implementing controls to mitigate claims fraud risks.
- Reinsurance Claims Recoveries and Third-Party recoveries
- Communicate with reinsurers to notify them of claims and initiate the recovery process.
- Provide documentation for all reinsurance related claims to the reinsurers
- Follow up on reinsurance debt to monitor the status of reinsurance claims
- Provide regular updates and reports on recovery status, including any delays
- Work closely with claims, underwriting, finance and legal departments to ensure smooth reinsurance and third-party recovery process
- Ensure all documents and files related to third party recoveries are up to date with regular reporting.
- Continuous Improvement
- Contribute to process improvements to enhance efficiency and customer satisfaction in claims handling.
- Stay updated on industry trends, regulatory changes, and claims management best practices.
Key Performance Measures:
- Loss ratio
- Timely collected Reinsurance recoveries
- Superior customer experience
- Claims Turnaround Time
100% fraud lockout
Knowledge, experience and qualifications required
1. Knowledge & Skills:
- Understanding of insurance principles, claims handling processes, and policy terms.
- Familiarity with Uganda’s insurance regulatory framework and industry best practices.
- Strong analytical and problem-solving skills to assess and validate claims.
- Attention to detail and accuracy in reviewing claim documentation and processing payments.
- Proficiency in Microsoft Office applications (Word, Excel, Outlook) and claims management systems.
- Strong communication and interpersonal skills for engaging with clients, brokers, service providers, and internal teams.
- Ability to work under pressure, meet deadlines, and manage multiple claims simultaneously.
- Customer service orientation with a focus on delivering excellent client experiences.
2. Experience:
- 1–2 years of experience in claims processing, underwriting, or a related role in the insurance industry.
- Experience handling general insurance claims is an added advantage.
- Previous experience working with brokers, loss adjusters, or service providers is beneficial.
3. Qualifications:
- A bachelor’s degree in Insurance, Business Administration, Actuarial Science, Law, or a related field.
- Professional certification in Insurance (Certificate or Diploma) is an added advantage.
