Zurich Insurance

Global insurer providing property, casualty, life

Senior Claims Specialist

Claims AdjudicationUpdated on Nov 14

Full-timeKuala Lumpur, Federal Territory of Kuala Lumpur, MalaysiaNo salary listedIn-person

About the Job

Requirements

A Bachelor’s degree and 6 or more years of experience in Claims and/or Litigation Management; or a Juris Doctor and 2 or more years of experience in Claims and/or Litigation Management; or a Zurich Certified Insurance Apprentice, including an Associate Degree, and 6 or more years of experience in Claims and/or Litigation Management; or completion of the Zurich Claims Training Program and 6 or more years of experience in Claims and/or Litigation Management; or a High School Diploma Equivalent and 8 or more years of experience in Claims and/or Litigation Management.
Must obtain and maintain required adjuster licenses.
Microsoft Office experience.
Knowledge of insurance regulations, markets, and products.

Responsibilities

Document claims files by accurately capturing and updating claims data and information in compliance with best practices for single- and multi-party personal or commercial line claims of moderate to high exposure and complexity.
Determine liability by gathering and analyzing relevant facts, utilizing applicable law, and establishing basic principles of negligence.
Determine policy verification and coverage by analyzing applicable coverage for claims and deciding whether the loss falls within the coverage.
Work toward timely claims resolution by developing case strategy and case evaluations, and escalating issues as appropriate.
Establish timely reserves and perform ongoing reviews throughout the claims cycle within authority limits by estimating and validating claim values.
Assess damages by calculating applicable damages or ranges of damages allowed by law.
Negotiate claim settlements by establishing appropriate negotiation strategies and using available tools and resources within authority limits.
Meet quality standards by following best practices.
May participate in customer marketing efforts.
Lead a team of claims handling specialists to develop and implement business processes and manage performance across all activities to achieve business objectives and continuously improve performance.
Translate business objectives into clearly defined business cases, costs, or schedules to support the achievement of claims objectives.
Monitor and control allocated human and material resources assigned to project work, maintaining financial and progress forecasts to ensure projects are delivered according to schedule and within budget.
Supervise and quality-assure the drafting of key claims-handling policy documents to ensure compliance with the organization's rules and regulations governing transactions.
Oversee compliance with claims policies, procedures, systems, and processes across multiple countries and lines of business to protect the organization's interests.
Analyze themes from a wide range of data sources to identify trends and areas for business improvement and provide potential solutions.
Contribute to process development and lead implementation of systems and process improvements in claims handling.
Provide technical guidance and recommendations as a subject matter expert to support resolution of the most complex customer cases and develop precedents to improve customer service.
Manage key internal and external stakeholder relationships across the organization to ensure colleagues are informed on relevant issues.
Act as a technical expert for the team and internal customers, maintaining up-to-date knowledge of the area of expertise so the operational claims team can best serve customers.

Desired Qualifications

Effective verbal and written communication skills.
Strong analytical, critical-thinking, and problem-solving skills.
Strong multitasking and prioritization skills.
Experience collaborating in a team environment and building cross-functional working relationships.
Proactively share and promote the sharing of insights.
Ability to gather unique perspectives from other teams and functions to optimize outcomes.
Understand, analyze, and apply the component parts of an insurance policy for complex claims.
Ability to follow the reserving process for indemnity and expense when analyzing potential exposure for complex claims.
Ability to determine scope and exposure for complex claims.
Ability to leverage trends and relationships to provide high-quality customer service.
Well-versed in identifying, understanding, and explaining complex financial and/or actuarial trends and concepts.
Ability to effectively communicate coverage determinations to customers, clients, and brokers for complex claims.
Ability to direct counsel on an ongoing basis to guide the course of complex litigation and settlement strategies.

Job Summary

To handle single and multi-party personal or commercial line claims of moderate to high exposure and complexity within specific authority limits, to ensure that claims are handled in the most efficient, effective way while delivering a customer-centric claims service.

Job Qualifications

Required:
• Bachelor’s Degree and 6 or more years of experience in the Claims and/ or Litigation Management area.

OR
• Juris Doctor and 2 or more years of experience in the Claims and/ or Litigation Management area.

OR
• Zurich Certified Insurance Apprentice, including an Associate Degree with 6 or more years of experience in the Claims and/ or Litigation Management area.

OR
• Completion of Zurich Claims Training Program and 6 or more years of experience in the Claims and/ or Litigation Management area.

OR
• High School Diploma Equivalent and 8 or more years of experience in the Claims and/ or Litigation Management area.

AND
• Must obtain and maintain required adjuster license(s)
• Microsoft Office experience
• Knowledge of insurance regulations, markets and products

Preferred:
• Effective verbal and written communication skills
• Strong analytical, critical thinking and problem-solving skills
• Strong multi-tasking and prioritization skills
• Experience collaborating in a team environment and building cross functional working relationships
• Proactively shares and promotes sharing of insights
• Ability to gather unique perspectives from other teams/functions to optimize outcomes.
• Understands, analyzes, and applies the component parts of an insurance policy for complex claims
• Ability to follow reserving process for indemnity and expense in analyzing the potential exposure of complex claims
• Ability to determine the scope and exposure for complex claims
• Ability to leverage trend and relationships to provide high-quality customer service
• Well-versed in identifying, understanding and explaining complex financial and/or actuarial trends/concepts.
• Ability to effectively communicate coverage determinations to customers/clients/brokers for complex claims
• Ability to direct counsel on an ongoing basis to guide the course of complex litigation and settlement strategies

Job Accountabilities - Key Accountabilities

• Document claims file by accurately capturing and updating claims data/information in compliance with best practices for single and multi-party personal or commercial line claims of moderate to high exposure and complexity.
• Exercise judgment to determine liability by gathering and analyzing relevant facts; utilizing applicable law; establishing basic principles of negligence.
• Exercise judgment to determine policy verification and coverage determination by analyzing applicable coverage for claims and determining whether the loss falls within the coverage.
• Work to have a timely resolution to claims by developing case strategy; developing a case evaluation; escalating issues as appropriate.
• Establish timely reserves and perform ongoing review throughout claims cycle within authority limit by estimating and validating value of claims.
• Assess damages by calculating applicable damages or range of damages allowed by law.
• Negotiate settlement of claim by establishing appropriate negotiation strategy and utilizing available tools and resources within authority limits.
• Meet quality standards by following best practices

Job Functions

• May participate in customer marketing efforts.

Business Accountabilities

• Lead a team of claims handling specialists to develop and implement business processes and manage performance across all activities in order to achieve business objectives and continuously improve performance.
• Translate business objectives into clearly defined business cases, costs or schedules in order to support the achievement of claims.
• Monitor and control allocated human and material resources assigned to project work, maintaining financial and progress forecasting in order to ensure projects are delivered according to schedule and within budget.
• Supervise and quality-assure the drafting of key claims handling policy documents to ensure full compliance to the organization's rules and regulations governing transactions.
• Oversee compliance with claims policies, procedures, systems and processes across multiple countries/Line of Business to protect the organization's interests.
• Analyze key themes from a wide range of data sources in order to identify trends and areas for business improvement providing potential solutions.
• Contribute to the development of process and lead the implementation of systems and process improvements in claims handling.
• Provide technical guidance and recommendations as a subject matter expert in order to support the resolution of the most complex customer cases and develop precedents to improve customer service.
• Manage key internal and external stakeholder relationships across the organization in order to ensure colleagues are informed on relevant issues.
• Act as a technical expert for own team and internal customers and maintains up to date knowledge of own area of expertise so that operational claims team can best serve customers.

You are the heart & soul of Zurich!

At Zurich, we like to think outside the box and challenge the status quo. We take an optimistic approach by focusing on the positives and constantly asking What can go right?

We highly value the experience and know-how of our employees and offer a wide range of opportunities across business areas to encourage you to apply for new opportunities within Zurich when you are ready for your next career step.

Let’s continue to grow together!

Location(s): MY - Kuala Lumpur
Remote working:
Schedule: Full Time
Recruiter name: Marina Destiana
Closing date:

About the Company

Zurich Insurance

Global insurer providing property, casualty, life

Zurich Insurance Group provides global multi-line insurance for individuals, families, small and mid-sized businesses, public entities, and multinational corporations in more than 200 countries. Its Property & Casualty arm covers personal lines like car and home, plus a wide range of commercial coverages (property, casualty, motor fleet, marine, construction, energy, financial lines, international programs); its Life business offers protection, savings, retirement, and unit-linked products. The Farmers Group manages Farmers Exchanges in the United States. The company also provides risk engineering and prevention services to help customers reduce risk and build climate resilience, with products sold through agents, brokers, bank partners, and direct channels. Its goal is to provide financial protection and risk management solutions that help customers manage uncertainty and build resilience over the long term.

Company size: 10,001+
Company stage: IPO
Headquarters: Zurich, Switzerland
Founded: 1872

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