Senior Legal Claims Officer at Britam

Job Description

Job Purpose:    

• Reporting to the Assistant Manager Legal Claims.

Key responsibilities:

• Review documents and pertinent requirements regarding an insurance claim.
• Ensure that the insurance claim made by the claimant is complete in form and complies with the documentary requirements of an insurance claim.
• Advice customers regarding basic matters about their insurance coverage in relation to the insurance claim.
• Respond to both internal and external claims inquiries concerning benefits, claims processes, service providers, and the filing/completion of proper forms.
• Record all claims transactions including appointment of advocates, doctors and investigators.
• Ensure that matters allocated are constantly tracked and updated in the registers.
• Update legal claims registers for claims meetings and update the various claims reports.
• Track and follow up on appeal deposits.
• Assist in giving advice on legal issues, compile comprehensive file notes both in the event of judgments and out of court matters.
• Assist in the review of reserves as per the reserving guidelines.
• Assist in managing external Advocates on Britam Panel of Advocates through pro-active interaction and correspondences.
• Review advocates legal costs to ensure that the same are within the SLA and Advocates Remuneration Order.
• Review status updates as received by advocates in an effort to keep abreast with all ongoing briefs and advice maintain adequate reserves  based on the established reserving guidelines. and documentation received from the panel advocates.
• Process payments to insured’s and service providers.
• Assist on Third party recoveries when called upon to do so.
• Perform any other duties as may be assigned from time to time.

Knowledge, experience and qualifications required:

• Bachelors of degree in LAW LLB and PDG from KSL.
• Obtain the relevant CLE points in every given year.
• 6-9 years’ experience in insurance claims processing.
• Knowledge and experience in the insurance sector.
• CPA or AIIK or ACII and added advantage.

Technical / Functional Competencies:

• Insurance Claims Management 
• Legal Claims & Litigation Management 
• Insurance Law & Regulatory Compliance 
• Policy Interpretation & Coverage Analysis 
• Claims Liability Assessment & Reserving 
• Legal Costs & Panel Advocate Management 
• Claims Recoveries, Subrogation & Settlements 
• Claims Reporting, Analysis & Systems Management