Organization:
One of the Leading PJSC Insurance Companiesin the Region.
Job Role:
Supervisor – Motor Claims Settlement and Operations (Head Office)
Job Purpose:
The job holder is responsible for planning and implementing motor claims settlements management and claims operations, as well as supervising a team of CSOs, Senior CSOs, and Senior Officers – Motor Claims (Head Office), to ensure that motor claims settlements and operations are managed promptly and in compliance with insurance policies, company standards, procedures, and guidelines.
Key Responsibilities
Policies, Processes and procedures:
• Communicate the requirement of operational procedures and instructions to subordinates and monitor their adherence so that work is carried out in a controlled manner.
Budget & Plans Control:
- Ensure the timely and accurate settlement of motor claims in accordance with policy terms and conditions, delegated authority limits, and company guidelines.
- Monitor and control claim settlement costs through proper coverage validation, liability assessment, and adherence to approved claims handling procedures.
- Oversee the review and investigation of claim settlement complex and high-value to ensure appropriate settlement decisions and minimize claims leakage.
- Coordinate and review ambulance expenses, medical expenses, workshop invoices, and other claim settlements under the supervision of the Assistant Manager – Motor Claims, where required.
- Ensure adequate claim reserves are maintained and periodically reviewed, and that all claim records and documentation are accurate, complete, and up to date.
- Supervise daily motor claims settlement and operational activities to ensure compliance with service standards, turnaround times, regulatory requirements, and internal controls.
- Monitor team productivity, workload distribution, and service quality to ensure efficient claims processing and a high level of customer service.
- Support and cooperate with teams responsible for monitoring the quality of repairs and service delivery by approved repairers and service providers to ensure customer satisfaction and compliance with company standards.
- Identify and implement opportunities to improve operational efficiency, streamline claims processes, and enhance service quality.
Operational Responsibilities
Day to Day Operations:
- Supervise the day-to-day settlement operations of the Motor Claims Processing team to ensure that claims are processed efficiently and in compliance with established policies, procedures, service standards, and regulatory requirements.
- Conduct periodic reviews of outstanding and ageing claims settlements to facilitate timely claim settlements, reduce claim backlogs, and improve settlement ratios and operational performance.
- Review, approve, and settle claims within delegated financial authority limits, ensuring that claim settlement decisions are accurate, adequately supported, and aligned with company guidelines and policy terms and conditions.
- Ensure that appropriate claim reserves are established, maintained, and periodically reviewed in accordance with approved reserving procedures and claims management guidelines.
- Monitor settlement turnaround times and team performance, taking corrective actions where necessary to enhance operational efficiency and customer service levels.
Rejection of Claims:
- Oversee the handling of invalid settlement claims and ensure that the required actions are taken in accordance with the guidance of the Assistant Manager – Motor Claims
- Ensure prompt and efficient processing of claims settlements in accordance with established service standards, and ensure that all repudiations are fully documented and communicated, with clear explanations of the reasons why the claim is not settled.
Planning:
- Plan and organize the workflow of Motor Claims Settlement operations, ensuring effective distribution of tasks and prioritization of critical and time-bound activities to achieve timely and accurate settlements
- Supervise the receipt and processing of all daily settlement requests, ensuring efficiency, accuracy, and compliance with company procedures.
- Review all daily settlement requests to ensure completeness of documentation and validity of insurance coverage.
- Audit settlement claims prior to system entry to ensure correctness, compliance with policy terms and conditions, and adherence to internal procedures.
- Ensure proper processing of settlements, including cheque payments and account transfers, in accordance with approved procedures.
- Receive and review court notifications and coordinate with the Legal Department regarding related claims matters.
- Follow up on judicial cases in coordination with conciliation and reconciliation processes to ensure proper handling and resolution.
- Guide, direct, and motivate team members to achieve optimal performance while ensuring consistent service quality and compliance with customer expectations.
- Monitor the quality of work across the department to ensure accuracy, efficiency, and adherence to settlement standards.
- Provide technical support and guidance to team members whenever required to ensure correct and compliant claims settlement decisions.
- Participate in team meetings and contribute to continuous improvement initiatives aimed at enhancing settlement processes and operational efficiency.
- Support when required in accident claims handling, including negotiations with repair workshops to assess and control repair costs and obtaining approval from the Assistant Manager – Motor Claims.
- Support when required in reviewing agency repair costs to ensure proper assessment, validation, and cost control for repairs conducted at authorized dealerships.
- Support when required in total loss cases by discussing and agreeing compensation amounts with customers in coordination with the Assistant Manager – Motor Claims.
- Support when required in monitoring repair quality to ensure high service standards and customer satisfaction with approved repairers.
Backlogs:
- Arrange to take action under the guidance of the Assistant Manager (Motor Claims) for any backlogs
Reports:
- Provide Management with appropriate reports regarding the unit and compliance with operational policy and procedures.
RELEVANT CERTIFICATIONS : Preferred Professional certifications: Certificate in Insurance (CII), Associate in Risk Management (ARM), Associate or Diploma in Chartered Insurance Institute (Dip CII or ACII), Associate in Insurance Services (AIS), Fellow Insurance Institute of India (FIII)
YEARS & NATURE OF EXPERIENCE : Requires 4 to 6 years of relevant experience
LANGUAGE REQUIREMENTS : Full Professional Proficiency in English and Arabic language
