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About the Role

Process incontestable and contestable major claims (e.g. Critical Illness, Total and Permanent Disability, Dismemberment, Death claims)

Roles and Responsibilities:

Major Claims Processing:Handle and settle both incontestable and contestable major claims (e.g., Critical Illness, Total and Permanent Disability, Dismemberment, Death) within the agreed turnaround time (TAT) and in compliance with established procedures and guidelines.
Pending Case Management:Review all pending cases monthly and work towards reducing the pending ratio in line with agreed targets.
OPAT Savings:Monitor closed file reviews and ensure timely provision reversals to achieve operational savings.
Productivity & Accuracy:Meet claims productivity benchmarks within authority limits, delivering work with high accuracy and efficiency.
Stakeholder Communication:Respond promptly to enquiries, calls, and emails from relevant stakeholders-within two (2) business days.
Suspense Case Management:Clear suspense cases within five (5) days from the date the email is received.
Additional Duties:Perform other responsibilities, projects, and special assignments as periodically assigned by the supervisor to meet operational or organizational requirements.

Minimum Job Requirements:

Non-Medical Claims, Assistant Manager/ Manager (Major Claims)

Non-Medical Claims, Consultant