About the Role:
Responsible for assessing and processing Personal Accident (PA) insurance claims accurately and efficiently while ensuring compliance with policy terms, service standards, and regulatory requirements.
Roles and Responsibilities:
- Assess and process Personal Accident (PA) insurance claims according to policy terms, guidelines, and approved authority limits.
- Verify completeness and validity of claim documents, ensuring accuracy and compliance with PA coverage requirements.
- Maintain quality and consistency of claim decisions while meeting departmental turnaround time (TAT) and service standards.
- Prepare and submit daily operational reports and other departmental reports on time.
- Participate and support process improvement initiatives, including workflow enhancement and Customer Journey Mapping.
- Ensure compliance with regulatory requirements, internal policies, audit recommendations, and risk management practices.
- Handle enquiries and complaints related to PA claims promptly and professionally across all channels.
- Perform any other tasks as assigned by the Supervisor/HOD to support operational and business needs.
Minimum Requirements:
- Possess a tertiary qualification preferably in Biomedical Science, Health Science, Biology, Insurance etc.
- Preferably with 2-3 years life claim processing working experience in Life /General Insurance Industry or any of the Insurance Certification e.g. LOMA certificate, FLMI, ICA, AII, ACII, AMII, STPM.
- Knowledge in Personal Accident claim processing or adjudicating background will be an advantage.
- Fresh graduate is welcome to apply.
