Senior Claims Analyst
Turn Protect- Posted 12 days ago
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Job Description
The Claims Analyst, Personal Accident is responsible for managing and processing personal accident insurance claims efficiently and accurately from notification to settlement. This role involves evaluating claims documentation, determining policy coverage and liability, and ensuring prompt and fair claim resolutions in accordance with company policies and Bank Negara Malaysia regulations.
- Process and manage Personal Accident (PA) insurance claims from notification through to settlement
- Review and assess claims documentation to determine coverage, validity, and extent of liability in accordance with policy terms
- Investigate claims thoroughly, including reviewing medical reports, police reports, and supporting documents where applicable
- Evaluate claims and recommend settlement amounts within delegated authority limits
- Liaise with claimants, agents, brokers, medical providers, adjusters, and other stakeholders to facilitate smooth claims handling
- Ensure accurate claims registration, data entry, and reserving in accordance with company guidelines
- Monitor and follow up on outstanding claims to ensure timely resolution and closure within service level agreements (SLAs)
- Identify suspicious or potentially fraudulent claims and escalate for further investigation where necessary
- Maintain accurate and complete claims records, ensuring timely updates in the system
- Ensure compliance with internal policies, audit requirements, and Bank Negara Malaysia's Claims Settlement Practices (Minimum Standards)
- Prepare reports and provide insights on claims trends, turnaround time (TAT), and operational performance
- Provide prompt and professional responses to claims-related queries, ensuring high levels of customer satisfaction
- Perform other duties as assigned from time to time
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About Company
Hello! We're Tune Protect Group of companies - that may sound like a mouthful, but we're all about something simple yet super important: keeping people like you, protected. You know those times when life gets adventurous We want everyone to dive into those moments with confidence, knowing they're covered. Now, here's the exciting part. At Tune Protect, we're all about breaking down the barriers to insurance. We believe that everyone deserves to be safeguarded without the hassle. So, we've made it easy to understand, easy to get, and definitely easy on the wallet. Our motto "Insurance Simplified" says it all. But hold up, we're not just any old insurance crew. We're stepping into the future as a Digital Insurer. What does that mean We're using tech to make insurance a breeze, not a headache. Think of it as insurance for the modern worldâ€"quick, convenient, and tailored to you. And guess what We're not keeping this amazing stuff to ourselves. We're spreading this insurance revolution across not just our backyard but way beyond, all across ASEAN and even more far-flung places. We're not just changing insurance we want to change how people feel about it. Now, here's the part where you come in. If you're looking for a place where you can make a real impact, where innovation is the name of the game, and where your ideas are welcomed with open arms, you're in the right spot. We're not just building a company we're building a family that's in it for the long haul. So, whether you're a tech whiz, a creative guru, a customer service superstar, or anything in between, there's a place for you here. We're all about bringing fresh minds on board to help us shake things up, challenge the norm, and create something extraordinary together. Ready to be a part of a team that's rewriting the rules of insurance Join us at Tune Protect, where protection meets innovation, and your talents are about to shine like never before.