Job Description
Role Profile: Claims Examiner Level 2 (complex / high value claims)
Location: Kuala Lumpur, Malaysia
Reports to: Claims Manager
Organization: Chubb Business Services Malaysia (CBSM)
Role Purpose
Manage complex or high-value claims for Australia region within CBSM, ensuring accurate assessment, resolution, and service delivery in line with Chubb standards. The role balances technical expertise and service excellence to meet TAT, productivity, and quality targets while supporting brokers, customers, and regional claims teams. A key accountability is to ensure claims decisions and communication quality enhance customer experience outcomes, contributing to positive NPS performance for both declined and paid claims.
Key Responsibilities
- Claims Assessment & Quality
▪ Review and assess complex claims end-to-end from coverage evaluation to settlement.
▪ Validate documentation, apply policy terms, and determine liability and quantum.
▪ Maintain accurate reserving and update claim systems in real time.
▪ Prepare formal correspondence including requests for information and settlement offers.
▪ Ensure claims outcomes and communication quality contribute positively to customer experience metrics,
including NPS results for declined and paid claims.
▪ Ensure claims decisions are well-documented and supported by clear rationale2. Stakeholder Engagement & Negotiation
▪ Negotiate fair and timely settlements with claimants and brokers.
▪ Collaborate with underwriters, regional claims, and CBSM operations to align on claim strategy and
service standards.
▪ Provide technical support and coaching to junior examiners and assist in complex case discussions.
▪ Maintain strong professional relationships to reinforce market confidence and service reputation.
▪ Ensure adherence to Chubb policies, governance requirements, and regulatory obligations.
▪ Maintain audit-ready records and accurate system entries.
▪ Identify and report potential fraud or risk issues promptly.
▪ Support internal and external audit reviews as required.
- Continuous Improvement & Development
▪ Recommend and participate in process and automation improvements to enhance claims efficiency.
▪ Contribute to CBSM and regional claims transformation initiatives.
▪ Maintain technical competence through learning and training programs.
▪ Share knowledge and best practice to improve overall team performance.
Qualifications
Qualifications & Experience
▪ 3–5 years experience in claims management or assessment within insurance operations.
▪ Proven technical expertise in claims evaluation, investigation, and settlement.
▪ Proficiency in commercial insurance claims applications (e.g., policy administration, workflow, CRM).
▪ Strong negotiation, communication, and stakeholder management skills.
▪ Demonstrated ability to deliver accuracy, TAT, and quality within governed frameworks.
Core Competencies
▪ Technical Expertise: Applies advanced claims knowledge to complex cases.
▪ Analytical Judgment: Evaluates facts and policy terms to make sound decisions.
▪ Operational Excellence: Drives accuracy, timeliness, and compliance in execution.
▪ Collaboration: Partners effectively with stakeholders across functions and markets.
▪ Customer Focus: Balances technical decisions with professional communication.
▪ Accountability: Owns results and ensures delivery against CBSM service standards
