Senior Claims Specialist -Long Tails

Job Purpose / Role： 

The main purpose of this role is to proactively investigate, negotiate and resolve medium-sized claims, involving more complex issues and/or litigation. Ensure claims handled within authority limits, and in line with AGCS Claims Standards procedures and guidelines. Drive third party service providers to achieve economical results and to provide a high quality service to all internal and external customers

Key responsibilities： 

• Claims Processing and Administration 

Input and maintain accurate claims records for designated accounts, within appropriate AGC&S Claims administration systems 

Proactively review late/non-payment of premium and support credit control process with Underwriting / Accounts  

• Investigation and Reserving of Claims 

Investigate domestic and international claims that involve some complex issues and/or litigation - requires qualified legal analysis (in cooperation with legal)

Evaluate and address coverage issues and determine appropriate reserving levels

Select and direct independent external service providers (e.g. Loss Adjusters) and establish and maintain professional relationship with litigation service provider under supervision.    

• Settlement 

Negotiate and resolve medium-sized claims ensuring cost effective, service orientated solutions

Ensure unpursued claims are settled in accordance with settlement guidelines

Drive effective subrogation processes. 

• Referrals and Compliance 

Ensure all claims handled within authority limits, and in line with AGCS Claims procedures and guidelines and Claims litigation management best practices

Refer cases outside of authority level, preparing referral documentation and materials as appropriate

Support establishment of claims management procedures on new business accounts in association with clients, brokers and loss adjusters

Undertake audits of external service providers as appropriate 

• Positively represent AGCS externally to the market 

• Develop and maintain strong relationships with key brokers and clients and other relevant stakeholders.

Key Experience / Requirements / Skills： 

• Specialized understanding of LoB products and portfolio with technical specialist knowledge.  Management of systems 

• Demonstrable, established relationships with brokers at peer group level and established within market 

• Understanding of legal and regulatory framework 

• Experience in working in complex, global matrix organization

Required Education/ Experience： 

• Degree in Economics, Law, or other appropriate discipline Engineering Degree. 

• Law Degree 

• Completion of professional insurance qualifcation (e.g. CII) 

Required General skills： 

• Fluent in English  

• Written and verbal communication skills. 

• Presentation skills in a various internal and external settings 

• Organisational and interpersonal skills 

• Business knowledge and professional disposition 

• A basic understanding of artificial intelligence (AI) and its potential applications in business is essential.