Claims Management
- Description
- Tasks
- Skills
- Useful Knowledge
- Entry Qualifications
- Professional Qualifications
- Trends
- Resources
When an individual or business needs to claim against their insurance policy, the claims management team have to fulfil the promise to pay valid claims to the policyholder. It is far from just authorising a cheque to be sent out. Your work may involve co-ordinating builders to make homes safe and liveable again following an incident, organising for replacement electrical and white goods to be dispatched immediately if a policyholder has been the victim of a burglary, or arranging for an engineer to assess damage after a road accident. You may also be involved in high drama cases such when a bridge falls down, when a tsunami strikes or a nuclear station erupts. The service you provide has to be efficient, empathetic, personal, professional and live up to the brand promise of why customers first chose your insurance company to place their business with. As well as gathering information from the claimant, claims management professionals, may also need to liaise with experts such as loss adjusters, who investigate the loss, and sometimes lawyers, to define and negotiate a fair settlement. You may become involved in legal discussions about the recovery of money paid out by insurers from the responsible party causing the loss. You may also be involved in loss adjusting activities, particularly if working in commercial insurance.
Salary
Entry level positions, such as a trainee claims handler, start at approximately £14,000 per annum. With the right experience, qualifications and skills you could progress to management roles and earn in excess of £50,000 per annum. This does not include potential bonuses or additional benefits. Salaries will vary considerably based on location and employer.
- Processing new insurance claims notifications, recording details accurately
- Obtaining accurate and complete information to proceed with the claim, resolving any queries
- Identifying any reasons why full settlement may not be made and notifying the customer of these
- Giving clear guidance to customers on any necessary loss mitigation and actions they need to take to proceed with the claim
- Obtaining any information and/or documentation required to support the claim
- Advising the customer of any specialists involved with the claim, where appropriate
- Constantly monitoring the progress of the claim and dealing with any delays
- Handling problems or complaints associated with the claim in accordance with your organisation’s procedures
- Arranging for settlement of the claim
- Taking appropriate action where fraud, or potential fraud is suspected
- Compliance with legal requirements, industry regulations, organisational policies and professional codes
- Offer guidance which will provide the best outcome for the customer, given legal principles, loss mitigation and prospects of recovery
- Ensure the claim is formulated and submitted to the third party correctly
- Negotiate settlement of the claim in the best interests of your customer and your organisation
- Loss adjusting duties (see Loss Adjusting Profile)
- Exceptional written and verbal communication skills, including report writing
- Strong customer service ethic
- Empathy, fairness and consistency
- Integrity and ethical
- Efficiency
- Professional manner and respectful
- Attention to detail
- Administration and IT user skills
- Methodical and organised
- Flexibility
A new entrant will not always be required to have this knowledge. Employers usually provide training to acquire skills for:
- Good knowledge of claims policies and procedures
- An understanding of the loss adjustment process
- Broad knowledge of the position of claims in the insurance industry
- How to recognise potentially false or fraudulent claims
Working in claims management requires an understanding of numbers and the ability to communicate with customers verbally and in a written format, so English and maths are important. General office administrative experience can be a good route in to an entry level position.
In order to gain an entry level position, employers will look for people who have:
- A Levels, Scottish Highers or equivalent qualifications such as Business, Administration and Finance (BAF) Diploma, BTEC National Diploma, Welsh Baccalaureate (BAC), SVQ Level 3 or Higher National Certificate (SCQF Level 7)
For people without experience or prior knowledge, the Foundation Insurance Test (FIT) Award offered by the Chartered Insurance Institute (CII) is a single unit course which requires the candidate to pass a multiple-choice style test which can then lead on to further professional qualifications.
Apprenticeships can be a useful way to gain entry and to progress on in the profession:
- Level 2 Apprenticeship in Providing Financial Services, General Insurance pathway (England, Wales, Scotland and Northern Ireland)
- Level 3 Apprenticeship in Providing Financial Services, General Insurance pathway (England, Wales, Scotland and Northern Ireland)
Professional qualifications undertaken depend on employers and personal abilities, but quite often start at the Certificate level:
- Cert Chartered Institute of Loss Adjusters (CILA) Claims
- CII Level 3 Certificate in Insurance
- CII Diploma in Insurance
- CII Advanced Diploma in Insurance
- Associate and Fellow of CILA providing credits towards a Masters degree
Cass Business School / CII also offer an MSc in Insurance and Risk Management.
Claims professionals work within insurance companies, insurance brokers or for claims management or loss adjusting companies. Teams are located in major towns and cities, with regional call centres spread throughout the country. Claims management is a core insurance function and demand for claims people at all levels will continue.
