Claims Executive / Claims Senior Executive

Claims Executive / Claims Senior Executive

The RHB Banking Group is a leading multinational financial services group in Malaysia, with a presence in ten countries. It offers integrated banking, insurance, and investment services through its subsidiaries.

Job Responsibilities

• Ensure the claim is registered and adequacy of reserve provision.
• Appoint Adjusters or Solicitors on a case-by-case basis.
• Closely monitor submission of the Adjuster report in accordance with internal / external guidelines.
• Attend incoming phone calls and emails from customers, agents, solicitors, and internal parties.
• Monitor fraud elements and adjuster irregularities while processing claims and inform the direct superior for further action.
• Verify, assess, approve and authorize payment promptly for all claims within authority; for claims exceeding authority, recommend and submit to Unit Head / Head, BA / FA for consideration in order to meet Customer Service objectives.
• Ensure all recovery cases are actively pursued, monitored, updated and reported to the Unit Head / Head, BA / FA on a monthly basis.
• Provide guidance and direction to subordinates, branches and customers in relation to technical claims matters to enhance customer service standards.
• Refer immediately any complaints received from customers, BNM, PIAM, OFS or branches to Unit Head / HOD for prompt and effective resolution.
• Monitor and review files at least once a year.
• Ensure each claim and potential claim are adequately reserved.
• Bring to the attention of Unit Head / Head, BA / FA any claims suspected of fraud elements or violation of policy conditions before repudiation.
• Submit all necessary advices to Treaty Reinsurers / XOL as required and in accordance with the Reinsurance Agreement.
• Ensure adherence to all laws, regulations and BNM Policy Document on Claims Settlement Practices (CSP PD) dated 1st July 2024.
• Carry out duties and functions as and when required or instructed by Unit Head / Head, BA / FA / Management.

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