Claims Specialist - eFinancialCareers : Job Details

PURPOSE OF THE POSITION

• To manage claims across all IP products by balancing the need for making sound commercial decisions with treating customers so that our brand reputation is enhanced with our customers
• To manage risk within the IP Claims team and the broader company by ensuring regulatory compliance and by offering the best service which will generate and retain business
• To reinforce TCF and the company Brand by ensuring KPI and SLA performance is achieved and maintained, and that team members live the values of our vision and purpose, to act as a role model.

KEY RESPONSIBILITIES

• To assess and authorise IP claims in an accurate and timely manner in accordance with policy terms and conditions, claims procedures and claim’s philosophy. Developing core capability to assess, approve and process IP Claims
• To review ongoing claims with appropriate referrals and make recommendations for management plans
• To liaise effectively with medical professionals, intermediaries, and internal and external customers
• To provide support and guidance to customers in relation to claims; both the large majority that are successful and in the small minority where it is necessary to decline the claim
• To source and arrange independent assessments, treatments, home visits and private investigators in conjunction with current claims management policy
• To have regular contact with policyholders via the Health Claims Advisory Service to build relationships and assist with a smooth and uneventful return to work
• To write confidential correspondence to medical professionals, financial advisors, policyholders, reassurers, employers, and suppliers where appropriate, ensuring that urgent issues are brought to the attention of the Manager
• To research and keep up to date with developments in the industry and initiatives in claims management
• To assist with the development of the claims philosophy, service, systems, and procedures
• To understand the relevant financial regulators Principle based Regulation and to report any failures/potential risks to the manager immediately.