Key Objectives

To manage and maintain own caseload within agreed authority limits and in accordance with published SLA’s.
To achieve this working within a team, lending support to other members wherever possible.

Duties:

• Behavioural and linguistics analysis, utilising conversation management and cognitive interviewing techniques.
• Claims Handling – ensuring the claims process follows the FSA guidelines, and the claim is consistent with the policy conditions/limits.
• Investigation of claims involving obtaining information from the policyholder against information obtained during the fraud screening process and that subsequently provided by engineers/inspectors.
• Compiling through reports for the client following investigations.
• Customer Service; often dealing with difficult policy holders in a confident and authoritive, yet professional and empathetic manner.
• Instructing suppliers matching the specifications of the claim and the client, and undertaking follow-up enquiries with the suppliers.
• Data Entry (imputing new claims, updating notes and figures etc)
• Calculation of cash settlements, applying depreciation deductions where appropriate.

Skill-set Requirements

• Microsoft Outlook intermediate level
• Microsoft Word Intermediate level
• Microsoft Excel Intermediate level

Soft Skill Requirements

• Insurance Background is an advantage
• Excellent Telephone Manner

• Implementation of validation and replacement process for jewellery claims.
• Validation of British jewellery in 9ct, 18ct, silver metal, fashion jewellery, branded watches.
• Maintain paper files and process database

Dimensions of Job

• Liaise with principals their agents, policyholders and appropriate jewellery distributors, manufacturers and suppliers.
• Dialogue with colleagues in arriving at correct solution to various situations.

Contacts

• Internal: Team members, Team Leader, Jewellery Consultant,
• External: Insurers claims staff, Insurers Agents Loss Adjusters or Claims Staff. Policyholders, manufacturers and suppliers.

Main Accountabilities

1. Monitoring incoming referrals by fax, post and email.
2. Allocation of daily mail receipts to file for prompt action. Check referrals and correspondence for duplication, correctness and attachments, Address etc
3. Monitoring telephone enquiries from insurers, policyholders, suppliers etc.
4. Preparing main file and initial notes and comments for Triage.
5. Following Triage, and receipt of additional documents, detailed discussion with policyholder on specific detail for each item, identification of each item and agreement on subsequent action following cost validation or further report if required.
6. Validation of jewellery and confirmation of current replacement costs and referral of items for further validation advice if and when they fall outside technical range.
7. Confirmation to policyholder of validated details with explanation as to how this has been arrived at, confirmation and agreement of recommended replacement arrangements.
8. Preparation of correspondence with confirmation to policyholder of agreed action, replacement instructions to selected suppliers and final reports to insurers.
9. Monitor diary system and action pending files
10. Ensuring file and database entries are correctly updated.

Validation, Costs and Process Protectors:

1. Confirmation of appropriate values from current and relevant documents, price lists jewellery consultant and trade sources.
2. Maintain status on open and pending files.
3. Dialogue with suppliers as to methodology used, understanding of current pricing trends and access to published confidential trade lists and memoranda, when discussing specific estimates, valuations and quotations submitted.
4. By clear explanation of pricing methodology, confirming access to confidential trade prices, sources and current trends correct management of policyholder expectations is possible.
5.  Negotiation of correct replacement, delivery and costs with suppliers.
6. Providing policyholder with replacement details, supplier, delivery and time constraints.
7. Clarification of material points and issues with policyholders, insurers or their agents.
8. Referring and discussing problems on validation with jewellery consultant, complaints or other points requiring clarification to Team Leader, colleagues, or management.