Claims Adjuster - Accident & Health in City of London

Role Purpose

To assess and evaluate the recoverability of all Accident & Health and Travel claims on policies underwritten by the Company whilst operating in line with the claims procedure guidelines and general compliance/regulatory and Company procedures.

• Handle claims in line with Starr and Lloyd’s Minimum Standards and your letter of authority;
• Process Electronic Claim Files (ECF) and Settle Direct claims via DOCOsoft and in line with Starr and Lloyd’s Minimum Standards;
• Effective management of Claims outcomes, including reporting to and sign off by the Claims Manager and or Senior Claims Adjuster, where appropriate;
• Produce timely and accurate large loss forms for Senior Management’s review.
• Attend client meetings with Underwriters and/or Claims Managers (UK or internationally) in order to provide specific claims handling expertise or relationship management for the account;
• Ensure Coverholder / Delegated Claims Administrators (DCA’s) submissions are processed on time and are compliant with the Service Level Agreement and adhering to Starr standards through review and approval of claims in excess of delegated authority;
• Ensure the DOCOsoft workflow, including diaries, are proactively managed and claims recorded accurately. Ensure all relevant documentation is attached to each transaction and use comprehensive notes, outlining the current status and next steps, in order to enhance claims outcomes and reduce static claims;
• Reviewing loss fund adequacy and pursue recovery of loss funds on prior years where appropriate;
• Assist CST where required to ensure that claims errors/warnings for Syndicate Claims Messages (SCMs) and Underwriter Settlement Messages (USMs) are cleared by each month end;
• Assist CST where required to ensure that claims errors/warnings for LIMCLM are cleared by each month end;
• Monitor and manage ECF/Lirma incompletes;
• Produce ad-hoc claims reports and statistical support to Claims Managers and Underwriters as required.

Experience Required

3-5 years relevant claims experience; Knowledge of specific line of business.