Claims Assessor – Personal Accident
Core
Manage personal accident claims from notification to resolution, assessing coverage, validity, and entitlements while balancing customer needs, policy requirements, and financial considerations.
Role type
Claims Assessor (Personal Accident)
Builds
Fair, timely, and well-reasoned claims outcomes for individuals, families, businesses, and farms.
Domain
Insurance (Personal Accident)
Deliverable
client delivery
Required skills
Claims assessment, policy interpretation, claim strategy development, medical/occupational/financial information review, stakeholder management, risk monitoring, regulatory compliance, claims file management, communication, problem-solving.
Preferred skills
ANZIIF qualification, Diploma of Financial Services, HAS qualification, experience in Workers Compensation or Income Protection.
Responsibilities
Manage a portfolio of Personal Accident claims from lodgement through to finalisation; Assess claim validity, policy coverage, and entitlement based on available information; Develop and maintain claim strategies to support timely progression; Review medical, occupational, and financial information to support sound decisions; Manage investigations and engage with medical practitioners, rehabilitation providers, and investigators; Maintain proactive communication with claimants, brokers, and stakeholders; Accurately manage claim records, payments, reserves, and diary actions; Monitor and manage claim risks, escalating matters when required; Ensure compliance with policy, regulatory, and internal procedure requirements.
Seniority
Mid-level, hands-on IC