Claims Specialist
Core
Advocating on behalf of clients on life insurance claims (death, TPD, salary continuance, trauma) and negotiating outcomes with insurers.
Role type
Claims Specialist (Life Insurance)
Builds
Claims settlements and client support for group life and income protection policies
Domain
Insurance (Life, TPD, Income Protection)
Deliverable
client delivery
Required skills
Life insurance claims management, policy wording interpretation, claims negotiation, regulatory compliance, complex claims adjudication, claims reporting
Preferred skills
Coaching and mentoring, process improvement
Technologies
WTW systems, Microsoft Office
Responsibilities
Manage a portfolio of group life, TPD and salary continuance claims; Act as key claims advocate between clients and insurers; Review policy wording to assess coverage and advise clients; Negotiate with insurers to resolve declined or disputed claims; Escalate and manage complex matters and complaints; Provide technical support to Claims Administrators and Account Executives; Monitor claims through to settlement and confirm benefit payments; Prepare claims experience reports and insights; Contribute expertise to client renewals and tender responses; Maintain accurate claims records in WTW systems.