Income Protection Claims Assessor

Role title: Income Protection Claims Assessor – Home Based

Location: UK National role

Salary: Circa £37k

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 brand reputation is enhanced with 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 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 claims 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

Financial Crime

• Ensure compliance with regulation and legislation surrounding fraud by reportingsuspicion of fraud to your Manager and / or Compliance, including, but not limited to, contrived claims (working and claiming), induced claims, application fraud and internal fraud.
• Ensure compliance with regulation and legislation surrounding Anti-Money Laundering (AML) by submitting (role dependant) a Suspicious Transaction Report (STR) when a financial transaction takes place as a result of financial crime, including fraud. This should include payments made to claimants in cases where have established that fraud has been committed.
• Ensure compliance with the Insurance Fraud Register (IFR) process by reporting cases of established fraud to (appropriate IP Claims Employee / Compliance) who will then report it to Compliance / the IFR, if sufficient evidence exists and is available to support such a report.
• Ensure compliance with the Bribery Act 2010 by reporting suspicion of bribery and corruption, which in some cases, depending on the circumstances, may include the giving of, or receiving of gifts and hospitality.
• Ensure the accurate collation and recording of evidence related to any instances of financial crime.

THEIR RESPONSIBILITIES

• Adherence to the relevant regulators principles and rules, including Treating Customers Fairly, and the company’s risk management policies

• Ensure compliance with regulations and procedures as laid down by the FCA by maintaining an up to date knowledge and training (CPD) record

• Promote the company’s core values and behaviours always
• Take care of own health and safety and that of others in the workplace

INDIVIDUAL CONDUCT RULES

• You must act with integrity
• You must act with due skill, care and diligence
• You must be open and cooperative with the FCA, the PRA and other regulators
• You must pay due regard to the interests of customers and treat them fairly
• You must observe proper standards of market conduct

EXPERIENCE AND QUALIFICATIONS

• Claim business processes including policy cover, financial/medical underwriting criteria and conflict handling
• Insurance industry knowledge
• Understanding of the financial advisor market and how it interacts with the company’s products
• Sound IT skills
• Must have the right to work in the UK

PERSON PROFILE

• Excellent customer service skills
• Excellent organisation and prioritisation skills
• Effective communication skills, both oral and written
• Good interpersonal skills and ability to deal with difficult customers
• Good team player, building relationships that are open and constructive
• Ability to think proactively, plan, organise and prioritise own workload
• Good solution finding, analytical and decision-making skills
• Excellent I.T skills including Microsoft Office
• A desire to grow and develop in a challenging and progressive environment, including a willingness to study for and take relevant examinations
• A commitment to developing the role in line with the growth of the organisation

For extra information please contact:- 

London: 0203 411 8430

Email: admin@lawesgroup.co.uk