Job Summary To assess and manage a portfolio of retail lump sum claims in accordance with the policy conditions, company procedures, service standards and relevant Qualifications Experience in a claims assessor role (either disability or lump sum claims management) DFP/ANZIIF qualifications highly regarded Familiarity with all risk products, including corporate superannuation Formal training in aspects of financial claims assessment and training in medical terminology or allied health/medical based course Job Accountabilities↵ Manage the claims process and stakeholder engagement from assessment to determination Review information provided and the application for insurance to determine non-disclosure or fraud Review the policy to determine type, validity, date risk commencement, quantum of insured benefit and whether the claim is payable Analyse information provided to make a determination in respect of the claim and an appropriate strategy for managing the claim Review re-insurance information to determine percentage of re-insurance on claim and communicate with reinsurer prior to determination on the claim Complete claims management templates for each claim and proactively communicate progress with internal and external stakeholders Identify and instruct external medical, legal, vocational and forensic vendors to act on Zurich’s behalf Maintain files notes of actions taken, and conversations had, in respect of claims and data entry on various systems including Excel, Independent Management Plans, Life 3, Access date bases Seek advice and recommendations of the Claims Manager or Senior Claims Assessors Refer matters to Zurich underwriters and re-insurance underwriters where non-disclosure or misrepresentation is detected during claims assessment Report claims to, and liaise with re-insurers on the management strategy for each claim Prepare and present declined claims briefs for consideration by the Claims Review Committee Manage the workload of a portfolio of claims and effectively ensure efficient use of time Business Accountabilities To provide a level of service that meets or exceeds the minimum standards by taking a proactive, flexible and considered approach towards managing the claims process without compromising the position of Zurich as the insurer. Maintain a professional and consistent approach towards all assessments, whilst operating within the authority levels and procedural guidelines. Possess a practical understanding of how processes and systems in Life Claims relate to the management of risk and compliance. Provide feedback and recommendations for improvement of Life Claims processes and systems. Respond to and resolve life claims enquiries and problems within authority, to provide an effective service and clear advice to colleagues and customers. Oversee life claims processing completed by more junior colleagues to ensure information is recorded in a timely and accurate manner. Answer queries from across the business related to Life Claims within authority. You are the heart & soul of Zurich! Together we are committed to delivering on our purpose - Let’s Create a Brighter Future Together! We highly value the experience and know-how of our employees and offer a wide range of opportunities across business areas. You can expect to work on challenges that will help you grow and to collaborate with a diverse and inclusive team. People are Zurich’s most important asset. Their varied skills, perspectives and experiences drive innovation. And they reflect the breadth and diversity of our customers, suppliers, communities and investors around the world. We are committed to attracting and retaining talented individuals from a variety of backgrounds and experiences. Zurich does not discriminate based on race, ethnicity, religion, national origin, sex, gender expression, gender identity, genetic information, age, disability, protected veteran status, marital status, sexual orientation, pregnancy or other characteristics protected by applicable law. Location(s): AU - Sydney Remote working: No Schedule: Full Time Recruiter name: Nicole Pemberton Closing date:
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