商业D&O及交易责任高级理赔理算师

Job Description Are you looking for your next opportunity? Sompo has a unique opportunity for a Senior Claims Adjuster, Commercial D&O and Transactional Liability in our Claims team. The role involves evaluating and processing claims estimates and paid claims accurately and in a timely manner, in accordance with policy terms and conditions, to ensure the appropriate level of service is delivered and the company’s contractual obligations are met at all times. It also requires the use of analytics and insights to drive continuous improvement in the use of TPAs and third-party experts. In carrying out these responsibilities, the role holder is expected to ensure that our Sompo Values are consistently reflected in the delivery and performance of the role. Location: This position will be based out of our London office. We strive for collaboration which is why we offer a work environment where our employees thrive and develop long lasting careers. Our business, your impact, our opportunity: What you’ll be doing: Key Result Areas Contribute to, monitors and advises on the plan developments and changes in order to ensure relevancy, compliance and optimal delivery Assist in the preparation and implementation of the operational team plans to ensure these are in line with wider business strategy and reflect key priorities. Determine own work priorities and activities in line with agreed plans to ensure the achievement of the function’s objectives. Partner with colleagues to perform data analysis work and provide valuable insights that improve claims performance Key Performance Indicators Benchmarking of delivery to plan objectives Management team feedback Alignment, and engagement of team to tactical goals Relevancy, accuracy and timeliness of contribution/advice Priorities aligned to tactical and wider strategic plans Insights drive performance improvement Risk mitigation & avoidance Policy, Process and Procedures Support the implementation of the Claims strategy to enable delivery of overall business targets Investigate and resolve complex Claims of a specialist nature in a professional manner in order to provide excellent Claims handling service with minimal leakage Proactively manage estimates and billings calculated by clients and brokers resolving any discrepancies in a timely manner Identify and investigate coverage issues so as to ensure that the company’s liability is in line with its contractual commitments and to communicate with relevant stakeholders Identify subrogation, contribution and other recovery issues and ensure that these are successfully pursued where appropriate Manage disputed Claims and other material Claims issues in order to resolve and settle claims on an economic basis Ensure Claims files are compiled and maintained in a logical and accessible manner and that coverage and/or other Claims issues are clearly documented at all times Ensure awareness of and compliance with regulatory and legislative requirements Key Performance Indicators High quality documentation/training material produced, with appropriate rationale Claims leakage within agreed tolerance Positive feedback from internal customers Satisfactory results from internal Claims audit and other, indirect financial benefits, such as efficient, cost effective use of internal and external resources and services All appropriate recoveries successfully pursued Environmental Awareness / Customer Focus Support the development of relationships with internal and external customers to enable the Claims function to fully support their needs Support the development of relationships with the Underwriters to enable the Claims function to support the needs of other areas within the business Ensure that Claims billings and advices are responded to within agreed timeframes to provide a professional service to brokers, and clients Ensure that base premiums have been received a before making Claim payments Where appropriate, ensure reinstatement premiums have been correctly calculated when making Claim payments Respond to internal and external stakeholder requests in accordance with service standards Key Performance Indicators Legal compliance Positive stakeholder feedback. Risk mitigation and avoidance Open and regular communication. Achievement of objectives. Quality response service provided. Positive feedback from clients, brokers, internal customers and management Relevant and accurate information and reports Technical Performance Support the claims management and claims operations colleagues in the production of Management Information reports Produce regular statistical and analytical Claims information to Claims Leadership, Risk Managers and Senior Management to enable effective monitoring of Claims Develop/maintain sufficient knowledge of Claims portfolio, so as to ensure delivery of accurate information to Underwriters and management when requested Ensure accurate and timely update of the company’s systems as and when required Act as a referral point to other members of the Claims team on specific tasks or in the absence of the Professional Indemnity & Management Liability Claims Manager or Professional Indemnity & Management Liability Technical Lead. Key Performance Indicators Quality, accurate information made available to Underwriters and external and internal customers Satisfactory audit from internal claims audit Leakage within agreed tolerance Claims reserves entered and coverage issues managed in accordance with Company claims philosophy Appropriate use of experts Management of static/slow moving claims Specific accountabilities assigned to the role of Senior Claims Adjuster within the claims function: Management of complex and disputed claims matters, including in-depth claims analysis and trends to provide expert guidance and/or opinion to the Portfolio Head and other internal stakeholders, as required. Developing good, constructive working relationships with the claims leadership team, wider claims team, market peers and wider Aspen business units Engagement and delivery of claims projects, where required. Lead continuous improvement initiatives via process and/or technology change – that will enhance quality of communication and collaboration across Aspen. Provide mentoring and career development to colleagues to strengthen their capabilities, build functional expertise and foster a collaborative, values-driven team culture of high standards, strong productivity, and innovation. Elevate claims talent to develop and share knowledge with the intention of enhancing both technical (e.g. data analysis and critical judgement) and non-technical (relationship management) skills. What you’ll bring: Knowledge Extensive and relevant knowledge of technical claims handling in a claims function, operating in a highly regulated environment. Strong understanding of delegated and third-party claims management from a technical, commercial, and operational perspective. Skills Strong interpersonal and communication skills. Good organisational skills. Able to work independently. Proficient in MS Office applications; Word, Excel and Powerpoint. Able to manage conflicting priorities to achieve deadlines. Ability to plan effectively and efficiently. Strong customer orientation skills. Ability to collaborate effectively within a team environment. Strong attention to detail. Strong Investigative skills Negotiation skills Able to produce MI and detailed reports at various levels Experience Experience and a proven track record of working in a Claims environment within a specialized/complex Claims area Recognised qualification(s) and/or good practical knowledge of the insurance regulatory framework Relevant commercial experience of the general insurance industry and claims trends to be able to provide expert advice and opinion where required. Desirable personal attributes aligned to what success looks like in the role: Independent challenger - ability to innovate and challenge, utilisin