To work within the Claims Fraud department. Depending on your entry level, you will deal with combating fraudulent claims presented to the business which vary from third party property damage, credit hire, personal injury and other suspected fraudulent claim matters.
- Investigating potentially fraudulent claims. Fraud types will range from property damage/credit hire cases to LSI & LICs (subject to career level).
- Investigating liability where required, by telephone enquiries, accident report forms, instructing accident investigators, applying for police reports or any other necessary investigations.
- Settle claims in a timely manner, achieving appropriate economic settlements and avoiding financial leakage
- Validation of claim ensuring policy is operational.
- To ensure all work is carried out to a high level of accuracy in line with our documented processes and our company quality and compliance standards.
- To ensure compliance with company and other relevant standards and regulations at all times including Data Protection, FCA and TCF.
- Communicating via telephone (incoming and outbound calls) and written correspondence with policyholder, keeping them updated of all material developments, witnesses, engineers, insurers, solicitors, engineers, third party representatives, medical experts, forensic accountants, rehabilitation providers, case managers, overseas handling agents, investigators, medical agencies, costs draughtsmen, CRU, Counsel, police authorities and third parties in order to bring about resolution of claims.
- Realistic, prudent inputting and prompt updating of claims reserves on to Guidewire claims system.
- To ensure each claim is dealt with in line with company/departmental procedure/philosophy and within service standards through to settlement stage in line with personal authorities.
- Comply with the MOJ, CPR and Pre-Action Protocol when handling personal injury cases in England and Wales.
- Making payments in respect repair accounts, hire accounts, agreed settlement figures in respect of Special and General Damages, agreed solicitors costs, rehabilitation and treatment invoices, own agents fees and own solicitors costs.
- Instructing, under direction from Line Manager or Senior Technical Negotiator or Panel Solicitors where proceedings issued and liaising with the same to progress case to settlement or trial.
- Registering claim with CRU, maintaining up to date Certificates, notifying of settlement, querying any inaccurate benefits and paying any amounts due.
- Ensure that you (and any direct reports) are meeting customers’ fair and reasonable expectations and provide fair outcomes. Question and challenge peers and managers where processes and procedures do not meet these expectations and any activity that does not place customers’ interests at the heart of how we do business.
- Ensure completion of all training as mandated by the company and regulated by the FCA.
This list is neither exclusive nor exhaustive and there may be other duties, within the remit of this position, required of the job holder from time to time. The Company reserves the right to alter this job description and will do so after consultation with the job holder.
Skills Knowledge & Experience
- Excellent problem solving skills
- Ability to identify inconsistencies between various documents/evidence
- Effective communications skills
- Ability to confidently use Microsoft Office Suite
- Ability to effectively manage own workload
- Negotiation skills
- Proven knowledge of Third Party Claims handling
- Proven knowledge of indemnity /liability
- Good understanding of regulatory requirements and company principles.
- Experience using Guidewire Claim Centre
- Proven experience in handling fraudulent claims
- Understanding of the MOJ portal and how to use COA
Hastings Group is an equal opportunities employer which means we treat people fairly. We welcome applications from all suitably skilled persons regardless of their gender, age, race, disability, ethnic background, religion/belief, sexual orientation, gender reassignment or marital/family status. Please also note that we have a thorough referencing process, which includes credit and criminal record checks.