Senior Manager, Customer Promise – Investigation and Technical Claims

Kuala Lumpur
Tetap
Sepenuh masa

1 bulan lepas

Prudential’s purpose is to be partners for every life and protectors for every future. Our purpose encourages everything we do by creating a culture in which diversity is celebrated and inclusion assured, for our people, customers, and partners. We provide a platform for our people to do their best work and make an impact to the business, and we support our people’s career ambitions. We pledge to make Prudential a place where you can Connect, Grow, and Succeed.Job Summary:
The incumbent is responsible for managing Claims Investigations, legal, litigation claims, jumbo claims, reinsurer management and deliver end to end Customer Journey and provide exceptional PRUexperience Service to our customers, fulfill the Claims Philosophy by ensuring that all claims are resolved quickly, pay valid claims quickly with compassion and care making it simple and easy without unnecessary requirements, to practice the company core values in all dealings and promote the company brand in their vision and mission of providing financial freedom and peace of mind for all Malaysians.PRINCIPAL DUTIES & RESPONSIBILITIES:1. Customer & Claims Management related to Investigations/ Legal/ Litigation/Jumbo claims

To support Major claims team on complex and large claims, engaging with reinsurers and external parties for a fast resolution.
To coordinate and assist to resolve urgently all escalation via CRM/emails, enquiries and complaints from all channels or customer.
To collaborate with all stakeholders internally, focusing on resolving Customers’ requests without delay.
To support on technical knowledge to the claims team where required for a quick resolution.
To manage Customers’ sentiments with Compassion and Care along the Claims episode and keep customers informed on the progress of their Claims.
To engage with internal stakeholders through regular meetings on outstanding and complex issues for a quick resolution.

2. Claims Investigations

To lead and support in investigation of suspicious, early and fraudulent claims, engaging with team members to efficiently manage investigation for a fast resolution.
To build an effective investigation management.
To drive fast investigation outcome for a quick resolution.
To provide technical support to team as well as other stakeholders on non-disclosure, fraudulent cases and covered/non-covered conditions.
To partake in activities to curb claims loss ratio.
To provide exceptional customers’ experience during their moment of truth while ensuring that we are in full compliance of Company’s governance and best practices, local regulations and Group’s standards and guidelines.

3. Litigation, Regulatory

To support and effectively manage all litigation cases through active follow-up and meet datelines.
To collaborate closely with all stakeholders i.e internal and external in handling of litigation cases and in preparation for trial.
To support and manage Ombudsman for Major claims by ensuring active follow-up and resolution to meet datelines.
To support by providing updates to regulatory i.e BNM, LIAM, PCA as and when required.

4. Risk Management

To support risk management through analysis and build strategy to manage risk and loss ratio such as fraud strategy, fraud, waste and abuse, etc (implement, monitor & control).
Work with reinsurers on sharing of claims investigation and legal fees related to claims where are ceded.

5. Others

To lead & drive Claim Committee Meeting discussing cases which requires CCM approval or notification striving to achieve consensus for all such cases.
To conduct Quality Review, identify areas for improvement, Training and Education and to review Quality Review SOP.
To support in Service Level, Training and Review when required.
To engage in People Development – HR participation.

JOB SPECIFICATION:
1. Qualifications

Degree in Biology / Biomedical Science / Business Administration / Mathematics / Economics / Statistics and/or a professional life insurance qualification eg. ACII, AMII, AAII, FLMI

2. Experience§ Minimum 10 years experience in Claims including 5 years at managerial level in life insurance claims administration
§ Extensive experience in all areas of claims with focus on Major Claims3. Knowledge

Excellent command in English language, both verbal and written
Strong conceptual and analytical skills
Strong technical skills in claims management
Knowledge on laws & regulations governing the insurance industry is highly essential
Able to multi-task and manage changing priorities effectively
Able to manage diverse relationships
Able to work with different stakeholders

Prudential is an equal opportunity employer. We provide equality of opportunity of benefits for all who apply and who perform work for our organisation irrespective of sex, race, age, ethnic origin, educational, social and cultural background, marital status, pregnancy and maternity, religion or belief, disability or part-time / fixed-term work, or any other status protected by applicable law. We encourage the same standards from our recruitment and third-party suppliers taking into account the context of grade, job and location. We also allow for reasonable adjustments to support people with individual physical or mental health requirements.

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