Insurance Claims Assessor

Job Description for Insurance Claims Assessor

An Insurance Claims Assessor plays a crucial role in evaluating and processing insurance claims submitted by policyholders. They are responsible for reviewing claim details, investigating the validity of claims, and determining the coverage provided under the policy. Their primary goal is to ensure fair and timely settlement of claims while preventing fraud or misinterpretations.

Key Responsibilities

• Review insurance claims submitted by policyholders accurately.
• Investigate and gather relevant information to verify the validity of the claims.
• Assess the extent of coverage provided under the insurance policy.
• Communicate with policyholders, witnesses, and other relevant parties.
• Ensure compliance with insurance regulations and company policies.
• Evaluate the extent of damages or losses to determine claim settlements.
• Negotiate settlements with claimants or their representatives.
• Document all claim activities, decisions, and payments accurately.
• Provide recommendations for claim approvals or denials based on findings.
• Participate in ongoing training and development programs to stay updated on insurance trends.

Qualifications

• Bachelor's degree in Business Administration, Insurance, or related field.
• Proven experience in insurance claims assessment or similar role.
• Excellent analytical and decision-making skills.
• Strong knowledge of insurance policies, regulations, and procedures.
• Effective communication and interpersonal abilities.