Roles and Responsibilities

Management and Co-ordination

• Assist the General Manager-Claims in supervision and  Management of the Claims Department
• Supervise the assigned staff within the Claims Department and  ensuring that  the highest quality  of service is rendered to the company and  the staff comply with the company policies and  guidelines
• Be the link between the claims department and  other departments
• Participate in the recruitment and  training  of quality  members of staff in the Claims and Legal departments

• Thorough and  detailed analysis of claim documents to enable early fraud  detection and ensure that  the fraudulent claims are effectively addressed within the company’s policies and  guidelines.
• Maintain a proper and  accurate reserves on claims and  incidents and  ensure that  all Journal vouchers are forwarded to the Accounts department within 24 hours of approving them
• Maintain a proper update of the system data and  documentation of the claims and incidents and  ensure that  the files submitted by the Claims officers or Deputy Claims manager are approved within 24 hours of posting.
• Ensure that  negotiation and  settlement of claims is completed within 30 days from the date of approval and  that  such settlement is within the least amounts possible
• Ensure that  correspondences from the insured, intermediaries, claimants and  their advocates are responded to within 72 hours from the date they are received.
• Ensure that  proper factual and  legal  research required for achievement of the strategy on the claims is conducted
• Engaging with third party  service providers  where  necessary to build evidence on liability, medical injury disputes  etc
• Where execution of court judgements has commenced, to firstly have  our advocates immediately instructed to file the appropriate pleadings and  secondly, deal  with the auctioneers to protect the insured’s interests as well as the business interests of the Company. This has to be done within 24 hours of receipt of the court warrants and  insured updated on the measures taken  and  copies of the warrants availed to the Managing Director, Claims Director and  General Manager-Claims for information and  follow  up.
• Ensure that  recoveries from the insured and  third parties is achieved
• Prepare and  review the relevant claim guidelines and  template documents to conform with the policy and  best practices
• Liaise with the Company’s re-insurers and  provide the requisite documentation to facilitate timely recovery of the recoveries due
• Handle  customer complaints from the insured or intermediaries and  instill confidence in the company’s claim process

• Preparing  reports to the Claims and  Risk Committees on the legal  implications of adopting proposed policies and  strategies on the management of claims
• Preparation of monthly performance reports of the departmental staff
• Preparation of monthly Claim Reports for internal  and  external  use
• Preparing  relevant claim and  incident reports for presentation to the relevant Board Committees.
• Preparing  necessary returns on the Claims portfolio to the Industry Regulators

• Review of the Claims IT system and  workflow and  making recommendations on modification
• Conducting legal  and  other forms of relevant training
• Providing advice on the legal  effects of proposed changes on policy documents and preparing responses to consulting documents
• Review and  approve Company contracts and  agreements and  identifying opportunities for efficiencies and  improvements.
• Monitoring changes in relevant legislation and  the regulatory environment, and  advising the company on the impact of such changes
• Attending court to represent the Company as a witness or any other capacity as may be approved by the Company
• Participate and  offer valuable advice to the Company and  Departmental Committees which you are nominated or elected to
• Represent the Company in meetings with Industry Stake holders and  proving the Company with the requisite reports from such meetings
• Signing the relevant and  authorized documents on behalf of the Company
• Maintain highest level confidentiality concerning the sensitive, strategic and  integral legal and  other information, data, decisions and  developments taking  place at the company.
• Any other duties that  maybe assigned from time to time

• Bachelor of Laws Degree
• Diploma in Law (KSL)
• Admission as an Advocate with a current Practicing Certificate,
• 5 Years Post Admission experience in Litigation, 2 of which must be in a Managerial/Supervisory position
• Diploma in Insurance will be an added advantage