Claims Senior Assessor

Company Description
Life can sometimes be unpredictable, and it pays to plan ahead. Our aim at Legal & General Retail is to help our customers plan for the unexpected, achieve financial security for their tomorrow, and protect everything that's important to them. To better understand our customers and meet their needs, we've brought our protection, retirement income, savings, lending and advice, fintech and mortgage businesses under one umbrella. Created at the start of 2022 through the merging of our long-standing and trusted retail retirement and insurance businesses, we're a fast-growing division with big, customer-centered ambitions.
Job Description
Are you an experienced Critical Illness Claims Assessor? Are you looking to join a team that supports your development and empowers you to make critical decisions regarding your clients? This could be the role for you. A remote position that offers flexibility to suit you!
You will work Monday - Friday with evenings and weekends off to relax and earn a base salary of up to £45,000, dependant on experience.
The purpose of your role is to provide excellent customer service and claims handling through working proactively with Claims Assessors, claimants, medical professionals and 3rd parties to obtain requirements to support claims assessment so that the end-to-end time is minimised and customer satisfaction is maintained.
We love working at Legal and General and know you will too. Here are some of the amazing benefits our colleagues get:

• *You'll have the opportunity to participate in our annual, performance-related bonus scheme (discretionary)
• As your skillset grows, it's possible your earning potential will too.
• 25 days holiday, plus bank holidays, 26 days after 2 years' service. You can also buy and sell holiday.
• Generous pension contribution
• Life assurance x8 of base salary
• Private medical insurance
• Recommend L&G as a great place to work and earn money if someone you know joins us.
• A variety of company share schemes, discounts at a huge range of high street stores and on our own products.

What you'll be doing;

• Gather appropriate evidence and medically assess information in order to accept or decline claims displaying logical reasoning, including complex and contentious claims, or sensitive such as those involving fraud, overseas issues, litigation or the prospect of litigation, liaising with Managers, GFC and legal services so that the claim is effectively resolved and decisions made are fair and Legal and General does not suffer unnecessary financial loss or reputational loss.
• Ensure quality and consistency across the area is maintained by completing and managing claim tasks in conjunction withbest practice and claims guide.
• Take ownership and of maintaining an excellent knowledge and understanding of legislative and regulatory requirements, e.g. breach knowledge and adherence to L&G Company Policy and Procedures, including following L&G TCF policy, to minimise risk to L&G and its customers.
• Communicate with internal, external customers and third parties in a professional and efficient manner ensuring customer satisfaction is maximised and expectations met by obtaining and giving the correct information and keeping them fully informed of progress, so that unnecessary incoming contact is minimised .Utilise the most appropriate method of contact whilst providing a positive impression of Legal and General.
• Identify appeals and complaints and take ownership for trying to resolve them with urgency, so that complaints are acted upon quickly, root causes are escalated and customer satisfaction is achieved. Where it is not possible to resolve, pass complaint to authorised complaint handler without delay to ensure compliance with complaints response time limits.
• Support the management team by providing ongoing training, coaching, feedback and technical support to team members, contributing fully to claims projects and identifying issues and recommending solutions for potential improvement to enhance the service given to claims customers to help ensure products continue to meet customers' needs and claims are dealt with in a timely, efficient and competent way.
• Gain understanding of industry and customer expectations of Claims Products and service. Use this knowledge to challenge existing work practices in an appropriate way by identifying and taking steps to improve service through liaising with team managers or other colleagues, and recording accurate Management Information regarding the claims experience so that service, processes and products are continually maintained or improved.
• Treating Customers Fairly (TCF)
• Apply the TCF principles when dealing with customers, clearly outlining the Claims journey to ensure expectations are managed and customer satisfaction is achieved.

Qualifications

Understanding of Claims Philosophy

Thorough understanding of ABI guidelines for misrepresentation and treating customers fairly and the ability to apply this approach to ensure correct claims outcomes.

Knowledge of legal aspects pertaining to claims, eg probate CIDRA

Claims Administration System (claim specific)

Extensive knowledge of the full claims processes, customer journey and different Claim events

Knowledge of Insurance products and policy conditions

Awareness of Compliance regulations, and adherence to these

Comprehensive knowledge of financial calculations to support Claims Payment, including awareness of state benefits

Product knowledge of claims dealt with

Medical knowledge to support the assessment of claims.

Comprehensive understanding of Underwriting, including New Business process

Good letter writing skills - especially when handling refuted claims

Good writing skills - to summarise case notes clearly and succinctly

Ability to look at a claim holistically - consider each case on it's own merits

Ability to present a case perspective so that complex claims are referred and properly considered

Ability to handle difficult calls, when researching circumstances which may lead to a claim being refuted

Ability to adapt communication style to suit the audience.

Good customer handling skills

Good attention to detail and accuracy in letters

Ability to handle communication with 3rd parties such as reinsurers and medical providers

Ability to work under pressure

Ability to anticipate and resolve problems

Excellent telephony skills

Ability to manage own time productively and prioritise workload effectively