Santiago de Chile Permanente

Publicado el 19/07/2022

  • Special focus in property, financial lines, and liability claims.
  • Analysis and resolution of complex insurance and reinsurance claims and coverage

Sobre nuestro cliente

recognized multinational General Insurance Company


Responsibilities include but not limited to:

  • Daily handling, analysis and resolution of complex insurance and reinsurance claims and coverage issues.
  • Management of claim portfolio at all levels of the adjustment process, ensuring the correct reserving, technical analysis, settlement and payment of claims.
  • Registering appropriate claim reserves, monitoring them and keeping them duly updated in the system and reporting large claims as per LCR definitions and Everest Guidelines.
  • Keeping the system updated with relevant claims communications, supporting documents, Preliminary
  • Reports & FAR, payment and settlement/release documents.
  • Preparation of complex denial of coverage presentations and coverage position letters, Impugnation to Final Adjustment Reports (FAR) and Observations to Preliminary Reports of Article 24 of DS 1055.
  • Due drafting & handling of settlement/releases and revision of supporting payment documents, ensuring its proper signature as per policies, protocols and formalities defined.
  • Daily assistance to insureds, brokers, reinsurers & coinsurers on complex claims related matters and queries.
  • Monitoring adjustment actions and process, and legal adjustment terms as per SLA and applicable regulations, requesting further technical arguments and explanations when required and updated reports.
  • Investigating, analyzing, and evaluating liability and damages.
  • Evaluating, determining and Monitoring trial development handled by panel counsel.
  • Preparing case summary reports related to matters of significant reserve, involving new trends, trial activity, denial of coverage or contingencies, etc.
  • Coordinating and monitoring recovery actions and salvage process, keeping the system updated.
  • Working with underwriters to support policy construction and drafting, reporting policy contingencies, gaps, claim trends, data analysis, and risk assessments.
  • Evaluation and definition of defense strategy on liability claims, and monitoring of nominated counsel.
  • Strict compliance with claim monetary and non-monetary authorizations.
  • Strict compliance of Everest International Claims Standards and LCR, and all other internal guidelines.
  • Strict compliance with Everest Macro Claim Process for Chile and all related guidelines.
  • Collecting and monitoring payment from reinsurers and coinsurers & keep the system updated with actions & payment status
  • Monitoring and control of claim related costs & expenses.
  • Developing and executing claim strategies as well as resolution strategies.
  • Managing, directing and monitor outside counsel on claim related matters, such as coverage opinions, arbitrations, etc
  • Attending conferences and handling all necessary and relevant communications related to claims and complex matters with insureds, brokers, reinsurers & coinsurers, actuaries, underwriters, adjusters, experts, and other vendors.
  • Negotiating and resolving complex coverage issues as per claim authorities and guidelines.
  • Monitoring relevant jurisprudence on Civil and Labor Cases.
  • Attending meetings and conferences with brokers and/or insureds, and industry functions to support retention and development of client relationships and business.
  • Performing similar work-related duties as assigned.

Perfil buscado (Hombre / Mujer)

Qualifications, Education & Experience:

  • Professional title (preferably law, accountancy & engineer). If lawyer, due knowledge of litigation, arbitration, and trial process.
  • 7-8 years of claims handling experience.
  • Language: Advanced English, written and oral.
  • Strong analytical and organizational skills.
  • Excellent verbal and written communication skills.
  • Strong negotiation and investigation skills.
  • Strong ability to think strategically.
  • Strong ability to work under pressure.
  • Stron ability to adapt to changes.
  • Strong ability to work with a Team.
  • Strong ability to identify and use relevant data and metrics to best manage claims.
  • Collaborative mind-set and willingness to work with a team, and also people outside immediate reporting hierarchy to improve processes and generate optimal departmental efficiency.
  • Strong ability and willingness to present any claims related matters to senior management and to others in other group settings.
  • Strong ability to influence others and resolve complex, disputed claims.
  • Deep knowledge of the insurance industry claims process, applicable regulations and regulatory environment.

Qué ofrecemos

Attractive total compensation package

Ingresar referencia para vacante

Resumen de empleo

Santiago de Chile
Tipo de contrato
Refencia de empleo