CLAIMS HANDLER JOB DESCRIPTION

A Claims Handler owns one of the most consequential handoffs in retail and commercial insurance: the moment a policyholder reports a loss and expects a fair, timely resolution. That sounds simple. In practice, it demands simultaneous command of FCA compliance and Treating Customers Fairly obligations, active fraud detection, liability assessment up to defined authority limits, and real-time negotiation with brokers, loss adjusters, and legal representatives. Each caseload is live. Decisions made here directly affect indemnity spend and policyholder outcomes alike.

As the Claims Handler, you are accountable for managing a portfolio of property, casualty, or motor claims from first notification of loss through to settlement, balancing cost control with regulatory compliance and customer outcomes across every stage of the claim. You operate within a claims operations team, working alongside specialists in fraud, litigation, and supplier management while reporting to a Claims Team Manager or Claims Supervisor.

Career Impact: Hands-on experience managing authority-limit decisions across commercial casualty and motor lines builds the technical credibility that underpins progression to Senior Claims Handler or Claims Advocate.

Business Impact: The accuracy and speed of your liability assessments directly affect indemnity spend and renewal retention for the insurer's client portfolio, outcomes that flow through to every annual result.

Growth Opportunity: Exposure to litigated matters, CPR-governed correspondence, and fraud triage expands your technical range in ways that open doors to specialist roles in complex claims, TPA operations, or claims management consulting.

• Manage a portfolio of property, casualty, or motor claims from FNOL through to settlement within defined authority limits.
• Assess liability, validate coverage, and establish accurate reserves throughout the claims cycle to control indemnity spend.
• Conduct fraud screening using questioning and investigation techniques to determine whether claims proceed to payment or repudiation.
• Negotiate settlements with policyholders, brokers, loss adjusters, and legal representatives to achieve timely, cost-effective outcomes.
• Communicate with all parties via inbound and outbound telephone, written correspondence, and claims management systems to keep cases moving.
• Review policy wording and apply terms accurately to each claim, providing clear verbal and written explanations to customers and third parties.
• Identify claims requiring escalation and refer complex or high-value matters to senior handlers or specialist teams with full documentation.
• Maintain accurate data across claims management systems, ensuring records, payments, and regulatory requirements meet FCA and TCF standards.

• Bachelor's degree in a relevant field or equivalent work experience.
• 2 or more years of claims handling or customer service experience in an insurance or regulated financial services environment.
• Demonstrated ability to assess liability, validate coverage, and make settlement decisions within defined authority limits.
• Sound knowledge of FCA regulatory requirements and Treating Customers Fairly principles as applied to claims handling.
• Strong written and verbal communication skills, with the ability to produce clear, accurate correspondence for customers, brokers, and legal parties.
• Proven ability to manage a concurrent caseload under time pressure while maintaining accuracy and compliance.
• Effective negotiation and influencing skills when dealing with customers, third-party insurers, loss adjusters, and legal representatives.
• High attention to detail in data entry, claims recording, and document review.

• CII Foundation Insurance Test (FIT) or progress toward a full CII qualification, demonstrating commitment to professional development in the sector.
• Experience handling litigated matters, including preparation of documents in accordance with Civil Procedure Rules (CPR).
• Familiarity with fraud indicator identification and the use of validation tools or databases to support claims triage decisions.
• Background in a specialist line such as property, commercial casualty, or motor total loss, providing depth beyond general claims administration.

• Average time to settlement per claim, reflecting how efficiently the caseload is progressed from FNOL to close.
• Indemnity spend variance against reserve, measuring accuracy of initial liability and quantum assessment.
• Fraud referral rate, tracking the proportion of caseload flagged for investigation relative to portfolio size.
• FCA and TCF compliance audit score, indicating adherence to regulatory obligations across all customer contact points.
• Customer complaint rate per handler, reflecting the standard of communication and decision quality delivered to policyholders.
• Typical tools: Claims management systems (commonly Guidewire or Solera); case communication platforms (commonly Eolis or bespoke insurer portals).

• Base Salary Range: $42,000 to $62,000 per year, varying by seniority and line of business
• Bonus: Performance-based bonus tied to KPI achievement, typically 5% to 10% of base salary
• Equity: Not standard at this level; offered selectively at senior or specialist grades
• Health Benefits: Medical, dental, and vision coverage; employer contribution varies by carrier
• PTO: 15 to 20 days annually, plus standard public holidays
• Common Perks: CII study support and exam funding, hybrid work arrangements, employee assistance programs

Figures are estimates based on general US market benchmarks and may be outdated. Adjust based on location, company size, and seniority level.

Employment in this role is contingent on successful completion of a background check, which may include verification of prior employment and criminal history screening consistent with applicable law. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected under federal, state, or local law. Applicants requiring a reasonable accommodation during any stage of the hiring process are encouraged to submit a request. Candidates must be authorized to work in the United States.

The Claims Handler delivers a focused claims service by resolving customer and external enquiries, finalising settlements within authority limits, and contributing to team productivity, reporting into a claims supervisory structure. Working closely with customers and external suppliers, the handler enables commercially sound outcomes across casualty claim types, supporting both service targets and business profitability.

Key Responsibilities

• Handle and resolve enquiries from customers and external contacts to deliver a focused claims service.
• Review, resolve and proactively finalise claims within authority limits, ensuring settlement at an optimum level with consideration to business implications.
• Maximise productivity and profitability within the team.
• Contribute to a positive and supportive team culture.
• Provide supervisory support on an ad hoc basis as required.

Required Qualifications

• Insurance claims experience is preferable; however, customer service experience is also desirable.
• Ability to review, resolve and finalise commercial casualty claims within defined authority limits.
• Experience in working within a team and managing varying workloads and pressures.
• Experience handling negotiations with customers and external suppliers is desirable.
• Experience managing a caseload to tight deadlines with a commercial mindset.
• Ability to deliver excellent customer service.
• Strong negotiation and decision-making skills.
• Ability to coach, motivate and develop team members where appropriate.

Reporting to a claims operations team, the Claims Handler manages inbound and outbound customer calls, supports customers from claim initiation to closure, and maintains accurate records on the claims management system. Working closely with clients, third-party insurers, and external companies, the handler builds efficient claim resolution that meets monthly KPIs and compliance requirements.

Core Functions

• Handle inbound and outbound calls to customers, clients, external third-party insurers and other external companies.
• Support customers efficiently from start to finish of a claim procedure.
• Ensure all relevant paperwork adheres to company compliance requirements and is dealt with on time.
• Organise vehicle hire for customers whilst claims are being processed.
• Accurately record all information on the claims management system.
• Follow company procedures at all times and meet monthly KPIs.

Qualifications & Experience

• Previous call centre or insurance experience preferable but not essential, as full training is provided.
• Proficient in Microsoft Word, Outlook and Excel.
• Good communication skills, both verbal and written, including the ability to converse with people at varying levels.
• Customer-focused mindset with a commitment to service excellence.
• Ability to work effectively as part of a team and independently on own initiative.

The Claims Handler owns end-to-end management of dispute resolution and litigation cases for a broad client base, investigating liability within regulatory guidelines and preparing CPR-compliant documentation to drive settlements. Partnering with internal process owners and external stakeholders across all levels, the handler shapes service delivery outcomes and supports continuous improvement across a specialist claims function.

Primary Duties

• Investigate claims liability within regulatory guidelines, ensuring indemnity spend is controlled.
• Organise, monitor and manage a caseload of claims and litigated matters end-to-end, ensuring the best outcome for clients and the firm.
• Communicate effectively with stakeholders internally and externally to minimise time-related pressures.
• Defend claims confidently and accurately, challenging any third parties where appropriate.
• Validate and assess claims and correspondence accurately, ensuring deadlines are met and processes are adhered to.
• Provide and receive 360-degree feedback, supporting a culture of continuous improvement and peer development.
• Identify and investigate matters for escalation to ensure appropriate specialist guidance is received from internal stakeholders.
• Prepare documents and responses to ensure litigated matters follow CPR guidance, and negotiate on settlement and defence matters.
• Record data and assist with analysis where required.
• Deliver training and coaching in collaboration with process and product owners as required.

Skills & Qualifications

• Strong technical understanding of claims handling principles and best practices.
• Experience working in a fast-paced professional environment preferred.
• Proven ability to engage and influence internal and external stakeholders across all levels.
• Keen attention to detail with strong organisational skills and the ability to meet deadlines.
• Flexible approach to problem-solving with proven planning skills.
• Ability to present information effectively and take ownership in a multi-task environment.
• Responsible and resilient with a proactive attitude.
• Willingness to learn new technologies, tools and systems.

Sitting at the intersection of customer service and technical claims management, the Claims Handler manages an allocation of motor claims from commencement through resolution, making liability and payment decisions in accordance with policy cover, fraud protocols and compliance requirements. Operating across inbound telephony, outbound contact and written correspondence, the handler enables cost-effective claim outcomes while protecting against fraud and maintaining regulatory compliance.

Duties

• Manage the commencement of motor claims, ensuring customer requirements and expectations are properly framed and understood.
• Ensure claims are handled in the correct technical manner, in accordance with policy cover, legal liability, fraud protocols and compliance requirements.
• Manage clear communications with customers and a variety of third parties, both verbally and in writing, including letter writing.
• Make proactive outbound calls to engage with external parties in order to move claims forward.
• Manage an allocation of claims proactively alongside incoming postal and telephony demand.
• Protect claims cost and make informed decisions relating to payment, liability, settlement costs and complaints.
• Prioritise claims to ensure urgent matters are managed efficiently and dealt with cost-effectively.
• Identify fraud indicators and use questioning and investigation techniques to determine if a claim can be progressed to payment or repudiation.
• Complete all supporting administrative tasks as required.

Experience & Qualifications

• Experience delivering customer service in a regulated or high-volume environment.
• Excellent communicator with strong attention to detail and accuracy across all contact types.
• Experienced in multitasking and prioritising a personal workload, with the ability to make decisions under pressure.
• Ability to influence and persuade others effectively.
• Computer literate with the ability to learn new systems.
• Positive attitude with a flexible and resilient approach to change and teamwork.

A key member of the claims team, the Claims Handler leads assessment and resolution of new and existing claims by gathering evidence through customer conversations and applying sound judgement across a wide range of claim types. Collaborating across policyholders, brokers, underwriters, loss assessors and suppliers, the handler enables compliant, empathetic service outcomes that meet both regulatory obligations and company policy standards.

Functions

• Engage with customers via telephone to provide a high-quality claims service.
• Make informed decisions regarding paying and rejecting claims up to handler authority limit, managing customer expectations and delivering updates with empathy.
• Liaise with policyholders, brokers, underwriters, loss assessors, suppliers and other parties.
• Identify fraud indicators and use questioning and investigation techniques to determine if a claim can be progressed to payment or repudiation.
• Take ownership of complaints, record details accurately and resolve where possible in line with company policy.
• Comply with all company and industry regulations, treating customers fairly and acting professionally at all times.

Requirements

• Skilled in managing conflict with an investigative mindset to resolve customer enquiries.
• Excellent communication skills, written and verbal, with the ability to write complex correspondence to company standards.
• Ability to negotiate and influence others whilst maintaining an empathetic approach.
• Strong attention to detail and accuracy when communicating with customers both in writing and verbally.
• Ability to make sound judgements under pressure and take a proactive approach when settling claims.
• High level of professionalism, integrity and commitment.
• Ability to work on own initiative when prioritising a personal workload.
• Positive attitude with a flexible and resilient approach to change.

Accurate settlement outcomes for policyholders and third parties depend on the Claims Handler, who processes property insurance claims from FNOL through to settlement in line with agreed client service levels, advising on policy wording and obtaining all documentation required for assessment. Based within a client-facing claims team, the handler liaises with policyholders, loss adjusters and suppliers while logging and communicating all claim activity through the claims management system.

Accountabilities

• Process property insurance claims from FNOL through to settlement in accordance with agreed client service levels, ensuring the best outcomes for clients, policyholders and third parties.
• Communicate with policyholders, clients, loss adjusters and suppliers, recording every aspect of each claim on the claims management system.
• Provide assistance and advice to all stakeholders, answer inbound calls to register new claims and accurately log claim details.
• Ensure claims are processed in a timely manner.
• Provide comprehensive verbal and written advice on all aspects of policy wording in relation to cover and claims, advising policyholders on the best method of settlement.
• Obtain relevant documentation for claim assessment, including claim forms, photographs, third-party reports and receipts or proof of purchase.

Position Requirements

• CII Foundation Insurance Test (FIT) qualification is preferable.
• Knowledge and understanding of property insurance claims is essential.
• Strong knowledge of customer service handling in an insurance context.
• Analytical mindset with the ability to evaluate facts and recommend appropriate decisions.
• Able to operate to agreed deadlines with strong attention to detail.
• Excellent communication skills, both written and verbal.
• Able to understand and work to business key performance indicators.
• Self-motivated with a collaborative team ethic and willingness to learn.

As the Claims Handler, this role oversees the full claims cycle within a TPA or underwriting environment, covering FNOL triage, expert appointment, litigation management, settlement negotiation, and invoice approval for employer liability and public liability claims. The claims team relies on this work to maintain accurate financial and factual records in the claims management system and to actively develop new business contacts in support of overall TPA growth.

Operational Focus

• Receive and triage first notification of loss.
• Liaise with brokers and underwriters.
• Appoint surveyors, lawyers and other experts to progress claims within a delegated authority, or with lead underwriter agreement if exceeded.
• Collect all documents relating to claims and consider policy wording and liability of the assured.
• Contribute to settlement negotiations with claimants and consider possible recoveries from third parties.
• Participate in regular claims conference calls to discuss claim progression with respective clients.
• Ensure appointed experts receive clear instructions regarding scope of works.
• Obtain and agree a pricing structure and estimate of fees.
• Manage litigation and oversee experts to ensure adherence to the agreed scope of works.
• Check and approve invoices for payment.
• Maintain the claims management system with accurate factual and financial updates.
• Actively promote the TPA service offering to existing and new business contacts to increase overall business.

Knowledge, Skills & Abilities

• 5 or more years of claims experience in a TPA or underwriting environment, with a focus on employer liability or public liability.
• Experience using the Ministry of Justice portal is essential.
• Accurate in recording information with strong numeracy skills.
• Comfortable learning bespoke IT systems and working in a paperless environment.
• Customer-centric approach, putting clients at the heart of all activity.
• Good communication skills with a team-oriented working style.

Claims Handler manages repair and total loss claims from first notification of loss through to settlement, adhering to FCA compliance, TCF obligations and Data Protection Act requirements while supporting team KPIs and SLAs. The work directly supports a claims operations team and involves daily liaison with customers, brokers, suppliers and accident management companies across both inbound telephony and administrative functions.

Day-to-Day Responsibilities

• Complete the first notification of loss, ensuring all relevant information is captured to fully progress the claim.
• Process repair and total loss claims in accordance with the claims philosophy.
• Work within the parameters of the agreed business plan for claims operations.
• Deliver own performance against agreed objectives, KPIs and SLAs to support the team manager.
• Liaise with suppliers to ensure delivery of customer service.
• Answer inbound calls from customers, brokers and accident management companies, handling queries, complaints, payments and claim updates professionally.
• Adhere to FCA compliance requirements and Treating Customers Fairly obligations.
• Ensure all Data Protection Act, FCA and TCF regulatory requirements are met.
• Complete additional administration duties as required.

Background & Experience

• Previous insurance experience is desirable but not required, as full training will be provided.
• Excellent customer service and communication skills.
• Strong literacy and numeracy skills.
• Ability to listen, identify and resolve customer issues calmly and professionally.
• Willingness to develop new skills and take a self-directed approach to learning.

The Claims Handler delivers inbound and outbound call handling for motor claims, contacting third-party customers promptly following accident notification and applying offer frameworks to meet customer needs while controlling costs. Working closely with external providers and accident management contacts, the handler enables accurate damage assessment, total loss determination, and injury referrals that support claim resolution targets.

What You'll Do

• Make and receive inbound and outbound calls to customers and third parties.
• Contact third-party customers promptly following accident notification using the outbound contact strategy.
• Use the available offer framework to find solutions that meet customer needs while remaining mindful of unnecessary costs.
• Apply active listening and effective questioning to understand and assess damage while capturing information accurately.
• Establish quickly and accurately whether a vehicle is repairable or a total loss.
• Identify customers who may have sustained injuries during the accident and refer them to the appropriate external provider.

Professional Experience

• Proven track record in a similar role within the insurance industry, or in a call centre or targeted sales environment.
• Experience collaborating in a team environment and building cross-functional working relationships.
• Exemplary negotiation, questioning and decision-making skills.
• Proven ability to meet and exceed targets in a performance-driven environment.
• Self-motivated with the drive to succeed in a fast-paced setting.

Embedded within a specialist international health claims team, the IPMI Claims Handler processes medical, travel and personal accident claims efficiently within policy terms, determining coverage and resolving queries for insured members, medical providers and underwriters across multiple jurisdictions. Working closely with assistance and medical teams, the handler maintains quality standards and regulatory compliance across a multilingual, remote-correspondence environment.

Role Responsibilities

• Represent the organisation professionally at all times in all interactions.
• Take calls from members regarding initial and ongoing claims, general scheme queries and benefit explanations.
• Answer incoming calls promptly and within SLAs, providing the highest level of customer service.
• Manage own claims tasks, outstanding actions and overall productivity.
• Adhere to all internal processes and procedures at all times.
• Monitor and update ongoing treatment plans for members with input from assistance and medical teams.
• Ensure treatment received and delivered meets policy requirements and standardisation.
• Escalate complaints in a timely manner to the relevant manager.
• Provide feedback and assist in the development of standard operating procedures and protocols.

Education & Experience

• Experience working within a healthcare setting, handling travel, medical or personal accident claims.
• Experience in private medical insurance or international private medical insurance is an advantage.
• Experience in managing claim reserves and providing accurate and detailed claim reporting and bordereaux.
• Strong numerical skills with a high degree of accuracy and attention to detail.
• Proficient in Microsoft Excel, Word and PowerPoint.
• Excellent written and verbal communication skills suitable for remote, multilingual correspondence.
• Calm, diplomatic and professional approach when handling enquiries from members, VIPs and underwriters.
• Ability to follow processes and collect data efficiently and accurately.
• Language skills are desirable, particularly German, Spanish, Japanese, Mandarin or Cantonese.

As the Claims Handler, this role maintains appropriate service levels per segment by entering and processing claims, analysing content for validity and coverage, and resolving issues with a direct impact on settlements and business retention. The claims team relies on this work to keep both shared and individual inboxes managed, data accurately captured, and repair claims handled from start to finish in support of customer satisfaction objectives.

Job Functions

• Enter and process claims received via fax, mail or the claims management system.
• Review and analyse claim content for validity and coverage to determine liability.
• Input data accurately, ensuring all information is correctly captured.
• Handle inbound and outbound calls in quick succession, ensuring information obtained is accurate and clearly noted.
• Monitor a shared inbox of incoming emails alongside a personal inbox.
• Handle repair claims from start to finish.
• Resolve claims issues that may have a major impact on settlements and business retention.

Technical Qualifications

• Strong policy knowledge with the ability to determine the appropriate course of action in assessing and settling claims.
• Knowledge of contract law and local insolvency procedures.
• Analytically minded with strong numerical skills, attention to detail and experience in decision-making.
• Good communicator with the ability to explain and justify decisions taken.
• Strong multi-tasking and prioritization skills.

Reporting to a claims leadership team, the Claims Handler refines coverage determinations, liability assessments, and quantum analyses across a portfolio of moderate- to high-potential claims within defined authority limits, interpreting policy wording accurately to drive timely and cost-conscious resolutions. Partnering with internal and external stakeholders including customers and brokers, the handler advances claims strategy and maintains relationships that keep all parties informed throughout the claims cycle.

Key Deliverables

• Manage a portfolio of moderate to high-potential claims from coverage determination through liability assessment and quantum analysis within authority limits.
• Manage a large portfolio of general claims proactively, efficiently and effectively, maintaining focus on customer service, indemnity and expense.
• Establish timely, accurate and consistent reserves and perform ongoing review throughout the claims cycle within authority limits.
• Interpret policy wording accurately and consistently to support coverage and liability decisions.
• Drive cases to timely and accurate resolution with a focus on customer service, indemnity and expense.
• Manage key internal and external relationships to keep all stakeholders informed on relevant issues.

Minimum Qualifications

• CIP qualification is desirable.
• 1 or more years of claims handling experience across any line of business.
• Strong communication skills, both written and verbal.
• Ability to manage and prioritise workload and diary effectively.
• Flexible and adaptable approach to work, with the ability to respond to change and learning opportunities.
• Ability to contribute effectively within a team environment and collaborate with claims stakeholders to direct claims strategy.
• Confident in delivering insight and recommendations to customers and brokers.

The Claims Handler builds expertise across the motor claims journey by handling inbound customer calls, contacting third-party drivers, validating information against fraud indicators, and using liability assessment tools and case law to progress genuine claims toward resolution. Working closely with fraud specialists and internal product teams, the handler enables continuous service and process improvements that benefit customers and the wider claims operation.

Areas of Ownership

• Provide outstanding service when a customer makes a motor claim by telephone, ensuring their needs are handled sensitively and effectively.
• Collect and record accurate details from customers, asking questions to gain a full and clear understanding of the circumstances of the claim.
• Verify and monitor claims received digitally, following up with customers to ensure their needs are met.
• Compare and validate information provided by customers, remaining alert to fraud concerns to ensure only genuine claims are progressed.
• Use liability assessment tools and case law to help establish liability.
• Proactively identify patterns in customer and third-party feedback to recommend process, tool or product improvements.
• Promote the benefits of using the organisation's claims services to third-party drivers to facilitate vehicle repairs and alternative transport arrangements.
• Use initiative and available databases to locate driver contact details.

Experience & Qualifications

• Experience in negotiating and settling complex liability cases.
• Knowledge of motor claims processes is desirable.
• Experience in negotiating credit hire and reviewing or disputing payment packs is desirable.
• Experience dealing with vulnerable, aggrieved or distressed customers is desirable.
• Excellent written and verbal communication skills.
• Strong eye for detail with the ability to make quick, sound decisions.
• Organised, self-starting and reliable, with a proactive approach to taking ownership.
• Quick learner who embraces change and actively seeks process improvements.

Sitting at the intersection of regulatory compliance and customer advocacy, the Claims Handler processes claims in accordance with Department of Insurance regulations, investigates potential fraud, manages multi-channel customer queries, and supports peer development within a start-up claims team backed by a global organisation. Operating across email, telephone and social media, the handler enables compliant claim outcomes for policyholders while contributing to product improvement and cross-functional team coverage.

Scope of Work

• Process pending claims swiftly and accurately in accordance with company policy, policy terms and conditions, and Department of Insurance (DOI) regulations.
• Manage a wide range of customer queries and requests across multiple channels, including email, telephone, and social media.
• Provide customer support to policyholders, enabling them to resolve questions and complaints promptly.
• Handle complaints constructively in line with company and DOI guidelines, escalating to the team leader as needed.
• Carry out investigations to ensure all relevant documents and information have been evaluated prior to completing the claim.
• Identify possible fraudulent or questionable claims and alert the team leader to potential risks.
• Adhere to all legal and regulatory policies and procedures, ensuring compliance with DOI requirements.
• Support the development and training of peers to ensure strong cross-functional coverage across the team.
• Identify and escalate trends, potential issues, and risks as needed.
• Provide feedback to the product team for the development of new products and champion process improvements to benefit the overall customer experience.

Education & Experience

• Undergraduate degree in Animal Science or a related field is desirable.
• Property and casualty producer and adjuster licence required, or willingness to obtain within the first 30 days.
• Insurance and claims experience is an advantage, ideally in pet or health product lines.
• Background in a veterinary setting, such as technician, receptionist or hospital manager, is highly desirable.
• Experienced in managing complex documentation and regulated record-keeping with high accuracy and attention to detail.
• High emotional intelligence with empathy, compassion and active listening skills.
• Flexible and adaptable, with a focus on outcomes and comfort with ambiguity.
• Strong time management skills with the ability to plan and manage a personal workload independently.
• Data-led decision-maker with sound pragmatic judgement.
• Fluent in English with a clear and confident communication style.

A key member of a high-performance shared services function, the Claims Handler coordinates Workers' Compensation claims activity across multiple business divisions, investigating exposures, negotiating advanced settlements, and producing trending reports that inform management strategy and staffing decisions. Collaborating across internal division contacts, third-party administrators, legal teams, underwriters and loss adjusters, the handler advances financial forecasting accuracy and process improvement initiatives within agreed authority.

Strategic Responsibilities

• Establish and maintain effective business partner relationships with internal division contacts, external customers, accounting, legal departments and other key stakeholders.
• Communicate with key stakeholders across contract risk, legal, customer service, insurers, underwriters and loss adjusters within agreed authority.
• Provide clarification on claims dispositions, Workers Compensation claim guidance and cost allocations.
• Coordinate business partner interaction, reporting and claims calls to limit financial exposures on claims.
• Provide Workers Compensation claims training and education to internal and external customers.
• Plan, recommend and implement process improvement initiatives in alignment with key stakeholders.
• Investigate Workers Compensation claims to determine business exposure and negotiate or advise on advanced claim settlements.
• Ensure accurate financial forecasting for the life of a claim.
• Make financial decisions within structured guidelines, policies and procedures with binding authority.
• Monitor the third-party administrator and make financial judgement decisions for claims.
• Interpret customer contracts regarding claim language and act as the subject matter expert for business partners.
• Produce and analyse Workers' Compensation claim trending reports to inform management strategy, department structure and staffing decisions.

Education & Experience

• Bachelor's degree preferred, or equivalent claims experience.
• AIC or ARM professional certification preferred.
• 3 or more years of claims handling experience preferred.
• Experience in logistics is preferred.
• Experience in analysing, negotiating and strategising claims is required.
• Knowledge of insurance programs with deductible structures.
• Experience working with a risk management information system is preferred.
• Understanding of claim contract language and insurance policy language.
• Proficient in Microsoft Office with strong analytical, problem-solving and organisational skills.
• Actively seeks growth, development and process improvement opportunities.

Claims Handler oversees an allocated portfolio of moderate complexity claims, monitoring key client outcomes, quality-checking carrier communications and driving settlements forward with insurers and reinsurers based on technical and market knowledge. The work directly supports claims advocates, loss adjusters, surveyors and solicitors in achieving timely client outcomes while ensuring the secure, auditable handling of client monies and full adherence to group regulatory requirements.

Performance Expectations

• Monitor key client outcome performance and take appropriate action to deliver pre-defined service standards across an allocated portfolio of claims.
• Guide first notification of loss to claims handlers.
• Quality-check client and carrier communications from offshore claims handlers before release, as appropriate.
• Provide ad hoc technical and service support to offshore claims handlers and clients.
• Support offshore claims handlers and claims advocates in producing accurate and updated renewal information and bespoke client reporting.
• Monitor underwriter, reinsurer and service provider performance and take action as required to meet service standards.
• Build constructive client and third-party relationships under the guidance of senior claims personnel, including attendance at client and carrier meetings.
• Maintain awareness of accounts, market developments and claims-specific changes, with an understanding of key client outcomes and service delivery targets.
• Notify insurers and reinsurers on receipt of new claim advice and provide advice to clients as appropriate.
• Manage and resolve client, carrier and internal day-to-day queries, seeking assistance from senior claims staff as required.
• Coordinate with external parties including loss adjusters, surveyors and solicitors to ensure timely delivery of client outcomes.
• Drive claims settlements forward with insurers and reinsurers based on technical and market knowledge.
• Ensure the secure, efficient and auditable handling of client monies and manage all financial aspects of the portfolio to avoid uncorrelated cash or bureau debt issues.
• Adhere to all standardised group policies, procedures and regulatory requirements across all client service activities.

Qualifications & Experience

• GCSEs in English and Mathematics.
• Currently working towards the CII qualification is preferable.
• A-level standard education or relevant industry experience is preferable.
• Insurance industry compliance awareness.
• Ability to organise and prioritise workload effectively.
• Ability to build strong working relationships with clients and internal teams.
• Good time management skills with experience working within established processes.
• Good communication skills with strong attention to detail.
• Ability to work both independently and as part of a team.
• Willingness to learn and support others.

The Claims Handler delivers comprehensive policy wording advice and accurate claims assessment across inbound and outbound contact centre channels, processing payments, monitoring recoveries and identifying fraud indicators in full compliance with FCA and Treating Customers Fairly standards. Working within a contact centre team under defined call handling and productivity standards, the handler enables consistent, regulation-aligned service outcomes for claimants and third-party suppliers.

Work Activities

• Review claims in accordance with policy wording as defined by the insurer.
• Provide comprehensive verbal and written advice on all aspects of policy wording in relation to cover and claims.
• Ensure all communications are accurately processed within agreed timescales and guidelines.
• Assess all claims accurately and respond to claimants with concise correspondence detailing further information or documentation required, or providing a full explanation of settlement.
• Process claims payments accurately to clients or third-party suppliers into the claims system.
• Monitor all recovery aspects of claims and obtain amounts due where appropriate.
• Identify and act upon any potential fraud indicators.
• Respond promptly to all inbound calls, providing clear and accurate advice to claimants.
• Adhere to all FCA compliance guidelines and Treating Customers Fairly standards.
• Work within agreed inbound and outbound call handling and productivity standards to achieve contact centre service levels.
• Maintain professional conduct and promote a positive team working atmosphere at all times.

Background & Experience

• Good standard of education with strong numeracy and literacy skills.
• Understanding of FCA regulations and the Treating Customers Fairly concept.
• Knowledge of the claims management system or similar claims platforms.
• Excellent written and verbal communication skills with a confident and helpful telephone manner.
• Ability to analyse statistical information and work accurately under pressure.
• Good organisational skills with the ability to work on own initiative and as part of a team.
• Integrity and ability to maintain confidentiality.
• Forward-thinking and proactive with a highly motivated and assertive approach.