claims Associate - with 13th monthFortune General Insurance Corporation

JOB SUMMARY
The Claims Evaluator is primarily responsible for all aspects of the Claims Process including acceptance of documents and filing of claim, ocular inspection and documentation of damages incurred in an incident, investigation of an incident, canvassing of parts and labor costs, evaluation of insurance's liability, negotiation of settlement of liability, issuance of approval or LOA to repair, releasing of settlement checks to claimants and repair shops.
MAJOR DUTIES AND RESPONSIBILITIES
1. Receiving of Claims/ Collection of Requirements/Documents
Checking of policy term, policy coverage, name of insured, unit details(make, body, plate number, etc.), and policy payment.
Checking of police report, incident date, driver's name, driver's license, its restrictions and expiration date, determine who is at fault of the incident if involving another party/ies.
Checking if details in the Certificate of Registration and its Official Receipt are updated and have the same details as the insurance policy.
Following up lacking requirements from claimants.
Sending of original files to Head Office for claims that exceed the settlement authority given to the branch.
2. Occular Inspection
Occular inspection to properties/units involved in an incident and analyzing relevance to the incurred damages and statements of the person/s involved.
3. Investigation
Conducts investigation if the statement of the claimant doesn't correspond to the damage incurred and if there are unclear matters on his/her statement and irrelevant damages that needs to be and verified.
Visits the incident site and gather information and witnesses within the area.
4. Evaluation
Evaluation of submitted official receipts for Personal Accident and Reimbursement Claim and evaluation of repair estimate base on canvassed parts and comparison of labor cost to other repair shops.
5. Negotiation
Negotiation of finalized evaluation to claimants and repair shops.
6. Encoding of claim
Encode details of incident to GENiiSYS Web to generate claim number.
Input reserve amount for the loss/liability.
Printing of preliminary loss report.
7. Issuance of LOA to Repair and Request for Payment
Issue and print LOA to repair shop and Purchase Order to parts suppliers.
Issue Request for Payment to repair shops, parts suppliers or claimant.
8. Closing of Claim
Input of claim number to GENiiSYS Web to close the claim and remove the claim from the active claim listing.
Log of closed claim file and filing it to the filing cabinet with a file number
9. Issuance of Certificate of No-Claim
Checking of policy term, policy coverage, name of insured, unit details(make, body, plate number, etc.) and policy payment.
Checking of police report, incident date, driver's name, driver's license, its restrictions and expiration date, determine who is at fault of the incident if involving another party/ies.
Checking if details in the Certificate of Registration and its Official Receipt are updated and has the same details with the insurance policy.
Issue the Certificate of No-Claim for the assured.
10. Issuance of Guarantee Letter
Checking of policy term, policy coverage, name of insured, unit details(make, body, plate number, etc.) and policy payment.
Checking of police report, incident date, driver's name, driver's license, its restrictions and expiration date, determine who is at fault of the incident if involving another party/ies.
Checking if details in the Certificate of Registration and its Official Receipt are updated and has the same details with the insurance policy.
Inspection of properties/units involved in an incident and analyzing relevance to the incurred damages and statements of the person/s involved.
Evaluate repair estimate base on canvassed parts and comparison of labor cost to other repair shops if the coverage is sufficient for the liability.
Issue the guarantee letter for the assured.
11. Collection of Salvage Parts
Coordination with dealers and repair shops for the collection of the salvage parts from the repaired properties.
Scheduling of pick up or drop off of salvage parts
Workbank

Manila City, Metro Manila
₱15,000-20,000 per month
Permanent
Full-time