Manage claim files

Description

Follow up on the progress of a claim file, keep all parties informed of the status of the file, ensure the customer receives the damages owed, treat any problems or complaints from customers, close the file and give information to an authorised person or department when there is suspicion of fraud.

Alternative labels

M41
oversee claim files
handle claim files
manage claim file
perform management of claim files

Skill type

skill/competence

Skill reusability level

sector-specific

Relationships with occupations

Essential skill

Manage claim files is an essential skill of the following occupations:

Insurance claims handler: Insurance claims handlers ensure that all insurance claims are handled accurately and that payment for valid claims is made to the policyholders. They use statistical data and reporting to calculate and adjust claims as needed, communicate with and guide policyholders and monitor the progress of a claim.
Insurance claims manager: Insurance claims managers lead the team of insurance claims officers to ensure they handle insurance claims properly and efficiently. They deal with more complex customer complains and assist with fraudulent cases. Insurance claims managers work with insurance brokers, agents, loss adjusters and customers.
Loss adjuster: Loss adjusters treat and evaluate insurance claims by investigating the cases and determining liability and damage, in accordance with the policies of the insurance company. They interview the claimant and witnesses and write reports for the insurer where appropriate recommendations for the settlement are made. Loss adjusters’ tasks include making payments to the insured following his claim, consulting damage experts and providing information via telephone to the clients.

Optional skill

Manage claim files is optional for these occupations. This means knowing this skill may be an asset for career advancement if you are in one of these occupations.

Financial manager: Financial managers handle all the matters in reference to the finance and investments of a company. They manage financial operations of companies such as the assets, liabilities, equity and cash flow aiming to maintain the financial health of the company and operative viability. Financial managers evaluate the strategic plans of the company in financial terms, maintain transparent financial operations for taxation and auditing bodies, and create the financial statements of the company at the end of the fiscal year.
Insurance agency manager: Insurance agency managers coordinate and oversee the operations of an institution or a branch of an institution that offers insurance services. They provide clients with advice on insurance products.
Insurance broker: Insurance brokers promote, sell and provide advice on various insurance policies such as life insurance, health insurance, accident insurance and fire insurance to individuals and organisations. They also work as intermediaries between individuals or organisations and insurance companies, and negotiate the best insurance policies for their clients, arranging insurance cover where needed. Insurance brokers engage with new prospective clients, provide them with quotes for their policy needs, assist them in the signing of new insurance contracts and propose specific solutions to their specific problems.
Insurance fraud investigator: Insurance fraud investigators combat fraudulent activities by investigating the circumstances of certain suspicious claims, activities related to new customers, buying insurance products and premium calculations. Insurance fraud investigators refer potential fraud claims to insurance investigators who then undertake research and investigations to support or deny a claimant’s case.

 


 

References

  1. Manage claim files – ESCO

 

Last updated on September 20, 2022