Policies & Procedures
• Set the claims policies and procedures for Takaful & Medical and General insurance services.
• Ensure the implementation of Claims Policies & procedures at each of claims centersand are in compliance with the overall Operations guidelines set by the CEO so that all relevant procedural/legislative requirements are fulfilled and deliver in a consistent manner.
• Manage all claims processing activities to ensure quick and efficient completion of claims processing with regards to Motor, General and Takaful & Medical insurance.
• Monitor all claims activities (including investigating and checking the accuracy of claims, evaluation of damage, determination of liability, etc.) and ensure all customer claims are assessed fairly.
• Coordinate with the finance department for claims settlement for insured members and providers.
• Direct Takaful & Medical claims in coordination with TPA legislations.
• Manage Takaful & Medical claims activities including investigating and checking accuracy of claims and coordinate with TPA to ensure that customers are assessed fairly.
• Review and audit suspicious customer claims.
• Decide on suspicious customer claims (by approval or reject).
• Manage surveys and estimate losses in coordination with surveyor, when needed.
• Prepare reports for loss ratio from claims in coordination with the underwriting management & make recommendations on means to avoid future losses.
• Review weekly suspended & denied claims report and paid & outstanding claims report.
• Ensure good relations with related service providers handle problems between them and clients and negotiate terms and conditions with the provider.
• Maintain a sound management development plan ensuring sufficient back up; availability of potential successors; and career opportunities for high performers.
• Monitor performance and training needs of subordinates in order to maximize their performance to achieve functional objectives.
Advisory and Consulting
Regulatory and Compliance
Decision Making Skills
Organizing and Planning
Problem Solving Ability
Risk Analysis & Management
Proficiency in English and Arabic languages
Insurance, Business Administration or any related field preferred.