Benefits Claims Assessor
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- Company Info
- We take pride in being there for our customers. We help them deal with whatever life has in store and support them in achieving financial security; and that's thanks to the talented and dedicated people who work with us. For us, 'social responsibility' is not just a buzzword. It defines us and runs through everything we do for our customers and as an employer. And working with us, you'll get a competitive reward package and have the flexibility and autonomy to deliver your personal, business and career goals.
- Department Info
- At Legal & General Insurance we look after our customers throughout life, death and everything in between so that you know that everything that's important to you is protected. With over 180 years' experience in providing Insurance policies, our customers trust us to be there and to do the right thing.
- Job Duties
- Principal Accountabilities:
- Triage and assessment of new Workplace Health & Protection claims, determining what medical evidence to obtain in line with Legal & General's philosophies.
- Provide a comprehensive assessment of Workplace Health & Protection claims, deciding whether to accept or reject liability and authorise payment as per individual authority limits as agreed by the Head of Benefits, whilst meeting the expectations of the IFA's and our corporate clients.
- Develop and build effective relationships with IFA's and Policyholders (employers), in order to maximise the effectiveness of our benefit management processes including the provision of support for the portfolio management of defined schemes.
- Authorise expenditure on appropriate external medical evidence to support the assessment of individual claims up to GBP5,000.
- Propose expenditure on rehabilitation or work re-integration programmes where there is a suitable cost/benefit justification for doing so.
- Where appropriate, assist in the provision of Management Data on portfolio accounts which analyses performance and identifies key trends.
- Train, mentor and develop other members of the benefits team, to improve their skill level
- Ensure a consistent, timely and accurate level of service is maintained in line with service level agreements and promises made to meet customers' expectations, and that are within scope of Legal & General's Customer Experience and Treating Customers Fairly policies. Where failures are identified, provide information and feedback to the relevant areas to enable changes and improvements to be made.
- Adhere to processes and systems to ensure that all customer data is dealt with appropriately in accordance with legislation, in particular the Data Protection Act (1995), the Access to Medical Reports Act (1988) and Legal & General's Confidentiality Policy.
- Skills Required
- The job holder is encouraged to obtain the Life & Disability Claims Diploma and the Group Risk GR1 module of the FPC qualification both of which are qualifications supported by the Chartered Insurance Institute.
- Knowledge of Income Protection, particularly Group Income Protection.
- Good understanding of medical conditions and the effect these can have on an individual's ability to work.
- Awareness of the investigative and rehabilitation services provided by external organisations.
- The jobholder requires legislative and regulatory knowledge including:
Finance Act 2004
DWP State Benefits
HMRC rules relating to Life and Pensions products
Data Protection Act
Financial Ombudsman Service
The Role is not regulated by the FCA, and the jobholder is not an approved person. However, the jobholder will be responsible for ensuring regulatory standards associated with the role are achieved at all times.
- The job holder requires excellent communication, both verbal and written, skills; analytical and risk management skills; ability to be creative and strategic thinking.
- Strong claims assessment skills - particularly medical assessment.
- Claims authorities: as agreed by Head of Benefits
- The job holder may represent the area at internal meetings.
- Whatever your role, we reward ability, performance and attitude with a package that looks after all the things that are important to you. Our employees have a wide range of benefits including a generous pension scheme, life assurance, 22 days' (with potential to rise to 26 days) holiday, discretionary performance related bonuses, paid overtime, a variety of share schemes, discounts at both a huge range of high street stores and our own great products, your hard work will be rewarded when you join us.
For more information on this role, please contact Helen Brockbank, UK Resourcing Lead at .