Insurance & Claims Officer

Job Title: Insurance and Claims OfficerDepartment/Division: FinanceService: Corporate FinanceTeam/Section: Risk Management and Insurance ServicesResponsible to: Principal Insurance Officer 

Overall Purpose of Role:To investigate and recommend action on insurance claims brought against the council which are disputed or possibly fraudulent.

Key Contacts & Purpose:

• Employees and business units: Advises on the protection afforded by the council’s insurance arrangements and helps them provide relevant evidence. 
• Insurers and council departments: Discusses and negotiates claims. 
• Claimants: Advises and elicits information about the claim. 
• Claimants and witnesses: Interviews them on the details of the claim. 
• Claimants, employees, solicitors, and managers: Discusses, provides information, and advises on significant claims or settlements. 
• Legal department: Works on possible fraud cases and seeks advice. 

Main Duties/Key Tasks:

• Progresses and records information on an allocated caseload of insurance claims against the council, including investigating potential fraud cases. (45%)
• Determines liability by reviewing and investigating cases and evidence provided. (15%)
• Works with council department staff on cases affecting them. (10%)
• Meets, interviews, and negotiates with claimants, their legal, and other representatives. (5%)
• Recommends and prepares cases to be challenged in court, including injury compensation. (5%)
• Instructs Loss Adjusters where necessary. (5%)
• Identifies and proposes actions to reduce incidents or procedural changes to improve team effectiveness. (5%)
• Arranges site meetings to determine circumstances surrounding specific incidents. (5%)
• Other miscellaneous tasks associated with the role. (5%)

Responsibilities & Objectives:

• Ensure insurance claims against the council are properly prepared, costs justified, and pursued with insurers.
• Repudiate claims from the public with no legal liability.
• Accurately enter incident details into the system in a timely manner and issue reports per DPA requirements.
• Handle difficult claimants professionally.
• Stay updated with current legislation, guidelines, and best practices relevant to the role.
• Follow and promote the council's policies and procedures in all areas of employment and service delivery.
• Deal professionally with people at all levels and from various backgrounds.
• Recognize and address discrimination in its many forms and actively implement the council’s equality policies.

Job Requirements/Personal Specification:

Training, Skills, and Abilities:

• Good English communication skills for face-to-face, telephone, and written correspondence. (Essential)
• Ability to analyse facts and situations and produce management/statistical/technical reports. (Essential)
• Literacy and numeracy skills for claim calculations and preparing correspondence. (Essential)

Knowledge and Preferred Qualifications:

• Progressing towards or willing to complete ACII qualification or equivalent knowledge & experience. 
• Understanding of common law negligence. 
• Understanding of risk management. 
• European Computer Driving Licence or equivalent knowledge. 
• Customer Service qualification or equivalent experience.
• Appreciation of roles and structures in a local authority environment.