Insurance claims handler
Administration

Insurance claims handlers are employed by insurance companies or brokers to process claims made by policy holders and others. They check that each claim is covered under the terms and conditions of the policy; then they arrange for help, repair or replacement and organise the settlement of the claim.

Work Activities

Insurance cover is available to help customers who have suffered losses caused by events such as theft, accident or illness. The customer pays a regular amount of money (called a premium) and receives a written policy. This sets out the conditions under which the insurance company will provide a settlement by way of repairs, replacement or reinstatement of items.

Insurance claims handlers are responsible for processing claims submitted by policy holders. Claims handlers often specialise in one type of insurance, for example:

  • Motor - theft, accident or injury to someone.
  • Travel - delays to flights, missing luggage, theft, personal injury or illness.
  • Household - fire, flood, theft or accidental damage.
  • Personal - accident, long-term illness or death.
  • Business - interruption of business, injury to a member of staff or the public, theft or damage to premises.
  • Pet - vet's fees, death or injury to someone else caused by a pet.
  • Marine and aviation insurance.

Policy holders can ring, write or email when they need to make a claim. Claims handlers first need to gather all the relevant information and evidence relating to a claim. They might send out forms for the claimant to fill in, asking for details such as:

  • A description of what has happened, sometimes asking for diagrams or digital photos, for example, in the case of a motor vehicle accident.
  • Names and contact details of witnesses in the case of an accident.
  • A crime reference number from the police.
  • Receipts for goods stolen or damaged.
  • Invoices for professional services, for example, vet's fees.
  • Medical reports.
  • Estimates for putting things right.

Some forms might be available online. In some insurance companies, the claims handler completes the form online while the customer is on the phone.

They check that each claim is covered under the terms and conditions of the policy and make sure that the claim for loss or damage is reasonable. The claims handler might have to speak to claimants who are upset, shocked or distressed, especially if death or injuries are involved.

Claims handlers might need to organise and co-ordinate immediate help, for example, for:

  • Alternative accommodation, for example, after a flood.
  • A breakdown vehicle to collect a damaged car and take it to an approved garage.
  • A builder, plumber, electrician or locksmith to carry out repairs at the claimant's home or business.
  • A medical assessment of someone who might be injured.

The claims handler might have to ask an investigator or independent loss adjuster to visit and assess damaged buildings or vehicles in order to gather the evidence needed to decide on a fair settlement. Depending on their level of experience, claims handlers often have to refer complicated or high-value claims on to a manager or senior claims handler for guidance.

Claims handlers need to keep accurate records of the status of each current claim and review outstanding claims at regular intervals. They keep policy holders and claimants informed about the progress of their claim. When payment has been agreed, the claims handler passes it for payment and settles or closes the claim. Most claims systems are computerised.

Often the claims handler might need to recover money from other insurers, such as insurers of other motorists who were responsible for a collision. In some cases, matters might need to proceed to litigation.

Personal Qualities and Skills

Key skills

  • Customer service, negotiation and problem-solving skills.
  • To be thorough, analytical, methodical, confident and decisive.
  • Communication skills, both verbal and written.
  • To use your initiative.
  • To be able to follow set procedures.
  • Number and IT skills.
  • To be able to show tact, sympathy and patience when dealing with claimants who are upset, shocked or distressed; you will need to keep calm and professional.
  • To prioritise and manage a large case load.
  • Record-keeping skills.
  • To be able to work under pressure at busy times.

Some legal knowledge could be an advantage.

Pay And Opportunities

Insurance claim handlers are employed by insurance companies and brokers.

Qualifications

Entry routes and training

Some claims handlers enter the insurance business as support staff or technicians. Entry to administrative support posts might be with GCSE / National 4 or 5 / equivalent qualifications.

Direct entry to claims handling is usually with A levels / Highers / equivalent, a foundation degree or a degree/HND. Some degree and HND business studies and economics courses include insurance options.

Intermediate Level Apprenticeships and Advanced Level Apprenticeships in Providing Financial Services might be available in your area.

Level 2 and 3 Awards and Certificates and the Intermediate Level Apprenticeship/Advanced Level Apprenticeship in Providing Financial Services include insurance claims options.

The ifs School of Finance offers the Certificate of Regulated General Insurance.

Claims handlers can work towards the qualifications of the Chartered Insurance Institute (CII), for example, the Certificate in Insurance (Claims) or the Diploma in Insurance (Claims). These qualifications are recognised across the world as a global standard.

The CII does not set any entry requirements although it is recommended that you have either completed the Certificate in Insurance or have five GCSEs at grade C or above (or equivalent) before commencing the Diploma in Insurance.

Some degrees could give exemptions from certain of the CII exams. Contact the CII for further details.

Holders of the Diploma in Insurance can progress to the Advanced Diploma and then to Associateship of the CII. Some companies offer graduate training schemes in claims that include direct entry to study towards the Advanced Diploma exams.

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