Claim Assessor

Overview

In this role, you assess and decide Group Income Protection claims from start to finish, ensuring timely, accurate decisions and clear communication with policyholders, clients, and intermediaries. You work within the Global Customer Service and Operations team to uphold service excellence and compliance while collaborating with underwriters, medical specialists, and reinsurers. The position emphasizes decision-making authority, fraud detection, and process improvements in a dynamic, AI-enabled environment. This is an opportunity to contribute to a trusted, customer-centric insurer that values continuous improvement and professional growth.

Pay / Benefits

• market leading annual bonus
• 9% employer pension contributions with up to 4% matching
• comprehensive private medical insurance
• income protection insurance
• life insurance
• annual leave buy/sell option

Responsibilities

• Perform end-to-end assessment, decision, settlement, and communication of Group Income Protection claims
• Operate with autonomy within approved authority and service levels
• Deliver exceptional customer service to policyholders, clients and intermediaries
• Manage relationships for all customers in an agreed portfolio
• Ensure compliance with regulatory, CBI, FCA, TCF and legal requirements; handle complaints accordingly
• Investigate potential fraudulent claims
• Identify and propose process improvements within the business framework
• Collaborate with Chief Medical Officer, underwriters, and external service providers for information gathering
• Maintain relationships with reinsurers to maximise recoveries
• Participate in claims projects and change initiatives
• Provide sign-off on claims for colleagues; manage appeals within authority
• Utilise approved AI tools to support routine tasks such as drafting and organizing information

Key requirements

• Experience handling Group Income Protection claims (direct insurer, reinsurer, or both)
• Demonstrated claims assessment and decision-making ability
• Knowledge of Medical or Scheme Underwriting beneficial
• Claims decision-making authority essential
• Working knowledge of AI capabilities with ability to validate outputs
• excellent communication skills (preferred)

• Articulation and attention to detail
• customer-focused mindset
• willingness to learn and pursue professional qualifications
• team collaboration
• AI tool usage for drafting/summarizing/organizing information
• claims assessment and decision support

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