What is a claims manager and what do they do?

A claims manager has overall responsibility for the proper administration of insurance claims. They ensure that insurance issues have been settled, that claims have been paid out to interested parties and that payments are correct and in accordance with company regulations. Claims managers may also contribute to the design and implementation of claims policies and procedures.

Key responsibilities

Responsibilities will vary, but examples include:

  • Responsibility for the administration of all insurance claims and associated queries
  • Ensuring claims are processed efficiently and correctly by working closely with insurers, loss adjusters, solicitors, brokers, claimants or their representatives, and relevant departments
  • Ensuring complete and sound claim settlements, legal reviews and investigations in accordance with company policies and procedures
  • Investigating potentially fraudulent claims
  • Maintaining company records on claims and providing reports to senior management on a regular basis
  • Generating own correspondence on contentious issues, providing updates and advice to senior management where required
  • Liaising with colleagues to identify improvements in claims procedures
  • Maintaining current knowledge with regard to industry compliance and claims regulation
  • Providing professional advice to staff and senior management on all aspects of insurance practice and law

Why are they important?

Efficient claims management is key to the success of companies working within the insurance industry. Claims managers ensure the efficient settlement of claims and also play an important role in detecting fraudulent claims, identifying strategies and technologies to reduce costs and working to avoid litigation risk.

Skills needed for this role

Claims managers must correspond and liaise with customers, senior management and many other internal and external parties, therefore, superior interpersonal and communication skills are essential. They should also demonstrate sound judgement and strong analytical skills.

Strategic Professional Options examinations linked to this role

Advanced Financial Management

Career opportunities presented by this role

Claims manager roles are available in a variety of specialisms including health, motor vehicles, buildings and contents. There is a natural career path through to the claims director position.

Competencies

High level competencies required include:

  • Governance, risk and control

    A. Evaluates organisational structures and governance to protect the long-term interests of stakeholders.

    B. Recommends appropriate strategies to ensure adherence to governance structures and application of best practice internal controls.

    C. Identifies and manages risk appropriately.

    D. Uses risk management for the best interests of an organisation and its stakeholders.

    E. Monitors and applies relevant legislation, policies and procedures.

  • Stakeholder relationship management

    A. Positively develops relationships with internal and external stakeholders.

    B. Communicates and gains commitment from internal and external stakeholder.

    C. Uses emerging technologies to collaborate and communicate effectively with stakeholders.

    D. Applies professional and ethical judgement when engaging with stakeholders.

    E. Aligns organisational strategic objectives with stakeholder needs and manages expectations.