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Claims Role Statement
Key Result Area and Main Activities
Competencies Required
Please click on the links below to see an expanded view of the competencies
Drive
Below Standard
Does only what is required
Shows no concern with measuring personal performance
Gives up on a project or responsibility
Standard
A self-starter: completes work independently without reminders or constant supervision
Finishes tasks completely and on time without "loose ends"
Shows persistence in overcoming obstacles
A doer: willing to take ownership and accountability
Strong
Does things before being asked to or forced to by events
Deals with multiple tasks, prioritising work effectively and completing on time
Uses time and resources efficiently and effectively
Very Strong
Sets and achieves challenging goals
Actively looks for new opportunities, ideas or approaches
Extreme drive for excellence and pride in their work
Professional Expertise
Below Standard
Appears to be unaware of personal strengths and weaknesses
Unconcerned with adding to existing knowledge
Standard
Willingness to study and learn
Keeps up-to-date on market knowledge and the technical aspects of the job
Strong
Works to establish significant knowledge in all aspects of claims
Makes self available to help others solve technical or professional problems
Very Strong
Has in-depth knowledge of all the experts - and knows which to use for specific needs
Provides technical leadership to colleagues for understanding situations, solving problems and building capability
Conducts post-mortem evaluations of own successes and failures
Strategic Thinking
Below Standard
Responds to immediate needs or requests without consideration of longer-term issues
Fails to spot the connections in information
Standard
Demonstrates good analytical and numerical skills
Draws logical conclusions
Sees the implications of events or information - e.g. identifies potential areas of contention
Sets priorities with an appropriate sense of what is most important or urgent
Uses accepted precedents, "rules of thumb", concepts or principles to describe problems or situations
Strong
Ability to apply specialist technical knowledge within and outside the procedural structure
Is able to cope with multiple tasks and problems concurrently
Spots connections, trends or discrepancies in information that are not obvious
Very Strong
Identifies the key issues in a complex situation
Thinks creatively / divergently: takes unusual perspectives on situations
Is willing to challenge traditional thinking
Ability to think quickly and retain judgement under pressure
Interpersonal Effectiveness
Below Standard
Sees others primarily in terms of racial, gender, or other stereotypes
Standard
Makes a conscious effort to build rapport with others
Can communicate effectively internally and externally
Listens "responsively" - is easy to talk to
Respects and relates well to people from different backgrounds
Strong
Can understand situations from the other person's point of view
Creates common ground with others (not necessarily based on personal liking)
Cultivates and maintains a network of contacts to share information and encourage cooperation
Very Strong
Seeks to understand what people are saying
Is attentive to emotional cues
Builds effective relationships with clients / third parties which endure throughout the insurance cycle
Works at rebuilding relationships when something goes wrong
Influence
Below Standard
Ineffective in presenting a case; unable to present convincing arguments that address the needs of others
Shows little concern for the need to influence or gain the support of others
Standard
Works at influencing. Persuades others by pointing out benefits to them
Uses information or data effectively to persuade others to support a position
Communicates fluently, interpreting and clarifying details and explaining reasons
Strong
Adapts influencing tactics to the audience
Anticipates and prepares for how people will react
Builds a positive professional reputation in the market
Demonstrates influence at all levels
Very Strong
Does things to make others feel ownership in one's own solutions or proposals
Tailors own language to the level and language of the audience
Negotiates "win/win" deals - e.g. with brokers / lawyers
Confidence
Below Standard
Acts solely out of a need for the approval of others
Blames others or circumstances for failure
Pretends to know more than they do
Standard
Approaches new challenges with a positive "can-do" attitude
Expresses confidence about own interpretation or viewpoint - e.g. when dealing with third parties
Strong
Recognises personal strengths
Accepts personal responsibility for own mistakes
Stands up for what they believe in when dealing with difficult / complex situations
Very Strong
Deals confidently with opposition
Maintains judgement under pressure
Instils a sense of confidence in the workforce around them
Flexibility
Below Standard
Fails to understand and appreciate the perspectives of others or relate to groups different from oneself
Fails to change approach or adapt to changes at work
Standard
Adapts easily to changes at work
Sees the merits of differing positions or opposing viewpoints
Modifies a strongly held opinion in response to contrary evidence
Strong
Shifts roles
Adopts multiple roles to fit needs of the situation
Enthusiastically takes on new ideas
Very Strong
Modifies own behaviour or approach, in response to a changing situation
Initiates / supports changes to the process (willingness / innovation)
Collaboration
Below Standard
A loner: selfish or uncooperative
Leaves colleagues to sort out difficult situations on their own
Standard
A co-operative team player, supporting team decisions, doing his/her share
Willingly does whatever work is necessary to get the job done successfully
Shares learning, knowledge and ideas with colleagues
Strong
Demonstrates respect for others contributions and a willingness to learn from them
Cultivates and maintains a network of contacts to share information and encourage cooperation
Very Strong
Encourages colleagues and publicly credits those who have performed well
Steps up to lead when the situation demands it
Team Leadership
Below Standard
Abdicates leadership responsibility
Refuses or fails to lead even when staff request or obviously need direction
Standard
Sets and communicates clear standards and feeds-back on performance
Ensures the completion of group tasks
Recognises good performance
Gives credit to people who have contributed to a specific success
Strong
Encourages colleagues and publicly credits those who have performed well
Delegates effectively: right task / right person / right reason
Generates enthusiasm and commitment to the group's or managing agency's goals
Very Strong
Acts to develop an atmosphere of teamwork and co-operation
Works to resolve conflicts and differences within the group
Encourages initiative
View expanded competencies
Accurate Reserving
Quantify the extent and range of damage, loss or injury
Enter claim data onto appropriate database(s)
Monitor and regularly update claims forecasts
Apply company reserve philosophy and relevant legal reports
External Specialist Advice
Develop partnerships with service providers (e.g. solicitors or attorneys / loss adjusters / TPAs)
Appoint service providers as appropriate
Review reports
Efficient Cooperation and Collaboration in the Claims Process
Develop and maintain effective relationships with clients and other stakeholders (brokers, underwriters, reinsurers, co-insurers and outsourced suppliers)
Identify and resolve conflicts of interest
Ensure clients understand the claims process and progress
Keep other stakeholders up-to-date on claims and their impact
Cost Effective Settlements
Identify and analyse the risk in each claim and consider the costs and benefits of early resolution in cases of disputed liability
Resolve conflicts and disputes
Make and negotiate offers
Arrange payments and close files
Monitor indemnity costs and cash flow
Compliance with Regulatory Requirements
Meet FSA requirements, including those for TCF (Treating Customers Fairly)
Apply Lloyd's Franchise Performance Standards (e.g. Lloyd's Claims Minimum Standards)
Report to Board of Directors, as appropriate
Claims Information
Enter all claims data onto appropriate databases
Analyse and assess the validity, reliability and consistency of data
Identify trends and their impact on business performance, reporting regularly and as necessary
