One of the main roles that underpins the insurance industry is the claims handler. As the first point of contact in the company after a customer has a car accident or a break-in at their home, claims handlers must be a good all-rounders; supportive, caring and decisive, with a great eye for detail.

Insurance claims handlers process insurance claims, assess the validity of claims, and make sure that payouts are made within agreed limits. Insurance claims handlers manage claims, from submission by a policyholder to eventual pay out. They decide whether a claim is valid and check for potential fraud.

 

Claims handlers also coordinate the response to a claim, such as ordering replacement items or organising tradespeople to carry out repair work.

 

(Source: Insurance Business Mag)

ANZSCO ID: 5523
     

Alternative names: Insurance Officer, Claims Administrator, Insurance Clerk

Specialisations:

• Insurance Claims Managers lead a team of claims handlers and make sure that they deal with insurance claims efficiently. Claims managers handle more complex insurance claims. They deal with, and resolve, customer complaints and appeals.

Knowledge, skills and attributes   

To become an insurance claims handler, you would need:

• attention to detail

• sound judgment and decision making skills

• strong customer focus

• excellent verbal and written communication skills

• tact and assertiveness when dealing with customers

• strong time management skills

• an aptitude for mathematics

• good IT skills.

 

(Source: Reassured)

 

Duties and Tasks

As a claims handler, you would :

• take details over the phone or internet when a claim is reported

• give advice on the claims process

• check that premiums have been paid and that the policy covers the claim

• advise on what information, such as receipts, photographs or valuations, is needed to process the claim

• advise customers on how their claim might affect future policy premiums

• arrange payments on straightforward claims

• refer claims to a claims manager where necessary.

(Source: Insurance Institute)

 

 

Working conditions

In a full-time job you would usually work a regular number of hours each week, Monday to Friday. You might work shifts including evenings and weekends in a contact centre. Part-time or flexible work is often available.

You would work in an office or contact centre, and spend most of your time speaking on the phone and using a computer.

Education and training/entrance requirements

You can work as an insurance claims handler without qualifications, although employers would usually require you to have gained your senior secondary school certificate or equivalent. It is common, and may be required, to study for insurance industry qualifications at the same time as working in an entry level role such as this.

With experience, you may be able to become an insurance claims manager, and lead a team of claims handlers.

 

A snapshot into the role of a Claims Representative: Work Cover Queensland
https://youtu.be/HbBN_HZhiw0

 

 

Employment Opportunities

Career progression:

• Start as a junior claims handler

• Progress to team leader

• Further progression to claims manager and claims director

• Possibility to move into other areas such as loss adjusting and risk surveying

Did You Know? Reported in Insurance Business Mag The majority (95%) of claims handlers in the US and the UK believe claims processing will be significantly impacted by technology in the next five years, according to a study by insurtech Sprout.ai. The survey sheds light on the daily challenges faced by claims handlers, revealing that 55% find the review and processing of claims documents and evidence particularly burdensome. An equal percentage reported frustrations with compliance and reporting requirements. From the perspective of customer service, the polled claims handlers provided insights into the most common customer grievances. Approximately 28% of handlers pointed to complaints related to delays or communication gaps. Another 20% encounter demands for greater transparency, while 17% noted calls for quicker claims resolution. “Claims handlers are responsible for the most important moment for an insurance carrier: delivering on their service promise,” Sprout.ai chief executive Roi Amir said. “They know the claims process inside and out, and they’re deeply invested in making it easier for customers as well as themselves, as pressure can be high at these critical moments. “The report confirms what we already knew: handlers are becoming increasingly frustrated by challenges around delays and customer communication – and they are now seeing technology as the answer. This is a really promising development for the insurance industry: technology has the potential to turbocharge claims processing.” Citing an example, Amir said using artificial intelligence can take a typical claims process from 30 days to real time, freeing up handlers to deliver better customer communication. Meanwhile, the poll also brought to light certain differences between the experiences of UK and US claims handlers. For instance, a notably higher percentage of UK handlers struggle with the retrieval and review of documents and evidence – 36%, compared to just 14% of their US counterparts. The research was conducted in collaboration with Opinium in March and April of 2024.

 

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Material sourced from
Web Archive Only - CareerHQ [Insurance Claims Handler; ]
Prospects UK [Insurance Claims Handler; ]
 Insurance Business Mag