Assistant Manager, Legal Claims

Key responsibilities:

Providing detailed liability claims analysis to assist the Management to understand the liability exposures and implications of strategic initiatives and operational decisions. This will include analysing court files, hospital records and obtaining documents as allocated with a view to recommending or approve (as appropriate) the best decision on legal claims.

Identifying fraud risks and implementing strategies to mitigate them and assist in maintaining financial stability.

Managing the Legal Claims team to ensure compliance with Standard Operating Procedures and achievement of departmental objectives/key performance indicators.

Preparation of reports and dashboards for presentation at relevant departmental & Management meetings.

Identifying and realizing opportunities for cost savings and more efficient management of liability claims contributing to the organization’s profitability and long-term sustainability.

Ensuring up-take and operational compliance with such IT/Digital operations system that shall be adopted by the Company from time to time. In addition, driving the continued innovation and process improvement efforts to enhance operational efficiency and effectiveness within the departmental operations..

Approval of payment of fees, judgements and/or discharge Vouchers within TAT's as per SODA, Claims Legal Manual and relevant Service Level Agreements. This shall include undertaking relevant reconciliations on service provider payments.

Continuous Improvement: Encouraging a culture of continuous improvement within the legal team drives ongoing enhancements in processes, efficiency and effectiveness.

Ensure closure of all outstanding open audit items within timelines indicated. Effective management of the Legal Panel to monitor and enforce compliance with the Service Level Agreement.

Effective management of other service providers including investigators and medical experts.

Ensure effective case management by the team including liaison with customers and service providers on required documentation, witnesses etc. on legal claims to secure the Defence.

Undertake handling of material claims and suits against the Company as per Delegation of Authority matrix and as designated from time.

Manage reputation risk exposures to the Company as a result of the handling of Legal Claims.

Ensure up-to-date record keeping as per Claims Legal Manual. Recommend updates to the policies and procedures governing the department from time to time.

Keep the management appraised on legal claims status and manage legal claims costs.

Knowledge, experience and qualifications required

Bachelor of Laws (LLB).

Advocate of the High court of Kenya.

5 years and above Legal claims experience in an insurance company.

AIIK/ACII qualification is an added advantage.

Proficiency in MS word applications and operational systems will be an added advantage

Industries:Health, Wellness & Fitness

Function: Legal/ Lawyer