Our esteemed client, a reputable insurance company based in Malta, is seeking a dedicated Senior Claims Executive to join their team. The Senior Claims Executive manages complex, high-value, contentious, or sensitive claims and serves as an escalation point within the Personal Lines Claims function. In addition to handling an advanced caseload, the role provides technical guidance, mentoring, and support to a team of claims handlers and the vast commercial network, helping ensure consistency, quality, and adherence to best practice across the team. The role requires advanced technical claims expertise, sound professional judgement, and the ability to manage cases involving legal complexity, complaints, fraud concerns, or reputational risk. The successful candidate will contribute to excellent customer outcomes while balancing regulatory, commercial, and operational considerations.
DUTIES AND RESPONSIBILITIES
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Assess and determine the validity of complex and high-value claims against policy conditions, applying advanced understanding of insurance principles and policy wordings.
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Manage complex personal and commercial lines claims from notification through to settlement, ensuring efficient resolution and excellent customer service.
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Provide senior-level guidance to policyholders and stakeholders on complex, sensitive, or contentious claims, including declinatures and partial settlements.
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Act as an escalation point for technical, legal, regulatory, fraud-related, and customer service challenges.
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Negotiate settlements within delegated authority limits, ensuring fair, consistent, and defensible outcomes.
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Investigate complex claim circumstances and identify potential fraud indicators or policy coverage issues.
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Liaise directly with lawyers, loss adjusters, medical experts, surveyors, engineers, and other specialists, providing clear instructions and oversight.
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Review and monitor claim reserves and costs, ensuring accurate estimation and effective cost control.
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Handle complaints relating to claims and assist in the resolution of escalated customer concerns.
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Support quality assurance and consistency in claims decision-making through technical guidance and knowledge sharing.
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Provide coaching, mentoring, training, and day-to-day support to junior claims handlers.
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Promote fair treatment of customers and ensure compliance with legal, regulatory, and company requirements.
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Contribute to continuous improvement initiatives, identifying opportunities to enhance claims processes, controls, and customer experience.
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Maintain accurate records and prepare reports as required by management.
CANDIDATE PROFILE
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Diploma in Insurance (Level 5) or equivalent professional insurance qualification.
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Commitment to ongoing professional development and technical learning.
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Strong understanding of insurance principles, policy interpretation, and claims management practices.
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Sound understanding of legal and regulatory requirements relevant to claims handling.
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Minimum of 2 to 4 years' experience in insurance claims handling.
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Proven experience handling complex, high-value, contentious, or sensitive claims.
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Experience dealing with lawyers, loss adjusters, external experts, and other stakeholders.
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Experience supporting or mentoring junior team members is considered an asset.
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Advanced knowledge of personal lines claims handling.
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Strong understanding of policy interpretation and coverage assessment.
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Excellent negotiation, decision-making, and problem-solving skills.
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Strong complaint handling and conflict resolution abilities.
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Knowledge of fraud identification and investigation techniques.
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Advanced communication and stakeholder management skills.
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Strong report-writing and analytical skills.
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Advanced IT proficiency
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Strong professional judgement and decision-making capability.
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Advanced communication, influencing, and interpersonal skills.
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Leadership by example and commitment to customer service excellence.
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Coaching and mentoring capabilities.
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Strategic thinking with consideration for precedent, consistency, and wider business implications.
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High degree of emotional resilience and ability to perform under pressure.
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Strong organisational and prioritisation skills.
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Attention to detail and commitment to quality.
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Excellent verbal and written communication skills in English and Maltese.
SALARY AND BENEFITS
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€25,000 - €30,000 Gross Per Annum
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Salary will be determined based on experience, qualifications, and skills. The advertised salary range is indicative, any offer will reflect the successful candidate’s suitability.
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The Senior Claims Executive will primarily be office-based, with limited flexibility for remote working depending on operational requirements.
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Standard office hours apply; however, flexibility may occasionally be required to manage urgent claims, complaints, or business priorities.
Due to the high volume of applications received at GRS Recruitment, only shortlisted candidates will be contacted.
To apply for this position, please email your CV to
Michelle Cooper, michellec@grsrecruitment.com quoting the above job reference or call +356 99998272 for further information.