Reports To:

Business Sustainability Manager

Function / Department:

Operations Support

Main Purpose:

Conduct audits across all types of business in accordance with regulatory and best practise requirements.
To ensure timely delivery of audit reports for local and senior management as appropriate.
To monitor adherence by all claims handling agents to recognised systems, procedures and service level agreements as laid down in delegated authority contracts.
To understand and analyse end-to-end claims processes highlighting potential weaknesses.
To identify and resolve problems through line managers as highlighted by audit.

Accountability:

The auditor is singularly and collectively responsible for monitoring adherence to claims handling guidelines via audit.

Key Responsibilities:

Follow the audit methodology.
Have a detailed understanding of the claims handling operation and the relevance/impact of ineffective/inefficient processes on customer service leakage and fraud recommending improvements where required.
Be aware of and act upon all Compliance matters, eg. Disability Discrimination, Data Protection, Proceeds of Crime, money laundering etc.
Have a detailed understanding of all Regulatory matters relating to Customer Service, eg. ICOB7, TCF, COI etc.
Ensure knowledge of contractual agreements with external claims handling agents including policy wordings and handling limitations.
Be aware of the introduction of new schemes and or processes and ensure that these are included in audits.

Inspire and Engage:

Maintain a personal profile across the sites.
Ensure operations recognise the impact of their actions – good and bad. Ensure all staff at all levels appreciates the importance of quality control.
Represent the Values and culture of the Group.
Support Health and Safety through highlighting issues.
Liaise and co-operate with other functions.
Engage in own self development.
Alert the Business Sustainability Manager to any potential risk issues.

Knowledge and Experience:

Candidates should have Insurance claims experience including Personal Injury claims handling.