Head of Technical Claims

Level: ARPC EL2

The purpose of this role is to serve as a technical authority in reinsurance claims for terrorism and cyclone risk with responsibility to ensure compliance with legislation and contract law, provide technical assistance to key stakeholders, ensure alignment with industry best practice and development/overseeing all aspects of claims leakage/fraud prevention, detection, and recovery.

Key responsibilities

Leadership of reinsurance claims practices

• Establish and maintain appropriate technical claims reinsurance policies, procedures, and processes.
• Establish and maintain working practices which serve to provide assurance that ARPC will routinely comply with contractual, regulatory, and legislative requirements and obligations.
• Identify risks in policy frameworks and working practices and design and implement mitigation strategies.
• Provide detailed assistance to stakeholders to promote their compliance with the Act and the ARPC Reinsurance Agreement.
• Provide technical support and advice in relation to claims related disputes.

Advisory to ARPC teams for both Cyclone and Terrorism Reinsurance

• Support and provide council to the CCO where required.
• Serve as the authoritative technical expert on legislative operations, the intersection and interrelation between legal definitions in contract law and function as the primary internal point of reference for reinsurance claims related matters.
• Provide high level professional guidance and comprehensive technical information to the stakeholders in relation to reinsurance offered by ARPC.

Development / Overseeing Reinsurance Claims Leakage and Fraud

• Detection and Prevention: Develop, implement, and continuously enhance claims leakage and fraud detection strategies and initiatives to reduce the risk of increased claims costs due to leakage and mitigate fraudulent claims. Collaborate with cross functional teams to strengthen anti-fraud measures.
• Investigation and Analysis: Conduct in -depth analysis of claims data and patterns, as well as internal benchmarking of insurers, to identify high risk claims and potential fraud. Lead the investigation of suspicious claims, using advanced tools and techniques where required.
• Recovery: For identified frauds liaise with appropriate parties to take action on recovery.
• Policy Development: Develop a framework to identify and assess fraud risks. Create and maintain policies and procedures related to fraud detection reporting and prevention. Ensure compliance with industry regulations and standards.
• Collaboration: Collaborate with claims and underwriting teams as well as other departments to share information and improve claims leakage and fraud prevention efforts. Partnership with the Commonwealth Fraud Prevention Centre for a whole of government approach to fraud detection and management working together on fraud countermeasures and reporting.
• Quality Assurance: Ensure the quality and accuracy of claims audit and fraud investigations, maintaining a high standard of work while adhering to deadlines.

Engagement with internal and external stakeholders

• Take a lead role in fostering stakeholder understanding of the relevant legislation for the Cyclone and Terrorism Reinsurance Pools.
• Provide detailed assistance to stakeholders to promote their compliance with the Act and the ARPC Reinsurance Agreement.
• Represent ARPC at relevant industry forums which may involve presentations, government reports and articles.
• Work with Underwriting, particularly the Head of Technical Underwriting, on disputes or retrocession claims recoveries should they arise.

Other

• Participate in ARPC Corporate projects as and when opportunities arise.
• Champion risk culture values and a strong advocate for good customer outcomes.
• Promote continuous improvement to ARPC’s products and services having regard to product assessments, IT solution and business efficiencies.
• Identify, communicate, and solve issues within ARPC that arise in the administration of the TCI Act.
• Draft Board papers on claims matters and present at Board level as required. Develop and maintain a commercial understanding of the markets in which ARPC operates to contribute to short, medium, and long-term business planning and development.
• Role model ARPC’s Values and Code of Conduct and Capabilities set out in the ARPC’s Capability Framework.

Closing date for applications is Friday, 13 September 2024.

Contact: [email protected]