Sample job description for a Claims Claimant
A sample job description was drawn up taking into account the professional standard
1. General Provisions
1.1. A person is admitted to the position of a loss adjustment specialist:
1) who has a higher education (bachelor's degree), additional vocational education according to advanced training programs, professional retraining programs;
2) with at least 2 years of professional experience in the field;
3) having no criminal record.
1.2. A loss adjuster should know:
1) civil and administrative legislation of the Russian Federation;
2) regulatory legal acts in the field of insurance;
3) insurance business;
4) practical aspects of insurance;
5) insurance conditions;
6) the basics of valuation activities;
7) methodology for assessing losses in insurance;
8) regulatory and methodological documents for the settlement of losses;
9) industry-specific features of insurance risk;
10) the fundamentals of the labor legislation of the Russian Federation;
11) Internal labor regulations;
12) labor protection requirements and fire safety rules;
13) ……… (other documents, materials, etc.)
1.3. A loss adjuster should be able to:
1) organize the submission of the policyholder's application;
2) identify the reasons for the insured event;
3) determine the insured event;
4) prepare documents for official bodies;
5) determine the loss in accordance with the insured event provided for by the contract;
6) assess the amount of damage;
7) work with appraisal documentation;
8) interact with structural divisions;
9) identify facts of fraud;
10) assess the insurance loss;
11) draw up documents on the assessment of the loss;
12) draw up an insurance act;
13) regulate interaction with appraisal organizations;
14) determine the amount of insurance payment;
15) draw up an expert opinion;
16) draw up a set of documents for the settlement of the loss;
17) resolve conflicts with clients;
18) make decisions promptly;
19) organize the process of insurance payments;
20) ……… (other skills and abilities)
1.4. A loss adjuster must be stress-resistant.
1.5. A loss adjustment specialist in his activities is guided by:
1) ……… (name of the constituent document)
2) Regulations on ……… (name of the structural unit)
3) this job description;
4) ……… (names of local regulations,
regulating labor functions by position)
1.6. The claims adjuster reports directly to ……… (name of the manager's position)
1.7. ……… (other general provisions)
2. Labor functions
2.1. Settlement of losses under insurance (reinsurance) contracts:
1) execution of documents for an insured event;
2) assessment of the loss for the insured event;
3) organization of insurance payments.
2.2. ……… (other functions)
3. Job responsibilities
3.1. The claims adjuster performs the following duties:
3.1.1. Within the framework of the labor function specified in subparagraph 1 of paragraph 2.1 of this job description:
1) accepts the application of the policyholder;
2) conduct familiarization with the circumstances of the insured event;
3) analyzes the insured event;
4) examines the exclusions of the insurance contract;
5) provides assistance in the preparation of documents for the registration of an insurance act;
6) draws up requests to official bodies;
7) draws up an insured event.
3.1.2. Within the framework of the labor function specified in subparagraph 2 of paragraph 2.1 of this job description:
1) interacts with the policyholder (insured, beneficiary);
2) inspects the object damaged as a result of the insured event;
3) qualifies the damage in accordance with the terms of the insurance contract;
4) assesses the damage caused to the object;
5) determines the amount of loss in accordance with the terms of the insurance contract;
6) interacts with appraisal organizations;
7) prepares a report on the amount of loss;
8) sets the amount of the insurance benefit.
3.1.3. Within the framework of the labor function specified in subparagraph 3 of paragraph 2.1 of this job description:
1) interacts with experts in damage assessment;
2) checks the insured event for the likelihood of fraud;
3) familiarize himself with the insurance act and the appraisal report;
4) confirms the reasons for the loss in accordance with the insurance contract;
5) reveals the presence of a deductible in the insurance contract;
6) determines the possibility of regression (subrogation);
7) prepares documents for receiving insurance payments;
8) submits documents to the financial service.
3.1.4. As part of the performance of his labor functions, he carries out instructions from his immediate supervisor
3.1.5. ……… (other duties)
3.2. ……… (other provisions on job responsibilities)
4. Rights
A loss adjuster has the right to:
4.1. Request clarifications and clarifications from the immediate supervisor on these instructions, issued tasks.
4.2. To request on behalf of the immediate supervisor and receive from other employees of the organization the necessary information, documents necessary for the execution of the order.
4.3. To get acquainted with the draft decisions of the management concerning the function performed by him, with the documents defining his rights and obligations in the position held, the criteria for assessing the quality of the performance of his labor functions.
4.4. Submit proposals for the organization of labor within the framework of their labor functions for consideration by their immediate supervisor.
4.5. Participate in the discussion of issues related to the duties performed.
4.6. ……… (other rights)
5. Responsibility
5.1. A loss settlement specialist is held liable:
For improper performance or non-performance of their duties provided for by this job description - in the manner prescribed by the current labor legislation of the Russian Federation, legislation on insurance activities;
For offenses and crimes committed in the course of their activities - in the manner prescribed by the current administrative and criminal legislation of the Russian Federation;
For causing damage to the organization - in the manner prescribed by the current labor legislation of the Russian Federation.
5.2. ……… (other liability provisions)
6. Final provisions
6.1. This job description was developed on the basis of the Professional Standard "" approved by Order of the Ministry of Labor and Social Protection of the Russian Federation dated 03.23.2015 N 186n, taking into account ......... (details of the organization's local regulations)
6.2. Familiarization of the employee with this job description is carried out when hiring (before signing an employment contract).
The fact of familiarization of the employee with this job description is confirmed by ……… (signature on the familiarization sheet, which is an integral part of this manual (in the job description familiarization log); in a copy of the job description kept by the employer; in another way)
6.3. ……… (other final provisions).
JOB DESCRIPTION
loss adjuster
1. General Provisions
1.1. This job description defines the functional, job descriptions, rights and responsibilities of the claims settlement specialist of the Insurance Technologies division (hereinafter referred to as the Claims Specialist) All-Russian Association of Employers Russian Union of Industrialists and Entrepreneurs (RSPP) (hereinafter the Institution).
1.2. A person who meets the following education and training requirements is appointed to the position of Claims Claimant:
with practical experience:
Special conditions for admission to work of a claims settlement specialist:
1.3. A loss adjuster should know:
1.4. A loss adjuster should be able to:
1.5. A claims settlement specialist is appointed and dismissed by order of the Executive Vice President of the Institution in accordance with the current legislation of the Russian Federation.
1.6. The claims handling specialist reports to the Executive Vice President of the Institution and the head of the Insurance Technologies division
2. Labor functions
3. Job responsibilities
4. Rights
A loss adjuster has the right to:
4.1. Request and receive the necessary information, as well as materials and documents related to the activities of a loss settlement specialist.
4.2. Improve qualifications, undergo retraining (retraining).
4.3. Enter into relationships with subdivisions of third-party institutions and organizations to resolve issues within the competence of a claims settlement specialist.
4.4. Participate in the discussion of issues included in his functional responsibilities.
4.5. Make suggestions and comments on improving performance in the assigned area of work.
4.6. Apply to the relevant local government bodies or the court to resolve disputes arising in the performance of functional duties.
4.7. Use information materials and regulatory documents necessary for the performance of their duties.
4.8. Pass certification in accordance with the established procedure.
5. Responsibility
The claims handling specialist is responsible for:
5.1. Failure to perform (improper performance) of their functional duties.
5.2. Failure to comply with the orders and instructions of the Executive Vice President of the Institution.
5.3. Inaccurate information about the status of the execution of assigned tasks and orders, violation of the deadlines for their execution.
5.4. Violation of the internal labor regulations, fire safety and safety rules established at the Institution.
5.5. Causing material damage within the limits established by the current legislation of the Russian Federation.
5.6. Disclosure of information that has become known in connection with the performance of official duties.
For the above violations, a loss settlement specialist can be brought to disciplinary, material, administrative, civil and criminal liability in accordance with the current legislation, depending on the severity of the offense.
This job description was developed in accordance with the provisions (requirements) of the Labor Code of the Russian Federation of December 30, 2001 No. 197 FZ (Labor Code of the Russian Federation) (as amended), the professional standard "Insurance Specialist" approved by order of the Ministry of Labor and Social Protection of the Russian Federation Federation of March 23, 2015 No. 186n and other normative legal acts governing labor relations.
Will you not pay for the training of your staff? -
You will pay for his mistakes. A person who is valued will always do more than what is required of him Knowledge that is not replenished daily - decrease every day Always act as prudent uninsured person
Always act like a reasonable uninsured person Today, for a project to be successful, you need to do certain things not "better", but fundamentally "different". О Don't be afraid that it won't work. Be afraid you won't try. M. Fry The only real mistake is not to correct your past mistakes. Confucius I think - it means I am free The main question of institutional theory:
decide - this company makes money with your help
or, on the contrary, is it you earn with the help of the company? The client always goes to the one who needs him least of all The most necessary and most important things in life are always given free of charge It does not make sense to hire smart people and then tell them what to do. We hire smart people to tell us what to do. Steve Jobs Until success comes, you can even benefit from expectation. VP Wise is not one who knows a lot. Wise is the one who knows what is needed. Aeschylus Eat food as medicine. Otherwise, you will have to eat the medicine as food. S. Jobs If you just want to go fast, go alone.
But if you want to go far, walk together. S. Jobs School of business should be like a dentist's office: there should be teeth treated, not chasing scientific ratings. Godin V. V. From repetition, memorization is born, memorization allows one to compare, comparison develops thinking, thinking gives rise to the discovery of a new one. ABOUT Failure gives birth to tenacity - which is the main factor of success. ABOUT Why does it take so long to study?
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Because mindset restructuring does not happen quickly. The source of income is your knowledge, and not hopes for complex financial instruments. Sergey Shvetsov Anything can be insured, but not everything that is horrible.
A. Kandybovich The task of the security guard is not to hide the cereals from the rats.
The safety guard's job is to catch rats. Vladimir Kleev Every person is the thought of God.
Therefore, follow your destiny, and do not resist it Happiness is doing math and not thinking at the same time,
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The rest is in your hands. OK If you graduated from a university and cannot manually schedule a loan or international loan repayment schedule, then perhaps you just donated your money to fraudulent universities If you graduated from a university and do not know a single programming language, then perhaps you just donated your money to fraudulent universities If you graduated from university and do not know what is the difference between "classical theory of finance" and "fundamental ideas" of financial business, then perhaps you just donated your money to fraudulent universities Whoever you are and where whatever you work,
you still have to look for a new job. Prepare for this in advance. Building a theory is creating an ontology of the possible. A. Sh. Once a student asked the teacher:
- How long to wait for changes for the better?
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Vladimir Kleev Insurance fraud exists where there is uncontrolled access to money. Lack of control over the movement of money is always fraught with the most dire consequences Those who do not expand their competencies today -
runs the risk of being left without a profession in 2-3 years. Not the one who insures plays, on the contrary! - the one who does not insure plays.
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than your criticism or condemnation Mathematics is the only method of reasoning and argumentation that is not based on perceived evidence,
but on absolutely abstract speculative positions, which do not correspond to anything in reality. Communicating with the staff, never
do not ask, do not order, do not threaten In negotiations, avoid four failing roles:
know-it-all, underappreciated, victim of circumstance, and supplicant To become a man of knowledge, you need to be a warrior, not a whining child. Don Juan's Teachings If you are offered a course and promised not to engage in "useless theory,"
then consider whether the real theory is useless.
Theory is always a systemic view of the picture of the world,
and everything else is just details. The highest justice of life is that everyone in the end does what he should do. L. V. There is no need to wait to become who we really are. We already are what we are. M.L. To get to the top of the hill, it is not necessary to multiply speed by time, but perseverance to purpose. The snail on the slope The fool has a huge advantage over the educated person: he is always pleased with himself. N. Democracy is when your opinion means absolutely nothing. A.M. Never hope that someone else will change.
Change must always start with yourself. Any problem can be solved if there is a determination to solve it. A. Kuraev Nothing disciplines the thinking of a financial specialist so much,
as a course in accounting and taxation. ABOUT Death is inevitable, but until it comes, everything can be changed.
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and self-education - for everything else. People don't like to learn because they intuitively understand
that they are simply not able to master this work. OH If God wants to make you happy, then he leads you the most difficult path, because there are no easy ways to happiness. O. Khayyam It is not necessary to win the dispute:
both parties have the right to be misled. ABOUT People who are dreaming have a smile on small troubles. ABOUT Invest your time before you invest your money.
Test your strategy before you risk your money Everything that matters is not urgent. All that is urgent is just vanity. Hsiang Tzu Very often life forces us to play not only without trump cards, but also without cards at all. ON Only death is ontological unambiguity.
From this point, the epistemological theory of probability begins. ON The one in whose life there is no change
- dies from lack of change. Baudrillard Understanding is not enough. You need to learn to be able to. ABOUT If a person has stopped learning, then he has given up on himself. ABOUT. Don't indulge. D.Kh. Do not risk. If you take risks, you just don't want to assess the consequences. ABOUT Every sale has five basic obstacles:
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Both are subject to relentless aging, which can and should be resisted. О Strive to be the best. You will become competitive. ABOUT You cannot teach anything. But you can help to learn. ABOUT Failure is not a crime; it is criminal to set goals below your capabilities. D. Lowell Your boss probably has the right to teach you, but he is unlikely to have the right to teach you. Den Kennedy If you could learn anything without a teacher,
then such a profession would not exist. ABOUT Choosing the safest path - you are choosing the path of missed opportunities Never let your subordinates impose their rules of the game on you. Dan Kennedy Pricing in Crisis: Little is More Than Nothing. MP When you are about to leave the house, ask yourself - why?
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Confucius First they ignore you, then they laugh at you, then they fight you, then you win. Mohandas Ghandhi You never notice what has been done: you only see what is left to do. M. Sklodowska-Curie Losses - the beginning of multiplication. Plurality is the beginning of losses.
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and the most powerful incentive. Titus Livy Confidence in strength itself is fraught with strength. C. Bowie Whoever is free from prejudice must be prepared to be misunderstood. Lyon Feuchtwanger Who wants to teach someone who thinks highly of his knowledge -
wasting time. Democritus Teachers are nothing more than blacksmiths forging plows. After them, much still needs to be done to make bread. The root cause of risk is ignorance. Democritus Fate is blind, but not malicious. What I understood is wonderful. From this I conclude that the rest that I have yet to understand is also fine. Socrates Most people are happy as much as they allow themselves to be happy. A. Lincoln Two things are very difficult to avoid: stupidity - if you withdraw into your specialty, and unreasonableness - if you get out of it. Goethe IV Do not neglect your enemies: they are the first to notice your errors. Antisthenes I pay little attention to critics. There are two kinds of people in the world: those who can and those who criticize. R. Reagan The whole problem with the world is that fools and fanatics are always so certain of themselves, but wiser people so full of doubts. B. Russel People tend to blame fate, the gods, but not themselves for their misfortunes. Plato Firmness of conviction is more often the inertia of thought than the sequence of thinking. V. Klyuchevsky Reasonable chases not what is pleasant, but what gets rid of troubles. Aristotle If you can "t explain it to a six year old, you don" t understand it yourself.
Albert Einstein There is more evil in fear than in the thing itself that is feared. Cicero If you have knowledge, let others light their lamps from it. Margaret Fuller Those are mistaken who, in times of prosperity, think
that we got rid of adversity forever. Cicero.
Those who, in times of adversity, think that this is forever, are mistaken.
To paraphrase Cicero, Man goes to knowledge the same way he goes to war - fully awakened, full of fear, awe and unconditional determination. Carlos Castaneda It is a greater shame to lose what you have acquired than not to be acquired at all. Crisp Who can go to the fountain must not go to the jug. Leonardo da Vinci When an arrow misses a target, the shooter blames himself, not the arrow. Confucius Be careful. Even while safe. Titus Livy The slowest man who does not lose sight of his goal, nevertheless is more agile than the one who wanders aimlessly. Gotthold Lessing People always blame others for what they themselves are to blame. ABOUT Those who are confident in their abilities win. Those who are unable to overcome fear have not yet learned their first lesson in life. Ralph Emerson If something cannot be avoided, then it can be foreseen. Seneca To justify ourselves in our own eyes, we often convince ourselves that we are unable to achieve the goal; in fact, we are not powerless, but weak-willed. François de La Rochefoucauld There is no great deed without great obstacles. Eleanor Roosevelt It's too late to be frugal when all is lost. Seneca Always remember: no one can make you feel inferior without your consent. Eleanor Roosevelt Make yourself indispensable for the world - and humanity will give you bread. Ralph Emerson To retrain a person is more difficult work than to re-teach. Quintilian Before it's too late, do not forget that the work of a lifetime is not a business, but a life. B. Forbes Don "t forget until too late that the business of life is not business but living. B. Forbes.
but only your memory. Leonardo da Vinci Anyone who conducts an argument by appealing to authority is not using his intelligence; he is just using his memory. Leonardo da Vinci Constant effort, not strength or intelligence, is the key to unleashing your potential. Winston Churchill Continuous effort - not strength or intelligence - is the key to unlocking your potential. Winston Churchill Whoever cannot smile should not be involved in trade.
Chinese proverb There are three mistakes in human communication:
the first is the desire to speak before it is necessary;
the second is not to say when it is necessary; the third is to speak,
without watching your listener. Confucius The wisdom of people is proportional not to their experience, but to their ability to acquire it. Bernard Shaw Let death be daily before your eyes, and you will never entertain any abject thought, nor too eagerly covet anything. Your thoughts are your life. Marcus Aurelius Three grand essentials to happiness in this life are
something to do, something to love, and something to hope for. Many people assume what they are thinking while they are simply rethinking their prejudices. William James Never follow the crowd. Whatever the project, start implementing it today. Jim Rohn A true teacher defends his students against his own personal influences Don't say, "We're doing our best." You just have to do what is needed now. W.Ch. A judgment does not cease to be true because it is not recognized by many. Benedict Spinoza An adversary looking for your mistakes is more useful than a friend who wants to hide them. Leonardo da Vinci If you measure success with praise and censure, your anxiety will be endless. Lao Tzu If time is the most precious thing, then wasting time is the greatest waste. Benjamin Franklin We reach the top most often through the wreckage of our cherished plans, discovering that it was our failures that brought us success. Steve Jobs When you meet a man of rare intelligence, ask him what books he reads. Ralph Emerson If we find a man of rare intellect, we should ask him what books he reads.
Ralph Emerson If you want to invent something new, constantly revise the old one. Development - in refutation of the current paradigm At present, any liberal arts education should have a clear practical orientation If you want to understand something, write an article,
to master science - write a book Only those who go through the toughest selection through the need to constantly study remain in the insurance profession.A specialist cannot be hired in an insurance company
without a diploma of insurance education The meaning of any training is to do with the student what
which he had not previously been able to do. Education is a merit blessing. Nobody wants to pay for it, but everyone likes it when it is. If the staff is not forced to study, then it gradually grows dull and swells with conceit. Meanwhile, science is moving forward. ABOUT
If you see on someone's business card the inscription "loss settlement specialist", you involuntarily imbued with respect for such a person. Agree, the very word “settlement” gives a certain authoritarian connotation and significance. Claimants are not the bats and tracksuit thugs that some think. No, “settlement” means a completely civilized approach and a decision related to the action of an insured event, when the client should be paid insurance.
The vacancy of a specialist in claims settlement implies the function of investigating all the circumstances of the occurrence of an insured event, to what extent it complies with the insurance contract, as well as determining the amount to be paid. Also, such a specialist oversees the settlement of losses of representatives of opposite parties.
The histogram below shows the change in the level of the average salary of the profession Claims Claimant in Moscow:
Features of the work of a loss settlement specialist in Moscow
A claims settlement specialist in Moscow, as well as in other cities, will interact with various expert organizations, prepare an opinion-justification for the payment of insurance (for example, when car insurance is valid), and also resolve claims issues - prepares a package of documents for payments.
Quite often, a specialist in claims settlement is required in car dealerships, official dealers, representatives of car brands: after all, people often take cars on credit, and in general the cost of many cars is very high. In addition, car insurance is a prerequisite for owning them, so there will always be a job for a loss settlement specialist in Moscow in the field of auto insurance - Moscow is overloaded with cars.
Below is a ranking of similar vacancies by salary level in Moscow. Among similar professions, the most highly paid is the Insurance Specialist. According to our website, the average salary is RUB 47,500. In second place is the Insurance Manager with a salary of 47,500 rubles, and in third place is the Manager of the agency group with a salary of 46,250 rubles.
It is not necessary to have experience in this business to become a specialist in claims settlement - many companies are ready to train employees. However, there will be a mandatory requirement for the vacancy of a claims settlement specialist: higher education, fluency in the Microsoft software package, communication skills, responsibility and attentiveness. Of course, those candidates who have already had experience in insurance will have an advantage.
Also, claims settlement specialists may be required in the construction sector - then the work will be associated with construction risks, if in the medical field - with medical ones.
However, the main employers are large insurance companies, which have the widest representation in areas where insurance may be needed.
Another specialist in claims settlement is called "adjuster" - from English. Adjuster - adjuster, adjuster.
