Review contestable life insurance death claims by evaluating cause of death and checking for material misrepresentation in the medical history used for policy issuance or medically underwritten reinstatement. Evaluate policy reinstatement requests using medical information and the Swiss Re manual, and review and respond to MIB inquiries.
Our client, a major Life Insurance carrier is seeking a Life Insurance Claims Specialist for a long term (2 year minimum) contract position. This job can be worked remotely.
The Life Insurance Claims Specialist will review contestable death claims, life insurance policy reinstatement requests, and evaluate Medical Information Bureau (MIB) inquiries for an existing book of business.
Life Insurance Claims Specialist responsibilities include the following:
Contestable claims review will require an evaluation of the cause of death and validating that there was no material misrepresentation with the original health history that was used at the time of the policy issue, or that was provided during a reinstatement that required medical underwriting.
Policy reinstatement requests will include evaluating client responses to medical questions, medical examinations, lab work, or review of physician’s records to complete the underwriting risk evaluation to determine whether a lapsed policy should be placed back in force. Use of Swiss Re manual for risk assessment. Run manual MIB for all reinstatement requests and report MIB codes
MIB inquiries: Medical Information Bureau may request member firms to validate prior medical condition reports made on individual life insurance applicants.
Business Process: Claims and reinstatement inquiries are received at insurance carrier administrative offices and are routed to an underwriting queue for review and evaluation. MIB inquiries will be sent via secure email for review and response.
Requirements:
Ideally, candidates should have good product knowledge of life insurance and annuities.
Strong verbal and written communication skills, ability to multitask, and logic is preferred.
Claims and or underwriting background is preferred.
Candidates should have an investigative mindset. Determined to seek answers ifs something does not make sense.
Will use multiple proprietary systems top process claims, so ability to learn new systems quickly is critical.
Solid experience with MS Office products.
At least 4 years of Life Insurance Claims experience.
Works well independently or with minimal supervision
Chartered Life Underwriter (CLU), Academy of Life Underwriting (ALU) or Life Office Management Association (LOMA) certifications, courses or designations a big plus.
A bachelor’s degree or equivalent combination of education/experience.
Nice to have : Experience with the Resonant underwriting platform.
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