Insurance Claims Officer Āpiha Tono Rīanga
Insurance claims officers decide whether an insurance company will pay out a claim.
Insurance claims officers may do some or all of the following:
- analyse claims and decide whether they are covered by policy
- make recommendations for the settlement of claims
- inform clients if claims are accepted and how they will be allocated
- organise payments to clients and repair or replacement of lost items
- make sure all enquiries and payments are dealt with quickly
- appoint insurance loss adjusters and private investigators when required
- contact independent experts in case of disputes and attend disputes tribunals.
Useful experience for insurance claims officers includes other work in the insurance industry – for example, in underwriting or sales.
Work in retail sales, banking, customer service, finance, health and law is also useful.
Insurance claims officers need to be:
- good at listening and able to relate to a wide range of people
- tactful, patient and calm
- empathetic and fair
- good communicators and negotiators
- good at report writing
- good at analysing and interpreting information, including legal documents
- accurate, with an eye for detail
- organised and able to work under pressure.
Insurance claims officers need to have:
- understanding of the insurance industry, particularly the area they work in, such as fire, life, accident or marine insurance
- knowledge of their firm's insurance policies, including what each policy covers
- understanding of relevant laws such as the Privacy Act and the Human Rights Act.
Insurance claims officers:
- usually work regular hours, but may work evenings or weekends to meet deadlines, or if they are on call
- work in offices, but may travel locally to Disputes Tribunal hearings.
NCEA Level 3 is required to enter tertiary training. Useful subjects include accounting, business studies, English and maths.
Insurance claims officers can progress into supervisory or management roles within insurance companies, or move into other insurance roles such as insurance agent or insurance loss adjuster.
Insurance claims officers may specialise in:
- general insurance, which includes house and contents, commercial, motor vehicle and marine insurance
- life insurance, which includes health insurance, disability insurance and superannuation.
Years Of Training
There are no specific requirements to become an insurance claims officer. However, customer service and sales experience is useful.
A New Zealand Certificate in Financial Services (Level 4 or 5) or Diploma in Financial Services (Level 6) may be helpful, and some employers may prefer you to have a Bachelor's degree in any subject.
Medical or paramedical qualifications are helpful for insurance claims officers working in the areas of health, disability or life insurance. Automotive technician qualifications may be helpful for insurance claims officers working in motor vehicle insurance.
The Australian and New Zealand Institute of Insurance and Finance (ANZIIF) offers courses to diploma level in general and life insurance, which focus on developing technical insurance skills for claims staff.