Life Claims Officer

Adjudicates and approves claim that fall outside Level 1’s authority limits, cases that require special handling, or claims submitted for and / or by VIP customers as defined in the Life Claims Business Guidelines

Adjudicates and approves Death, Critical Illness, Daily Hospitalization Income, Accident Medical Expense reimbursement, Waiver of Premium, Accidental Death & Disability, Permanent Total Disability, and Terminal Illness Benefit claims from the retail (individual) and / or group lines of business within your delegated authority limits and stipulated turnaround time

Conducts the end-to-end claim case management from claims adjudication to the timely emailing of the decision letter to the claimant and / or distributor using WFI, RLS, iBPS, SCRM, MAP, and MS Outlook as work tools

Assist Claim Officers, as needed, in conveying the relevant claim terms and conditions with properly identified claimants and / or distributors, via email or a virtual meeting, when encountering objections to the process of obtaining supporting documents

Reviews and analyzes insurance policies, product technical notes, medical records, and other documentation to determine whether the claim is approved, denied, or needs additional documents.

Complies with set policies and procedures in the identification of and prevention of losses due to fraudulent claims

Ensures complete and accurate claim documentation by asking for and obtaining relevant information that will help arrive at the appropriate claim decision. Ensures that all relevant case notes, documents, and correspondences are available in the WFI case file and RLS claim assessment module

Prepares the complete case summary for claim referral to Level 3, or higher, for cases where the total payable benefit exceeds your delegated authority limits. Makes recommendation on the provisional claim decision on such cases

Assesses the precise payable amount for the claim benefit (work) type after determining the applicable deductions or additions, if any, using the computing tools provided by AXA Philippines

Your Profile

Bachelor’s degree holder of any 4-year course, preferably in the medical sciences, and have at least 5 years of experience in life claims processing or life insurance operations.

Detail-oriented and analytical. You can draw sound judgment and take a decision on the facts being presented in the claim documentation available to you without missing the important details in the documentation.

Self-driven, motivated individual who shares a commitment to delivering exceptional customer service and provide timely resolution on complex cases.

Highly organized individual who can easily keep track of your responsibilities, deadlines, and promises made to a claimant and / or distributor.

Works professionally and ethically with department colleagues, clients, claimants, vendors, and distributors.

About AXA

A global leader in insurance and investments, AXA takes care of 103 million lives in 64 countries worldwide. We actively invest in pioneering and personalized solutions to meet your ever-changing needs and exceed your expectations. In the Philippines, we are in partnership with Metrobank, one of the country's strongest banks.

About the Entity

Established in 1999, AXA Philippines is one of the largest and fastest growing life insurance companies in the country. It offers financial security to more than one million individuals through its group and individual life insurance as well as general insurance products through its subsidiary Charter Ping An.

AXA Philippines is one of the first to introduce bancassurance operations in the country, and is among the pioneers in the investment-linked insurance sector.

AXA now offers a complete range of products for all its customers’ insurance and financial protection needs, including savings and investments, health plans, income protection, and health coverage; and through its general insurance subsidiary Charter Ping An Insurance Corporation : fire, motor car, marine cargo, personal accident, bonds, casualty, and engineering insurance products.

AXA Philippines closed 2017 with billion in total premium income and billion in gross written premiums from Charter Ping An. Today, AXA has more than 4,000 financial advisers in 36 branches, and 700 financial executives in over 900 Metrobank and PSBank branches nationwide. Charter Ping An, on the other hand, has 22 branches nationwide and 2,007 agents.

AXA Philippines is a joint venture between the AXA Group, headquartered in France, and the Metrobank Group, one of the largest financial conglomerates in the Philippines.

The Metrobank Group is a conglomerate of industry-leading businesses that includes First Metro Investment Corporation, Metrobank Credit Cards, Federal Land, Toyota, and Manila Doctors Hospital. It was hailed Best Bank in the Philippines in 2010, 2011, and 2012 by Euromoney and recognized as the strongest bank in the Philippines by The Asian Banker in 2013. It is owned by the Ty Family whose major business interests include financial services, real estate development, power, and manufacturing.

What We Offer