Claims Assessor

Legal & General
11 Jan 2018
16 Feb 2018
Contract Type
Full Time

Job duties

  • Triage and assessment of new Group Income Protection claims, determining what medical evidence to obtain in line with Legal & General’s philosophies
  • Provide a comprehensive assessment of Group Protection claims, deciding whether to accept or reject liability and authorise payment as per individual authority limits as agreed by the Head of Benefits, whilst meeting the expectations of the IFA’s and our corporate clients
  • Develop and build effective relationships with IFA’s and Policyholders (employers), in order to maximise the effectiveness of our benefit management processes including the provision of support for the portfolio management of defined schemes
  • Authorise expenditure on appropriate external medical evidence to support the assessment of individual claims up to £5,000
  • Propose expenditure on rehabilitation or work re-integration programmes where there is a suitable cost/benefit justification for doing so
  • Where appropriate, assist in the provision of Management Data on portfolio accounts which analyses performance and identifies key trends
  • Train, mentor and develop other members of the benefits team, to improve their skill level
  • Ensure a consistent, timely and accurate level of service is maintained in line with service level agreements and promises made to meet customers’ expectations, and that are within scope of Legal & General’s Customer Experience and Treating Customers Fairly policies. Where failures are identified, provide information and feedback to the relevant areas to enable changes and improvements to be made
  • Adhere to processes and systems to ensure that all customer data is dealt with appropriately in accordance with legislation, in particular the Data Protection Act (1995), the Access to Medical Reports Act (1988) and Legal & General’s Confidentiality Policy

Skills required

The job holder is encouraged to obtain the Life & Disability Claims Diploma and the Group Risk GR1 module of the FPC qualification both of which are qualifications supported by the Chartered Insurance Institute.


  • Good knowledge of all Group Protection products past and present
  • Good understanding of medical conditions and the effect these can have on an individual’s ability to work
  • Awareness of the investigative and rehabilitation services provided by external organisations

Specific Experience:

The jobholder requires awareness of legislative and regulatory knowledge including:

  • Finance Act 2004
  • Equality Act
  • Employer Law
  • DWP State Benefits
  • HMRC rules relating to Life and Pensions products
  • Data Protection Act
  • Financial Ombudsman Service
  • The Role is not regulated by the FCA, and the jobholder is not an approved person. However, the jobholder will be responsible for ensuring regulatory standards associated with the role are achieved at all times


  • The job holder requires excellent communication, both verbal and written, skills; analytical and risk management skills; ability to be creative and strategic thinking
  • Strong claims assessment skills
  • Claims authorities: as agreed by Head of Benefits
  • The job holder may represent the area at internal meetings