Blog Page No. 3
Civil Fraud Investigation Position Vacant of the Month December 2011
This position was advertised under the radar on the Queensland Government's website. It is an excellent opportunity for a civil investigation professional with formal qualifications and management experience to influence, implement and manage the fraud control and customer service activiy of a major Insurer. Excellent conditions, excellent salary. Apply for this - Closes Friday December 2nd 2011.
Claims Performance Team Leader
CTP Division; Motor Accident Insurance Commission; Office of the Insurance Commissioner; Brisbane
The Office of the Insurance Commissioner (OIC) is a portfolio office within Treasury Department with responsibilities for Queensland’s motor accident insurance scheme, insurance arrangements for the Government’s assets and liabilities, and advice to the Government on general insurance issues. The OIC comprises the Queensland Government Insurance Fund and the statutory bodies of the Motor Accident Insurance Commission (the Commission) and the Nominal Defendant. The purpose of this role is to: • manage the legislative functions in relation to claims compliance, claims management monitoring and insurer oversight, including referee referrals, fraud prosecutions and complaints from stakeholders involving potential breaches of the MAI Act • provide technical advice and recommendations about the MAI Act and other relevant legislation, claims management and legal and litigation trends.
Job type: Permanent Full-time
Category: Management
Classification: AO8
Location: Brisbane - CBD
Job ad reference: QLD/TY1010/11
Closing date: 02-Dec-2011
Salary per annum: $101609 - $107466
Salary per fortnight: $3894.70 - $4119.20
Contact name: Kim Birch
Contact details: Ph (07) 3224 5954
The Office of the Insurance Commissioner (OIC) is a portfolio office within Treasury Department and comprises the Queensland Government Insurance Fund and the statutory bodies of the Motor Accident Insurance Commission (the Commission) and the Nominal Defendant.
The Commission is responsible for the Compulsory Third Party (CTP) scheme for Queensland in accordance with the Motor Accident Insurance Act 1994 (MAI Act).
The purpose of this role is to:
• manage the legislative functions in relation to claims compliance, claims management monitoring and insurer oversight, including referee referrals, fraud prosecutions and complaints from stakeholders involving potential breaches of the MAI Act
• provide technical advice and recommendations about the MAI Act and other relevant legislation, claims management and legal and litigation trends.
Reporting/work relationships
The role reports directly to the General Manager, Motor Accident Insurance and works collaboratively with the Policy and Research Team and the Scheme Performance Team, as well as the broader Office of the Insurance Commissioner. This role has approximately four staff (full-time equivalents).
Your key responsibilities
The responsibilities and duties of the role include the following:
• Lead, manage and motivate a team of technical specialists to ensure delivery of required outcomes.
• Manage the Claims Performance activities to ensure accurate technical advice is provided on claims management and litigation trends, insurer legislative compliance and strategic analysis of the CTP scheme.
• Oversee the preparation of technical reports, presentations and general communications concerning CTP claims performance and contribute to policy development.
Insurer Compliance
• Lead the activities of monitoring insurer compliance with the claims management provisions of the MAI Act, Regulation, Guidelines and other relevant legislation.
• Coordinate and review processes for managing complaints against insurers .
• Establish an appropriate insurer self-audit program, review submitted reports and, based on insurer outcomes and experience, conduct Commission claims audits.
• Manage the investigation of complex and/or sensitive allegations concerning potential breaches of the MAI Act and provide recommendations and advice to the Insurance Commissioner.
Claims Monitoring
• Monitor CTP scheme claim management, undertake analysis of complex issues and trends concerning claims, formulate recommendations to improve CTP scheme operations and performance.
• Develop and maintain sound working relationships with insurers and other key stakeholders, as and when required.
• Oversee claim file reviews so as to inform policy development and advice to Government.
• Provide expert strategic advice to the Insurance Commissioner and Government on claims legislation, systems, costs, trends and performance.
• Oversee insurer claims performance and report areas of concern and non-compliance to the Insurance Commissioner.
• Conduct legal and litigation trend monitoring and interpretation and report and make recommendations on areas of concern to the Insurance Commissioner.
Fraud
• Develop and coordinate strategies and initiatives to identify and combat fraud in or related to motor vehicle accident claims.
• Coordinate the processes for investigating fraud referrals and preparation of cases for prosecution through barristers.
CTP Helpline
• Oversee the operation of the CTP Helpline by ensuring operators are equipped to respond to enquiries from claimants, motor vehicle owners and scheme stakeholders.
• Provide technical assistance and support to the CTP Helpline operators to enable appropriate responses to customer enquiries on matters related to CTP claim processes.
• Monitor trends in enquiries to inform the development of education and information strategies and policy development.
Applications to remain current for 12 months
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