Neil Grender

During my time at MetLife I was senior claims assessor dealing with individual A&H policies, CI, Life, IIP, Mortgage Protection and GIP.

The role included:

• Assessing, reviewing and managing accident claims which mainly consisted of claims for fractures and hospitalisation for a wide variety of illness's / conditions.
• Assessing, reviewing and managing individual income protection and mortgage protection policies ensuring all policy terms and conditions were met and that no policy exclusions applied,
• I also dealt with Critical Illness and Life claims, which again involved ensuring policy terms and conditions were fully met and also that standard ABI medical definitions for these policy were also met. This sometimes would involve referring medical evidence to the Chief Medical Officer.
• Working under strict deadlines without compromising quality of work or client service.
• Complied fully with all regulatory requirements whilst handling insurance claims.
• I also had 2 years learning Group Income Protection, which involved liaising with brokers, HR representatives, 3rd party health / early intervention providers such as HCB (to ensure the employee's were receiving all the support available to help a return to work), and also other 3rd party providers.
• Experienced in analysing complex claims information and medical evidence to identify fraudulent claims.
• Resolved issues promptly by liaising with relevant departments.
• Part of the role at MetLife was to also re-assess declined/complaint claims to check that the original decision was correct.
• Demonstrated a thorough understanding of policy terms and conditions for accurate assessments.
• During my time at MetLife I reached a £40K authority limit on the Accident and Health policy (reduced to £25k due to a change in structure). Also had a limit of £1k per monthly payment on the Individual Income and Mortgage Protection policies. My life and CI authority limit was £50k.

• My role at Aviva involved assessing payment protection claims for sickness and unemployment for Lloyds TSB credit card scheme.
• I progressed to Lead Advisor / Technical Assistant role after 2 years at Aviva. This role involved agreeing claim payments and decisions for assessors, along with conducting monthly audits/reviews on the teams work and a sample of their claims assessments.
• The role also involved deputising for the Team Manager when on annual leave or absent from work. This would include work allocations for the team, and reporting to the department head on the teams work situation for that week. Another aspect of the deputising role would be to conduct 1-2-1s in the managers absence.
• Another part of my role at Aviva was being involved in the transfer of legacy policies to a third party insurer. This included designing and implementing the best ways to transfer manually transfer all the policies and claims data on cases we had in progress at that time i.e. amounts paid on a claim with limited payment periods etc, along with designing an easy calculation for the Aviva staff who were responsible for calculating benefits received and payments left for the handover to the third party.
• I also assessed claims for the Lloyds TSB business loans and overdraft protection insurance whilst at Aviva.
• Responded promptly to queries from clients about their claims status or concerns.
• Reviewed complaint cases on previous decisions made by the team of assessors under me.
• Trained junior assessors, enhancing team performance and productivity.
• Conducted detailed investigations to prevent fraudulent activities.
• Handled all claims and communications within established service level agreements.