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About the Role

This senior technical and operational role is responsible for the end-to-end management of Accident & Health claims in Australia. The position will ensure the delivery of high-quality claims services, maintain operational efficiency, and support the Vice President in the strategic oversight of the claims function, including the management of Third Party Claims Administrators (TPAs).

Responsibilities

• Review, evaluate, negotiate, and resolve claims within designated authority levels, in accordance with established standards, procedures, and regulatory requirements.
• Conduct thorough investigations into suspicious or potentially fraudulent claims, implementing appropriate actions and maintaining timely communication with relevant stakeholders.
• Perform periodic internal audits of claim files and actively monitor outstanding recoveries to ensure financial accuracy and accountability.
• Provide authoritative technical guidance on complex claims matters to both internal teams and external stakeholders.
• Demonstrate sound judgment and independent decision-making on high-complexity legally sensitive cases.
• Support continuous improvement initiatives within the claims process to enhance efficiency and service quality.
• Manage all customer and intermediary interactions with professionalism and efficiency, ensuring a consistently high standard of customer satisfaction.
• Handle complaints and oversee the internal dispute resolution process, in a manner compliant with the Corporations Act, the ASIC Regulatory Guide 271 (Internal Dispute Resolution), the General Insurance Code of Practice and any other applicable regulatory requirements.
• Engage proactively with internal and external stakeholders to support the delivery of broader business strategies and objectives.
• Promote claims services and contribute to business development through client and intermediary meetings.
• Coordinate with approved suppliers, vendors, and legal counsel to ensure the timely and appropriate delivery of services to customers.
• Supervise and manage supplier, vendor, and legal counsel expenditure, as well as the performance of Third Party Claims Administrators (TPAs).
• Demonstrate proven capability in selecting, engaging, and evaluating legal counsel and independent experts.
• Support the Vice President in day-to-day team management, including the training, mentoring, and professional development of team members.
• Foster a collaborative, high-performance team culture aligned with the company's values and service standards.
• Prepare reports, data analyses, and management information as required.
• Ensure strict adherence to all applicable legal, regulatory, and internal policy requirements.
• Undertake additional duties and responsibilities as reasonably required by the business.

Requirements

• Relevant tertiary qualifications in insurance, law, business, or a related discipline.
• 7–10 years of progressive claims experience, with demonstrated team management experience in Accident & Health or a related line of business preferred.
• Professional insurance designation (ANZIIF, ACII, or equivalent) preferred or actively in progress.
• Demonstrate knowledge and experience in adhering to local licensing, regulatory, and complaints-handling requirements.
• Proven ability to independently manage complex and legally sensitive claims with strong analytical, negotiation, and decision-making skills.
• Sound knowledge of legal principles and claims litigation processes.
• Experience in claims process improvement and operational efficiency initiatives.
• Proficiency in relevant PC applications and claims management systems.
• Strong leadership, communication, and organizational capabilities.
• Effective collaborator with the ability to engage confidently with senior management, clients, and external partners.
• Customer-centric mindset with a commitment to service excellence.
• Self-motivated and capable of managing a diverse and demanding claims portfolio independently.
• Strong professional communication skills, both written and verbal, are essential.

Skills

• Claims Management
• Technical Leadership
• Stakeholder & Relationship Management
• Vendor & Third-Party Management
• Team Leadership & Development
• Reporting & Compliance
• Analytical skills
• Negotiation skills
• Decision-making skills
• Legal principles
• Claims litigation processes
• Claims process improvement
• Operational efficiency
• PC applications
• Claims management systems
• Leadership
• Communication
• Organizational capabilities
• Collaboration
• Customer service
• Self-motivation
• Written communication
• Verbal communication

Location

• Australia

Work Type

• Full-time

Experience Level

• Senior
• 7-10 years of claims experience
• Team management experience

Education Level

• Relevant tertiary qualifications in insurance, law, business, or a related discipline
• Professional insurance designation (ANZIIF, ACII, or equivalent) preferred or actively in progress

Benefits

• Instant membership in the Allied World — a global network of colleagues who will support your career journey
• A manager who will help you build your career through a structured coaching program
• Access to a full suite of learning and development tools and resources

About the Company

• Allied World is an ideal place for talented professionals who are driven by a belief in the value of collaboration and the power of knowledge.
• We believe that when our great people work together and support one another, our clients receive the best solutions.
• We embrace unique perspectives and empower each person to grow through professional development, career training and mentoring programs.
• Our people are our most important asset, and we are very proud of the quality of our team members.
• Our team of over 1,650 professionals has deep expertise in the industry.
• They enjoy their work, and many have served for several years.
• Headquartered in Bermuda, Allied World has offices in Atlanta, Boston, Brisbane, Chicago, Costa Mesa, Dallas, Dublin, Farmington (CT), Hong Kong, Houston, London, Los Angeles, Malaysia, Manchester, Miami, Nashville, New Jersey, New York, Philadelphia, San Francisco, Singapore, Sydney, Switzerland and Toronto.
• We strive to provide exceptional service to our clients and distribution partners.
• Allied World Assurance Company Holdings, Ltd, through its subsidiaries, is a global provider of insurance and reinsurance solutions.
• We operate under the brand Allied World and have supported clients, cedents and trading partners with thoughtful service and meaningful coverages since 2001.
• We are a subsidiary of Fairfax Financial Holding Limited, and benefit from a worldwide network of affiliated entities that allow us to think and respond in a non-traditional ways.

Equal Opportunity

• Allied work is an equal opportunity employer. Subject to applicable law, all qualified applicants will be considered for employment without regard to race, color, religions or belief, gender, age, disability, military service, marital or civil partnership status, family status, sexual orientation, ethnic or national origin, genetic information or any other characteristic protected by applicable law or regulation in the relevant jurisdiction where we operate.