Melissa Anderson
Waitakere City,AUK
Summary
Dynamic Senior Claims Consultant at IAG with expertise in claims assessment and conflict resolution. Proven track record in evaluating complex claims, enhancing service delivery, and training junior staff. Adept at policy interpretation and regulatory compliance, consistently achieving fair outcomes while balancing customer expectations and business risk.
Overview
12
12
years of professional experience
Work History
Senior Claims Consultant
IAG
Auckland
05.2014 - Current
- • Manage and assess complex customer claims and complaints, applying policy wording, legislation, internal guidelines and principles of fairness to reach well-reasoned outcomes.• Investigate disputed claim decisions, identifying gaps in evidence, inconsistencies and opportunities to achieve fair and reasonable customer outcomes.• Prepare clear, evidence-based explanations of complex decisions, ensuring customers understand the rationale behind outcomes.• Resolved escalated complaints by identifying effective remediation strategies.• Demonstrate strong judgement when balancing contractual obligations, customer expectations, business risk and fairness considerations.• Provide guidance and support on complex claims and decision-making, contributing to consistent and defensible outcomes
- Evaluated complex insurance claims for accuracy and compliance with company policies.
- Collaborated with cross-functional teams to streamline claims processes and enhance service delivery.
- Led training sessions for junior staff on best practices in claims management.
Skills
- Claims evaluation
- Policy interpretation
- Evidence evaluation
- Regulatory compliance
- Insurance expertise
- Process improvement
- Conflict resolution
- Customer relationship management
Timeline
Senior Claims Consultant
IAG
05.2014 - Current