Key Responsibilities and Required Skills for Insurance Officer

🎯 Role Definition

An Insurance Officer coordinates policy administration, underwriting support, claims handling and client servicing to protect the company’s financial exposure while delivering an excellent customer experience. This role combines technical insurance knowledge (policy wording, risk assessment, premium calculation), regulatory compliance (KYC/AML, local insurance law), and operational execution (claims settlement, renewals, reporting). The Insurance Officer works closely with sales, underwriting, claims, finance and third-party administrators to ensure accurate policy lifecycle management and timely resolution of client issues.

📈 Career Progression

Typical Career Path

Entry Point From:

Junior Claims Assistant / Claims Handler
Insurance Sales Executive / Broker Support
Customer Service Representative in insurance

Advancement To:

Senior Insurance Officer
Underwriting Officer / Underwriting Manager
Claims Supervisor / Claims Manager
Risk Manager / Loss Control Manager

Lateral Moves:

Account Management / Relationship Manager
Compliance Officer / Regulatory Liaison
Product Specialist / Policy Administration Lead

Core Responsibilities

Primary Functions

Perform end-to-end policy administration for individual and commercial lines: prepare quotations, issue and endorse policies, process renewals, generate policy documents and maintain accurate policy records in the policy administration system.
Evaluate new business and renewal submissions to identify risk exposures, calculate appropriate premiums, apply endorsements, and recommend underwriting decisions within delegated authority.
Process and manage claims from first notification (FNOL) through investigation, reserve recommendation and settlement, ensuring adherence to claim handling procedures and SLA targets.
Conduct detailed risk assessments by reviewing client-provided information, site surveys, inspection reports and loss history to support underwriting and pricing recommendations.
Liaise with brokers, agents and clients to clarify policy terms, coverage limitations, exclusions and claims processes; resolve disputes and negotiate settlements when appropriate.
Investigate potential fraudulent activity through collection and analysis of documentation, coordination with fraud units and recommendation of recovery or denial actions.
Prepare and validate premium invoices, track premium collection, follow up on overdue payments and coordinate cancellation or reinstatement of policies as required.
Monitor regulatory and compliance requirements, ensure KYC/AML procedures are followed, maintain accurate audit trails and prepare documentation for internal and external audits.
Review and apply endorsements, cancellations and mid-term adjustments; ensure system records and client documents reflect changes accurately and promptly.
Coordinate with third-party administrators, loss adjusters, legal counsel and external vendors for claims investigations, expert reports and cost control measures.
Maintain accurate provisioning and reserves data for active claims and collaborate with finance to reconcile claims payments and accounting entries.
Produce regular management reports and KPI dashboards (e.g., loss ratio, claims frequency, claims severity, renewal retention) to support senior management decision-making.
Support product development by providing market feedback, claim trends and underwriting insights to refine policy wordings, pricing and coverage offerings.
Conduct periodic portfolio reviews to identify concentration risks, adverse loss trends and opportunities for reinsurance placement or risk mitigation.
Execute policyholder onboarding: verify eligibility, collect required documentation, explain policy schedules, and guide clients through policy benefits and obligations.
Handle escalated customer complaints professionally, document remedial actions and implement corrective measures to reduce recurrence.
Maintain up-to-date knowledge of local insurance laws, regulatory changes, and industry best practices; implement policy and procedure updates accordingly.
Train and mentor junior staff on claims procedures, policy administration workflows and system use to ensure consistent service quality and operational efficiency.
Support internal investigations and disciplinary processes related to breaches of policy or compliance requirements; maintain confidentiality and documentation discipline.
Optimize operational processes by identifying automation opportunities, recommending system enhancements and participating in implementation of policy administration or claims management software.
Manage reinsurance reporting and follow-up by preparing ceded claims files, liaising with reinsurance partners and ensuring timely recovery submissions.
Coordinate recovery and subrogation efforts where applicable, including litigation support, vendor coordination and recovery accounting.
Maintain strong relationships with distribution partners—brokers, agents and bancassurance channels—to drive retention, cross-sell and referral business.

Secondary Functions

Produce ad‑hoc analytical reports and trend analyses (claims trends, loss drivers, portfolio performance) to support commercial and underwriting decisions.
Contribute to the continuous improvement of the department’s operational processes, SOPs and knowledge base.
Collaborate with IT and data teams to translate business needs into system requirements for policy and claims platforms.
Participate in project workstreams, testing, and user acceptance testing (UAT) during system upgrades or new product launches.

Required Skills & Competencies

Hard Skills (Technical)

Insurance policy administration and lifecycle management (issue, endorse, renew, cancel).
Claims management and settlement procedures across personal and commercial lines.
Underwriting fundamentals: risk assessment, premium calculation and use of underwriting guidelines.
Regulatory & compliance knowledge: KYC/AML, local insurance regulations and reporting requirements.
Proficiency with policy administration and claims management systems (e.g., Guidewire, Duck Creek, InsureEdge, Sapiens) or similar platforms.
Strong MS Excel skills: pivot tables, VLOOKUP/XLOOKUP, data cleaning and basic financial modelling for premium/reserve analysis.
Familiarity with CRM tools and document management systems for client communications and record-keeping.
Billing and receivables management including invoicing, endorsements and premium reconciliation.
Basic data analysis and reporting: KPI creation, loss ratio calculations and trend identification.
Knowledge of reinsurance processes and ceded claim reporting.

Soft Skills

Excellent written and verbal communication skills with the ability to explain complex policy language clearly to clients and intermediaries.
Strong negotiation and conflict resolution skills for claims settlement and dispute resolution.
High attention to detail and accuracy in documentation, endorsements and financial transactions.
Customer-centric mindset and professional service orientation under pressure.
Problem solving and decision-making capability with sound commercial judgment.
Time management and multitasking skills to manage competing priorities and SLAs.
Teamwork and collaboration across underwriting, claims, finance and distribution channels.
Ethical conduct, discretion and commitment to confidentiality in handling sensitive client and claim information.
Adaptability and willingness to learn new systems, products and regulatory changes.
Initiative and continuous improvement mindset: identify process gaps and propose pragmatic solutions.

Education & Experience

Educational Background

Minimum Education:

Bachelor’s degree in Business, Finance, Economics, Insurance, Risk Management or related field.

Preferred Education:

Bachelor’s or Master’s degree in Risk Management, Actuarial Science, Insurance, Finance, Commerce, or related.
Professional insurance qualifications (e.g., CPCU, CIP, ACII, ANZIIF) or local insurance certification preferred.

Relevant Fields of Study:

Insurance / Risk Management
Finance / Accounting
Business Administration / Commerce
Law (insurance regulatory understanding)

Experience Requirements

Typical Experience Range: 1–5 years of hands-on experience in insurance operations, claims, underwriting or policy administration.

Preferred: 3+ years experience handling claims or underwriting for relevant lines of business (motor, property, liability, health, commercial) with demonstrated exposure to policy systems, regulatory compliance and client-facing interactions.