The role is responsible to assisting Head of Complaint Management in ensuring that an organization’s complaint handling system is responsive to complainants such as a policyholder, payor, beneficiary, or claimant, agent or broker or business partners, etc. SM-Complaint Management should be empowered to make decisions, or have access to the Company’s Complaint and Market Conduct Committee who can make decisions, in order to deal with complaints promptly, and, where possible, to achieve early resolution. SM-Complaint Management is responsible to liaise with all organization staff to help provide information, investigate and resolve complaints, and to implement actions to provide remedies or systemic improvements arising from complaints.

Role & Responsibilities

• Overseeing the Company’s overall management of fair customer services and complaint management, including policies, procedures to ensure consistency with relevant policies and guidelines of the Chubb and local regulatory requirements
• Serve as liaison with The Complaint and Market Conduct Committee, who provides oversight of customer complaints.
• Consult legal counsel and compliance if need advice as to the authority and applicability or if the complaint involves a material matter, or poses a reputational risk to Chubb.
• Acts on behalf of the company if any court case, lawsuit or regulation case.
• Coordinate all complaint activity in the claim office or business division and ensure that the business division/branch/claims office that is the subject of the complaint is responsible for recording and resolving the complaint in the manner set out in the Complaint Management Procedures.
• Handle both non-regulatory and regulatory complaints within a certain number of business days, from the date of receipt of the complaint or from the date of the complaint letter.
• Handle “Serious or Complicate Complaint Case” in accordance with the related regulations prescribed by the OIC, SEC and other competent regulators.
• Acknowledge complaints in a timely manner, address complaints promptly and according to Chubb’s Complaint Handling standard, keep the complainant informed throughout the process.
• Carry out any activities or responsibilities to ensure that the management of fair customer services and complaint of the Company is operated with fairness, transparency and accountability to the stakeholders under the concept of corporate governance and creating long-time value to the company.
• Register, review and keep track of complaint records monthly for RO/local management and quarterly for HO/RO as required.
• Accountable for ensuring that the policies and procedures, guidelines and manuals related to complaint handling management are in place and up to date.
• Ensure that information about how and where to complain is kept up to date and available at all service delivery points.
• Manage the complainant’s expectations by explaining the complaint handling process, what the organization can and cannot do, the timeframes for dealing with the complaint and when they may expect a response.
• Respond directly to the regulator so that the response is received on or before the due date and keep a copy of response and any attachments in place.
• Conduct an independent investigation of the matter contained in the complaint if needed.
• Respond within the statutory timeframes prescribed for completing the response.
• Respond fully and provide all requested information following requirements when responding to complaints.
• Maintain a central log of non-regulatory and regulatory complaints including certain key elements of the complaint.
• Handle specific complaints at the direction of management.
• Review complaint records quarterly to develop trends and to insure corrective actions were taken if required.
• Ensure remedies are provided where appropriate.
• Analyze complaints to identify recurring themes and trends and report these to management to assist with organizational continuous improvement programs.

• Minimum ten (10) years of operations with strong experience in understanding the end-to-end operations process, insurance benefits, terms and conditions, and/or regulations related to insurance products and services.
• Evidence based investigation skills.
• Interpersonal skills, such as listening, questioning skills and conflict management.
• Outstanding communication skills for dealing with unreasonable complainant conduct or the unreasonable conduct of the person who is the subject of the complaint.
• Professional communication skills for dealing with regulators.
• Good record keeping plan, policies and procedures.
• Advanced knowledge (broad expertise or unique knowledge) of insurance benefits, and claims process and procedure from either or both a provider and payor perspective along with insurance industry policies, practices and systems.
• Problem recognition and proactive implementation of effective solutions, ability to provide constructive advice, and flexibility in developing alternative solutions/action.
• Work well individually or as part of a team.
• Good knowledge of insurance business and operations experience.
• Good & professional communication skills both verbal and writing.
• Good understanding on regulations and Thai laws.