Senior Complaints AssociateExperience Level: Senior Level | Posted Date: 2025-04-15
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Context:
The strategy of the Complaints Handling team is to oversee the interests of policyholders so they receive fair treatment in terms of buying policies from competent intermediaries and to make sure that their claims and complaints are properly and fairly handled. The LIC Complaints team is the primary point of contact for Lloyd’s EEA policyholders and market participants.
There are different regulatory regimes operating across EEA countries and each brings a complex and bespoke nature to how complaints must be handled. This role has the function of a complaints department but also a regulatory operational role that handles a significant of data for over 500 complaints a year alongside an oversight role that analyses the data and monitors the markets performance in regard to complaints to ensure they are handled in accordance with LIC Complaint Guidance and the rules international regulatory bodies. Managing Agents, Coverholders and Delegated Claims Administrators will be informed about failures on a case by case basis - this is a regulated activity. Systemic issues are escalated to the Head of Customer Excellence & Partnership Management, to allow appropriate intervention to be taken.
Managing customer complaints is not only a matter of being compliant with global / local regulations in force, it is also the opportunity to assess and improve the LIC customer journey. Feedback must be used to identify opportunities and to share them with key stakeholders across the market. Raising alerts but also proposing actions to become a more Customer Oriented organization.
Overseeing complaints will make sure that where we grant complaints handling authority, complaints are handled in line with the different regulatory regimes, the LIC complaints handling guidance and in the best interest of the Customer.
Role purpose:
Complaints against Lloyd’s underwriters are made against LIC and as such it is imperative that policyholder complaints are handled in an appropriate manner. Due to the unique eco system of the Lloyd’s market, complaints can be made through third parties (coverholders and delegated claims administrators); or directly to LIC team. Direct contact is made with policyholders/complainants and this is often their first touchpoint with LIC and therefore high impact.
The Senior Complaints Associate, major activities:
Oversight of EEA policyholder complaints and monitoring (including data analysis) of managing agents and their representatives to ensure that they are investigating and handling complaints from European policyholders appropriately, and that EEA regulatory requirements (including reporting) are adhered to as well as to the LIC Complaint guidelines and providing feedback where appropriate.
Managing escalated complaints to external dispute resolution bodies across EEA
Acting as a 2nd line for more complex complaints and assist the Junior Complaints Associate in the day to day activities providing guidance and technical expertise
Responsible for maintaining the LIC Complaint guidelines, procedures and tools up to date.
Expert in Complaint regulations across the EEA.
Making sure the Customer is in the middle of the attention of the key stakeholders within our framework.
Preparing annual complaints internal & regulatory reports to regulators across EEA with key complaints data. Communicating the submissions to the regulators in the EEA.
Principal Accountabilities:
To protect LIC Brand by:
(1) Monitoring managing agents and their representatives to ensure that they are investigating and handling complaints from European policyholders correctly in accordance with LIC EEA regulatory requirements and that deadlines were met.
(2) Undertaking detailed, fact-based negotiations with managing agents and their representatives to influence them to alter their position;
(3) Ensuring high profile or contentious issues are escalated as required as per internal guidelines
To provide guidance to coverholders and delegated claims administrators with regard LIC Complaints both verbally and in writing and to provide technical guidance to managing agents, both on process and specific complaints and to represent LIC at external meetings and conferences.
To build and maintain relationships with key internal and external stakeholders through frontline and daily contact.
To be the go to systems expert for CareSmart (complaints tool) to handle market queries and user set ups.
To support the resolution of complaints by the relevant EDRs involving the provision of information, challenging their decision and providing supporting evidence where it is felt their decision is inappropriate or fails to take into account the facts of the case.
To be a complaints subject matter expert, both internally and externally with managing agents, their representatives and the relevant EDR.
To analyse complaints data monitoring evolution / tendencies to be able to report performance highlighting potential deviations and to enhance our reporting capabilities. Ensure accuracy of international regulatory reports.
To review on an ongoing basis work processes with a view to continual improvement in the handling of complaints
To represent on top of the regulatory aspects the Customer, to make sure he is well and fairly managed but as well that the main customer pain points are addressed.
Skills:
Ability to remain calm and objective under pressure, to handle difficult complaints with tact and diplomacy.
Proven negotiation and influencing skills.
Effective case management, balancing short term and long-term objectives and deadlines to ensure all cases are progressed in a timely manner.
Flexibility to work independently and as part of a team to organize work to meet prescribed regulatory deadlines.
A high standard of written and telephone communication skills, particularly the ability to discuss issues effectively with all levels of the market, third parties and produce high quality written communication whilst being customer oriented.
Ability to interpret varied policy wording and insurance terminology.
Capacity to perform root-causes analysis of complaints and capturing accurate information and details throughout the end-to-end customer journey to help LIC to become an even more customer focused company.
Confident, self-starter, capable of showing initiative and can demonstrate achievement.
Good, clear communicator, able to convey the message appropriately and ensure it is understood by the audience.
Mentoring / coaching skills to help others to grow and to learn.
Time Management to ensure delivery according to agreed standards/commitments.
Development of colleagues through empowerment and delegation
Microsoft tools – Excel, PowerPoint and Word
Knowledge:
Detailed knowledge of EEA complaints handling.
Detailed knowledge of general insurance matters (including EDR rulings and common technical approaches).
Detailed knowledge of claims investigation and settlement procedures.
Detailed knowledge of Customer Experiences matters.
Experience:
Working within a team dealing with high volume workloads.
Must be able to work accurately and with no supervision and be able to make decisions based on a broad understanding of relevant policies and procedures and of operational requirements.
Complaints / claims handling experience.
Oversight & data analytical experience.
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