MOHAMAD HAFIZUDDIN BIN MOHAMAD SUHAIMEI
Claims Adjuster
Shah Alam
Summary
Driven insurance professional, prepared to bring extensive experience in claims analysis and resolution. Proven track record in handling intricate cases with precision and ensuring fair settlements. Valued team player with focus on results, known for adaptability and reliability.
Overview
7
7
years of professional experience
4
4
years of post-secondary education
2
2
Certifications
3
3
Languages
Work History
Express Claim Adjuster - Singapore Travel Claim
Cover-More Group
10.2024 - Current
- Claim assessment and investigation by reviewing and determine the extent of coverage, eligibility and liability based on the policy terms and conditions
- Ensure proper claim management by updating reserve according to documents submitted, follow up for open claims and ensure timely settlement and closure
- Responsible for denial of claims by issuing denial letter with correct policy terms and conditions
- Handle inbound and outbound call with stakeholders not limited to customers, agents, brokers and service providers Ensure appeals are handle appropriately to prevent complaints by coordinating with team lead and manager
- To liaise with complaint team upon first indication of potential complaints
- Assist FNOL team with claim registration and HFLC team with express claims handling during peak season
- Strive for continuous improvement on claim handling with feedback and discussion with head of department, account manager and team members
- Ensure align mindset within team members consistent with policy wording by passing all required tests and quizzes
Claims Management Associate - Singapore Work Injury Compensation
Accenture
08.2023 - 10.2024
- Handle WICA claims adjudication, reserving and settlement of claims within given authority level.
- Interpretation of WICA policy wording to determine coverage under the Act.
- Ensure In depth understanding of computation of medical expenses and leave wages and eventually driving resolution of claims in an effective and timely manner, within the required turnaround time, both according to internal claims SOP and MOM mandatories.
- Ensure fair and impartial adjudication of regulatory coverage and communicating developments and outcomes to all concerned parties under the ambit of the Act as guided by MOM.
- Strive for continuous improvement on claim file handling with feedback and support through the Quality Assurance Review processes.
- Align mindset with the team members to maintain adherence of best practice protocols for (WICA) regulatory claims, consistent with global best practice.
Protégé (Insurance and Claims Management)
Persada PLUS Malaysia Berhad
06.2022 - 08.2023
- Evaluated, analyzed, and oversaw claims documentation to assess liability in accident cases & offered recommendations.
- Identified and addressed discrepancies in information or documents, seeking clarification from relevant parties internally or externally as needed.
- Aided in evaluating claims by examining case details & available documentation to determine their eligibility for payment.
- Provided recommendations and initiated approval processes for payment, accompanied by detailed justifications.
- Handled responses to claim outcomes and addressed inquiries from claimants throughout the claims processing.
- Maintained up-to-date records of claim progress in the Claim System CIP.
- Drafted correspondence to respond to claimants.
- Supported the Claims Person in Charge (PIC) in managing emails, walk-ins, and phone calls related to claims matters.
- Assisted the Insurance and Legal Advisory Unit with day-to-day operational tasks assigned by the Head of Department.
Takaful Planner (Part Time)
Prudential Puchong
09.2019 - 03.2024
- Identified client requirements and financial circumstances through active listening and arranging fact-finding meetings.
- Developed new business opportunities by delivering presentations on financial security to both individuals and groups regarding term and whole life insurance.
- Reached out to potential clients through direct marketing mailings and phone outreach.
- Organized fact-finding sessions and consultations to assess client needs and overall financial positions.
Grab Car Driver
Grab Malaysia
08.2018 - 10.2018
- Engaged with passengers and provided transportation to and from their destinations, ensuring exceptional customer satisfaction.
- Managed vehicle loading and unloading, utilized efficient routes, and demonstrated composure during challenging circumstances.
- Maintained a consistent 5-star rating as a Grab driver.
Education
Bachelor's Degree - Jurisprudence & Its Foundation: Islamic Studies
The World Islamic Sciences and Education University
Language Study - Arabic
Arab Community College
Sijil Pelajaran Malaysia (SPM) - undefined
Sekolah Menengah Setiabudi
01.2011 - 01.2015
Skills
Microsoft Office
Certification
Basic Insurance Concepts and Principles, Singapore College of Insurance, 10/2023
Extracurricular Involvement
Participant, Microsoft Excel Workshop, 2022 Head Treasurer, AGM & ADG Malaysian Student Association (Jordan), 2020 Head Multimedia, Kedah's Student Association (Jordan), 2019 Vice Treasurer, Malaysian Student Association (Amman, Jordan), 2018
Awards
- MPC Award, Insurance & Claim Management, PLUS Malaysia Berhad, 12/2022
- Aspiring Talent for Q1 2024, Work Injury Compensation (WICA), Accenture, 01/2024
- AIG Spotlight Recognition Program FY24 Q1, Star of Business, AIG, 01/2024
- AIG Spotlight Recognition Program FY24 Q4, Trailblazer, AIG, 08/2024
Timeline
Express Claim Adjuster - Singapore Travel Claim
Cover-More Group
10.2024 - Current
Claims Management Associate - Singapore Work Injury Compensation
Accenture
08.2023 - 10.2024
Protégé (Insurance and Claims Management)
Persada PLUS Malaysia Berhad
06.2022 - 08.2023
Takaful Planner (Part Time)
Prudential Puchong
09.2019 - 03.2024
Grab Car Driver
Grab Malaysia
08.2018 - 10.2018
Sijil Pelajaran Malaysia (SPM) - undefined
Sekolah Menengah Setiabudi
01.2011 - 01.2015
Language Study - Arabic
Arab Community College
Bachelor's Degree - Jurisprudence & Its Foundation: Islamic Studies
The World Islamic Sciences and Education University
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