ZACHARIA MWANGI
Summary
Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals.
Overview
15
15
years of professional experience
Work History
INTERNAL DISPUTE RESOLUTION SPECIALIST
| Zurich Insurance
04.2022 - 02.2023
- Ensure all complaints are resolved quickly, fairly, and effectively based on IDR procedures and regulations.
- Ensure IDR processes comply with regulations and obligations set out in ASIC RG165/RG271, Life Insurance Code of Practice and AS/NZS 10002:2014 Guidelines for Complaint Management in Organizations and ISO 10002:2014 (International Standard).
- Undertaking investigations of customer complaints, including liaising with relevant business units, obtaining, and reviewing relevant information, communicating with customers and undertaking a independent reviews.
- Engage in verbal and written communications with customer, including acting as a contact point for call escalations and debriefing.
- Advise customers of their rights, including their ability to lodge their complaint with external dispute resolution scheme.
- Record complaints accurately and in a timely manner. Maintain complaints register by ensuring all recorded information is up to date and recorded accurately.
- Provide necessary complaints guidance /training/coaching/feedback to the business regarding the complaints process where required.
- Identify and analyse root cause of complaints, engaging stakeholders on recommendations and driving implementation of continuous improvement activities.
- Knowledge of regulatory guide 165, regulatory guide 271, consumer protection laws relating to financial products and services, AFCA approaches and relevant industry codes of practice.
SENIOR CLAIMS CONSULTANT-GROUP & RETAIL
| BT Life
02.2018 - 03.2022
- Manage a mixed portfolio of complex Retail and Group TPD, IP, Death and Trauma claims including contentious claims within AFCA.
- Act as 2IC and interim manager. Manage all complaints and escalations within the team in a timely and professional manner.
- Review claim reports, assess complexity of submitted claims and utilize expertise and specialist knowledge to provide high quality, effective and timely recommendations on claims' strategies
- Oversee complex claims assessments including underwritten claims to ensure that proper evidence is collected to assist in proper management of claims
- Coach and mentor claims assessors and oversee claims assessor's portfolios to ensure proper claims and efficient claims strategies
- Provide technical advice including answering claims queries from advisers, clients, staff and the Funds- both verbally and in writing
- Initiate and undertake claims related research in order to develop goals and objectives which positively impact the overall results of claims to assist in management and making strategies and recommendations
- Providing required assistance to all inbound calls and resolve all customer queries regarding various aspects of the claim to ensure proper service levels are met
- Prepare various documents including reports to Fund, decline and procedural fairness letters
- Review all letters drafted by claims assessors prior to sending to ensure they adhere to the Life Insurance Code of Practice and Insurance Contracts Act
- Attending conferences with rehab team, visiting medical officers, legal team, re-insurers and claim technical team to deliver a consistent level of support and ensure proper claims management
- Managing and ensuring data integrity is met by properly recording claims reports and all correspondence
- Conducting regular reviews of pending files to determine whether claims are processed appropriately; identifies areas for improvement and discuss if any necessary training and development needs are required
SENIOR CLAIM CONSULANT- GROUP LIFE CLAIMS
| CommInsure
08.2016 - 01.2018
- Manage a portfolio of IP claims.
- Act as 2IC and interim manager. Manage all complaints and escalations within the team in a timely and professional manner.
- Review claim reports, assess complexity of submitted claims and utilize expertise and specialist knowledge to provide high quality, effective and timely recommendations on claims' strategies
- Oversee complex claims assessments including underwritten claims to ensure that proper evidence is collected to assist in proper management of claims
- Implement and oversee return to work measures on IP claim and positively engage claimants with occupational rehabilitation
- Provide technical advice including answering hypothetical claims queries from advisers, clients, staff and the Fund both verbally and in writing
- Organise and contribute to case conferencing discussions with the team manager and other stakeholders including rehab consultants, investigators and solicitors, in order to prepare proper claims strategies
- Initiate and undertake claims related research in order to develop goals and objectives which positively impact the overall results of claims to assist in management and making strategies and recommendations
- Providing required assistance to all inbound calls and resolve all customer queries regarding various aspects of the claim to ensure proper service levels are met
- Assessing and interpreting complex financial claims related documents including profit and loss statements, balance sheets and trust documents
- Attending conferences with rehab team, visiting medical officers, legal team, re-insurers and claim technical team to deliver a consistent level of support and ensure proper claims management
- Managing and ensuring data integrity is met by properly recording claims reports and all correspondence
- Conducting regular reviews of pending files to determine whether claims are processed appropriately; identifies areas for improvement and discuss if any necessary training and development needs are required
CLAIMS CONSULTANT- GROUP LIFE CLAIMS
| TAL Insurance
02.2015 - 08.2016
- Manage a mixed portfolio of TPD, IP, Terminal Illness and Death claims including contentious claims
- Review claim reports, assess complexity of submitted claims and utilize expertise and specialist knowledge to provide high quality, effective and timely recommendations on claims' strategies
- Oversee complex claims assessments including underwritten claims to ensure that proper evidence is collected to assist in proper management of claims
- Implement and oversee return to work measures on IP claim and positively engage claimants with occupational rehabilitation
- Provide technical advice including answering hypothetical claims queries from advisers, clients, staff and the Fund both verbally and in writing
- Manage and ensure high standard data integrity is met
- Organise and contribute to case conferencing discussions with the team manager and other stakeholders including rehab consultants, investigators and solicitors, in order to prepare proper claims strategies
- Providing required assistance to all inbound calls and resolve all customer queries regarding various aspects of the claim to ensure proper service levels are met
- Assessing and interpreting complex financial claims related documents including profit and loss statements, balance sheets and trust documents
- Attending conferences with rehab team, visiting medical officers, legal team, re-insurers and claim technical team to deliver a consistent level of support and ensure proper claims management
- Managing and ensuring data integrity is met by properly recording claims reports and all correspondence
IN-HOUSE LEGAL COUNSEL
| Allianz Insurance
09.2011 - 02.2015
- Manage a mixed portfolio of front to end litigated liability claims which included: workers compensation claims, compulsory third party claims and property damage claims.
- Review claim loss reports, assess complexity of submitted claims and utilize expertise and specialist knowledge to provide high quality, effective and timely legal advice and support to the claims' managers to ensure optimal claims processing is met.
- Oversee complex claims investigations to ensure that proper evidence is collected and is compliant with legislations and courts' practice and procedures.
- Reviewing and preparing court and tribunal documents including defences, consent orders, notices of motion and tribunal documents.
- Appearing at court and tribunal proceedings at the District Court, Supreme Court, Court of Appeal Administrative Appeals Tribunal and various tribunals.
- Negotiate early and pragmatic resolutions on various litigious matters on behalf of the company, including arranging for settlement conferences and mediations.
- Attending conferences with key witnesses in litigation proceedings including medical professions, investigator, witnesses and other parties to proceedings
- Develop goals and objectives which positively impact the overall results of claims management and make recommendations to enhance claims processes.
- Providing support to claims' managers regarding progress of claims, resolving queries and attending to drafting and interpreting legal, compliance and policy documents
SOLICITOR
| Benjamin & Robinson Lawyers
02.2008 - 09.2011
- Providing legal advice to clients on personal injury claims including CTP, Workers Compensation, TPD, Life Insurance and Income Protection; contract, superannuation and other civil matters.
- Conducting and managing civil, commercial and contract proceedings at the Supreme Court, District Court (Civil Division), Local Court (Civil Division) and various tribunals.
Representing clients at settlement conferences and mediations, negotiating settlements and early resolution on behalf of clients. - Preparing written advice to clients on various matters.
- Reviewing, drafting and negotiating a wide range of legal documents including Court documents, deeds, contracts, company instruments and other policy documents.
Interpreting and providing advice on various legal documents to clients. - Collating evidence in litigation matters and briefing Counsels on various matters.
Education
MASTERS - BUSINESS FINANCE
University of Technology
Sydney, NSW2017
GRADUATE DIPLOMA - LEGAL PRACTICE
College of Law
Sydney, NSW2008
BACHELOR OF LAWS - LAW
Notre Dame University Australia
Fremantle, WA2007
Skills
- Management: act as interim manager and 2IC Manage complaints and escalations Attend meeting with stakeholder (including Trustees, legal consultants, upper management etc) Prepare and provide written reports to various stakeholder
- Training: organise and provide on-going training
- Coaching and mentoring junior staff and overseeing portfolios to ensure efficient management and strategies
- Research: undertake and compile industry research relating to insurance, legislations and policies coupled with superior investigative and analytical ability
Timeline
INTERNAL DISPUTE RESOLUTION SPECIALIST
| Zurich Insurance
04.2022 - 02.2023
SENIOR CLAIMS CONSULTANT-GROUP & RETAIL
| BT Life
02.2018 - 03.2022
SENIOR CLAIM CONSULANT- GROUP LIFE CLAIMS
| CommInsure
08.2016 - 01.2018
CLAIMS CONSULTANT- GROUP LIFE CLAIMS
| TAL Insurance
02.2015 - 08.2016
IN-HOUSE LEGAL COUNSEL
| Allianz Insurance
09.2011 - 02.2015
SOLICITOR
| Benjamin & Robinson Lawyers
02.2008 - 09.2011
MASTERS - BUSINESS FINANCE
University of Technology
GRADUATE DIPLOMA - LEGAL PRACTICE
College of Law
BACHELOR OF LAWS - LAW
Notre Dame University Australia
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