Role Purpose
To provide stakeholders (e.g. clients, account executives) with efficient claims advice and administration according to the required standards and procedures in support of the business strategy.
Financial:
Ensure appropriate minimisation of claims and claims expenses
Ensure and contribute to minimisation of general expenses
Client:
Ensure that all stakeholder (e.g. clients, AE's, insurers) communication is accurate, timeous, professional and relevant
Build and maintain mutually beneficial relationships with internal (e.g. account executives) and external (e.g. clients) stakeholders
Keep clients informed regarding the progression of the claim
Ensure and contribute to achieving the required client satisfaction targets
Business Processes:
Adhere to company quality standards and broader regulatory frameworks regarding the following processes (but not limited to):
Claims Administration:
Receive claims notification, and send and obtain any relevant forms or documents as may be required
Administer the complete claims process according to defined claims procedures until claims are settled
Appoint assessor or loss adjustor
Apply policy terms and conditions
Keep internal system and records up to date at all times
Keep relevant internal stakeholders up to date on the progress of registered claims
Make assessment of claims validity and estimate value and administer mandated claims
Forward claims in excess of mandate to insurer
Obtain quotes for services
Arrange approval and payment for claims costs in line with claims and cover
Act as intermediary between insurer and client and timeously relay communication, requests and documentation
Follow the recoveries process, diarise follow-ups and keep clients informed
Ensure productivity targets are met
Contribute towards and ensure continuous improvement in own and team performance
Adhere to company mandates
Participate and contribute in ad hoc projects
Report any suspected fraud, misrepresentation and/or dishonesty
Keep accurate record of own activities
Learning and Growth:
Live the RBS values by committing to the organisational values
Ensure continuous self-development
Share information and knowledge with the team
Minimum Qualifications and Skills:
Matric or equivalent
RE 5
FAIS appropriate qualification/credits
Computer literate
CIMS - essential
Excellent communication skills (verbal & written)
Minimum Experience:
3 years of claims experience (Personal Lines and Commercial)
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