Your:
Formal Education:
MatricRelevant NQF 5Successfully completed the RE 5 Examination Level 1Experience:
A minimum of three (3) years Claims experience with a claims settling mandate
A minimum of five (5) years working experience within the Short Term Insurance industry
will enable you to do the following duties:
Processes:
Effectively maintain claims standards and provide quality client service:Register motor / non motor claims for personal and commercial policiesAppoint assessorsConfirm and make sure that cover is sufficientResponsible for handling of and settling of claims for clients allocated and ensuring accurate capturing and updating on all data systemsManage the claim from start through to settlement stageGathering information about the insurance claim from the client and any others involvedExamining the details on completed forms and checking these against the cover provided by the insurance policyConsulting with other staff to decide the outcome of the claim and any compensation to be paidInforming the client of the outcome of the claim in writingReferring large or complex claims to other professionals such as a loss adjusterDetermine merits based on facts and investigation of reports presentedSettle claims within set parameters to avoid leakageObtain all information required for settlement or rejection of claimsDo continuous adjustments of reservesArrange / deal with the fulfilment of the following:Car hire for insured in the event of an accident where vehicle not drivable or of car has been stolenArrange contractors to assist insured with obtaining critical documents to support claimManage salvage processmotor & non-motor salvage right through to recovery payment receivedFollow up with loss adjustors/assessors periodically/ daily if requiredAbility to negotiate claims with clients, service providers and Insurance marketKeep detailed, dated file notes of all discussions on the claim filesAbility to negotiate contentious claim with Insurance market and clientsPotential errors and omissions must be immediately referred to Claims ManagerResponsible for completion of claim files upon finalisation of claim and do filing to EDSEnsure that claims files are maintained in accordance with operational standard and company proceduresDaily system updates (Such as diary & daily mail)Detail Prompt feedback and handling of complaints (internal & external)Ensure resolution of queries and complaints speedilyTo submit and provide insurer feedback & reports as per agreed timelinesEnsure a pleasant claims experienceFacilitate and maintain sound working relationships with clients, colleagues, markets, and service providers, including but not limited to local marketsEnsure policy maintenance after a claim is completedUpdate underwriting of items to be deleted/replacedMaintain records of all reports submitted to clients.People:
Service delivery to ensure customer satisfaction:Maintain service, quality and desired outputs within a specific functional process through ensuring compliance to tactical policies, procedures and standardsResolve escalated customer queries and complaints and provide feedback to customers on matters resolvedDevelop work routines in line with operational plans / schedules in order to manage achievement of serviceDelivery goalsShare knowledge on, and participate in the creation of new standards, control systems and procedures to maintain service delivery.Maintain effective people practices:Align own behaviour with the organization culture and valuesShare and transfer product, process and systems knowledge to colleaguesCollaborate and work with the Claims team to ensure required service levels are delivered.Technology:
Continuous improvement to ensure effective service:Ensure adherence to organizational policies, practices and proceduresIdentify and recommend areas / ways to improve processesDOFA confirmation from FSBCardinal 360 system experience will be an advantage.
