Job title : Officer: Claims Investigation
Job Location : Western Cape, Cape Town
Deadline : December 27, 2024
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Key Performance Areas Investigation and assessment of claims lodged. Trace insured driver / witnesses to consult and obtain statements and docket. Ensure that a proper sketch plan of an accident scene is drawn as part of the investigation and assessment process. Ensure that clear photographs of an accident scene, faces of the people interviewed, damaged vehicles and injuries to a person is taken as part of the investigation and assessment process. Obtain / and verify existing affidavits from different parties (e.g. claimants, witnesses, employers, etc.). Identify possible fraud and corruption and escalate to Forensic Investigation Department (FID). Testify in court cases when claimant is guilty and accused of fraud. Provide assistance in ensuring witness presence at court.
Administrative support. Validate supporting documents (e.g. employment details, paternity/maternity details, SARS documents, etc.) for all related quantum investigations. Verify details of the claimant and those injured in an accident through Natis and Cross Check systems (e.g. ID no, contact numbers, address/S, employment details etc.). Verify the details of the secondary vehicle/s involved in the accident to determine the owner/s. Quality check the supporting documents from the stakeholders to determine the validity of the logged claim. Validate loss of earnings. Provide progress reports as per the internal service level agreement.
Document and records Management. Monitor and maintain an effective filing system. Ensure that files are correctly categorised and stored to ensure a smooth retrieval of documents. Administer the records management and filing processes in line with the RAF filing plan. Ensure confidentiality of all documents under control and that correspondence from the department office reaches intended recipients. Perform File Retrieval in Archive Services.
Stakeholder Management. Provide advice to different parties (e.g. claimants, witnesses, employers, etc.) Handle any assessments associated complaints. Maintain relationships with internal and external stakeholders.
Qualifications NQF 7 (Bachelor's Degree/Advanced Diploma) related qualification to discipline. Driver's License Completed training as an investigator will be an added advantage. Being a certified fraud examiner will be an added advantage.
Experience Relevant 3 years' experience in a similar environment. Experience in merit and quantum investigations will be an added advantage.
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