22 Oct
Competent Candidates
Sandton
Your:
Formal Education:
- Matric
- Relevant NQF 5
- Successfully completed the RE 5 Examination Level 1
Experience:
-
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 policies
- Appoint assessors
- Confirm and make sure that cover is sufficient
- Responsible for handling of and settling of claims for clients allocated and ensuring accurate capturing and updating on all data systems
- Manage the claim from start through to settlement stage
- Gathering information about the insurance claim from the client and any others involved
- Examining the details on completed forms and checking these against the cover provided by the insurance policy
- Consulting with other staff to decide the outcome of the claim and any compensation to be paid
- Informing the client of the outcome of the claim in writing
- Referring large or complex claims to other professionals such as a loss adjuster
- Determine merits based on facts and investigation of reports presented
- Settle claims within set parameters to avoid leakage
- Obtain all information required for settlement or rejection of claims
- Do continuous adjustments of reserves
- Arrange / 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 stolen
- Arrange contractors to assist insured with obtaining critical documents to support claim
- Manage salvage process
- motor & non-motor salvage right through to recovery payment received
- Follow up with loss adjustors/assessors periodically/ daily if required
- Ability to negotiate claims with clients, service providers and Insurance market
- Keep detailed, dated file notes of all discussions on the claim files
- Ability to negotiate contentious claim with Insurance market and clients
- Potential errors and omissions must be immediately referred to Claims Manager
- Responsible for completion of claim files upon finalisation of claim and do filing to EDS
- Ensure that claims files are maintained in accordance with operational standard and company procedures
- Daily system updates (Such as diary & daily mail)
- Detail Prompt feedback and handling of complaints (internal & external)
- Ensure resolution of queries and complaints speedily
- To submit and provide insurer feedback & reports as per agreed timelines
- Ensure a pleasant claims experience
- Facilitate and maintain sound working relationships with clients, colleagues, markets, and service providers, including but not limited to local markets
- Ensure policy maintenance after a claim is completed
- Update underwriting of items to be deleted/replaced
- Maintain 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 standards
- Resolve escalated customer queries and complaints and provide feedback to customers on matters resolved
- Develop work routines in line with operational plans / schedules in order to manage achievement of service
- Delivery goals
- Share 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 values
- Share and transfer product, process and systems knowledge to colleagues
- Collaborate 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 procedures
- Identify and recommend areas / ways to improve processes
- DOFA confirmation from FSB
- Cardinal 360 system experience will be an advantage.
Desired Skills:
- CLAIMS
- HANDLER
- SHORT TERM INSURANCE
▶️ CLAIMS HANDLER at HR Options - Gauteng, Sandton
🖊️ Competent Candidates
📍 Sandton