CLAIMS HANDLER

Description:

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 mainta