CLAIMS HANDLER I

Experience:

• A minimum of two (2) years Claims experience with a claims settling mandate
• A minimum of five (5) years working experience within the Short Term Insurance industry

Processes:

• Effectively maintain claims standards and provide quality client service
• Register motor/non-motor claims for personal and commercial policies
• Appoint assessors
• Confirm and ensure that cover is sufficient
• Responsible for handling and settling claims for allocated clients, ensuring accurate capturing and updating on all data systems
• Manage the claim from start through to settlement stage
• Gather information about the insurance claim from the client and any others involved
• Examine the details on completed forms and check these against the cover provided by the insurance policy
• Consult with other staff to decide the outcome of the claim and any compensation to be paid
• Inform the client of the outcome of the claim in writing
• Refer 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
• Perform continuous adjustments of reserves
• Arrange/deal with the fulfilment of the following:
• Car hire for insured in the event of an accident where the vehicle is not drivable or if the car has been stolen
• Arrange contractors to assist the insured with obtaining critical documents to support the claim
• 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 the Insurance market
• Keep detailed, dated file notes of all discussions on the claim files
• Ability to negotiate contentious claims with the Insurance market and clients
• Potential errors and omissions must be immediately referred to the Claims Manager
• Responsible for completion of claim files upon finalization of claims and do filing to EDS
• Ensure that claims files are maintained in accordance with operational standards 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
• 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

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
• 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.