Technical Evaluator : Non Motor Claims

Technical Evaluator: Non Motor Claims

Location: Johannesburg

Time Type: Full time

Posted On: Posted Today

Job Requisition ID: JR-58568

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Job Description

Old Mutual Insure is looking for a Technical Evaluator in the Non Motor sector. The role will be responsible for conducting operational claims reviews, work in progress, close file reviews, and client service assistance on the non-motor portfolio nationally. Responsibilities include identifying lost economic opportunities, investigating quality complaints, and handling ad-hoc requests. This role will ensure that technical evaluations are conducted as planned and that operations comply with regulatory requirements imposed by the market or industry organizations. Additionally, the role aims to ensure customers receive quality experiences when interacting with all levels of the claims value chain.

You Would:

• Ensure compliance with agreements/contracts, Company Policy, and Claims handling policy.
• Limit unnecessary financial losses to the Company (LEO).
• Inspect repairs for quality and adherence to authorization.
• Conduct CFR’s.
• Handle ad-hoc requests from other areas (i.e., Forensics, Governance, Risk & Compliance).
• Ensure compliance with all regulatory environments.
• Evaluate claims completed by suppliers/service providers to minimize financial loss regarding Quality and Compliance to the policy code.
• Maintain good client service to retain clients.
• Accurately report facts obtained during evaluations and inspections.
• Rectify WIP deviations.
• Evaluate compliance of work instructions (i.e., in accordance with Assessors authorization) and contractual agreements with service providers.
• Evaluate compliance with company policy and claims procedures by Assessors and Claims Staff.
• Recommend corrective measures where necessary.
• Report deviations to the National Assessing Manager for Audit feedback to Regional Claims Managers.
• Conduct technical evaluations of various Service Providers, specifically Building Contractors.
• Manage the quality of repair work, as needed, due to complaints generated by poor repair work.
• Manage Quantum disputes, where necessary.

Experience, Knowledge & Skills Required:

• 3 years non-motor assessing and quality assurance experience.
• Short Term Insurance Knowledge/NQF Level 7 qualification in general insurance.
• Certified and Accredited Fraud Examiner (ACFE).
• Strong Investigative/Analytical skills.

The Recruitment Process:

• TA Interview: Discussion with a member of the TA Team to understand our business, culture & values, and more context on the role.
• Panel Interview: With 2 members of the senior leadership of the data team and 1 member of the HC leadership team.
• Technical & Psychometric Assessments: These will depend on the role and will sometimes happen concurrently with MIE & Internal Verification.
• Final Feedback.

All About OMI:

Old Mutual Insure

LinkedIn Post

Closing Date: 11 November 2024

The appointment will be made from the designated group in line with the Employment Equity Plan of Old Mutual South Africa and the specific business unit in question.

Old Mutual Limited is pro-vaccination and encourages its workforce to be fully vaccinated against Covid-19.

All prospective employees are required to disclose their vaccination status as part of the recruitment process.

Please refer to the Old Mutual’s Covid-19 vaccination policy for further detail. Old Mutual reserves the right to reinstate the requirement to vaccinate at any point if it is imperative to do so.

About Us

Old Mutual is a premium African financial services organization that offers a broad spectrum of financial solutions to retail and corporate customers across key market segments in 14 countries. Our lines of business include Life and Savings, Property and Casualty, Asset Management, and Banking and Lending. We are rooted in our purpose of Championing Mutually Positive Futures Every Day and believe that a great customer experience is anchored in a great employee experience.