Key Purpose
To provide best customer experience to all customers by resolving claims and providing support and ensure timely claim settlement while applying risk management principles at the consultant level.
Minimum Requirements:
• Matric
• Preferred Qualification:
• Insurance related qualifications e.g. FETC: Short Term Insurance NQF 4, RE5
• 4 years Short Term insurance related experience, preferable Homeowners Claims Assessment experience
Preferred Experience:
• 5 years Short Term Claims insurance related experience, preferably with Homeowner’s experience
• 5 Years HOC Claims Experience
Key Responsibilities
• Authorize all claims within the set mandate and resolve all claims within the agreed productivity targets and turnaround times by utilizing the claims diary system effectively.
• Demonstrate a clear understanding and execution of customer complaints and resolutions that must be maintained and exceeded, as well as a clear understanding of claim rejections. Demonstrate a clear understanding of the management of claims handling that must be followed within the regulated agreements as specified by the relevant regulatory boards.
• Ensure a clear understanding of all payments, the correct application of rates to be authorized to the service provider, and the correct appointment of service providers to the claims. Demonstrate a thorough understanding of the report and quotes in order to communicate prompt claims resolution to the customer. Have a clear understanding of how to operate a claims management system, as well as the use of relevant tools that can enable the quick resolution of a claim and ensure effective communication, such as using Outlook to send emails and exporting own reports to Excel. Have a working knowledge of the internet and how to use Google Maps.
• Ensure that all claims are treated fairly, you must have a clear understanding and accurate interpretation of the reported incident, claims history, and correct application of the policy wording. When communicating technical detail to the customer, Loss Adjusters in order to consult or debate the outcome of the claim, ensure lateral thinking and professional engagement with all parties.
• Possess the ability to communicate calmly yet assertively with difficult customers at all levels and outcomes in a fair, sensitive, and persuasive manner, always keeping in mind that the customer has to be treated fairly as required.
• Have a clear understanding of how to engage and communicate with the appropriate specialist service providers to engage on each claim, such as engineers, etc.
You are responsible to ensure that you maintain effective relations with all stakeholders within the organization. This includes but is not limited to:
Technical Competencies:
• Short term insurance claims and Customer Service orientated.
• Computer Literate, Excel, Word, Microsoft Outlook,
• Claims Management and effective ability navigate systems.
• Have the ability to understand and communicate technical matters analytically.
• Have excellent verbal and written communication skills
