Claims Consultant


Description

Company

Risk Benefit Solutions

Location

Cape Town, Western Cape, South Africa

Introduction

To provide stakeholders (e.g. clients, account executives) with efficient claims advice and administration according to the required standards and procedures in support of the business strategy.

Job Functions

Administration

Specification

    • Ensure appropriate minimisation of claims and claims expenses
    • Ensure and contribute to minimisation of general expenses
    • Ensure that all stakeholder (e.g. clients, AE’s, insurers) communication is accurate, timeous, professional and relevant
    • Build and maintain mutually beneficial relationships with internal (e.g. account executives) and external (e.g. clients) stakeholders
    • Keep client informed regarding to progression of the claim
    • Ensure and contribute to achieving the required client satisfaction targets
    • Adhere to company quality standards and broader regulatory frameworks wrt the following processes (but not limited to):
    • Receive claims notification, and send and obtain any relevant forms or documents as may be required
    • Process and ensure all claims and recoveries are processed within the required parameters
    • Appoint assessor or loss adjustor
    • Apply policy terms and conditions
    • Keep internal system and records up to date at all times
    • Keep relevant internal stakeholders up to date on the progress of registered claims
    • Make assessment of claims validity and estimate value and administer mandated claims
    • Forward claims in excess of mandate to insurer
    • Obtain quotes for products and/or services
    • Follow and ensure adherence to claims settlement processes
    • Act as intermediary between insurer and client and timeously relay communication, requests and documentation
    • Follow the recoveries process, diarise follow-ups and keep clients informed
    • Follow and ensure adherence to underwriting processes for cancellations
    • Ensure productivity targets are met
    • Contribute towards and ensure continuous improvement in own and team performance
    • Adhere to company mandates
    • Participate and contribute in ad hoc projects
    • Report any suspected fraud, misrepresentation and/or dishonesty
    • Keep accurate record of own activities
    • · Live the company values · Ensure continuous self-development · Share information and knowledge with the team

Requirements

    • FAIS appropriate qualification/credits
    • Excellent communication skills (verbal
  • Min 3 yrs Personal Lines Claims experience is essential (gained at an insurer)


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