Claims Analyst

2 weeks ago

Randburg, Gauteng, South Africa Green Marble Recruitment Consultants Full time

Minimum requirements:

  • Completed Matric.
  • Completed RE5 Regulatory Examination.
  • At least 3 years' experience in claims.
  • Own transport and valid licence.
  • Clear criminal and credit checks.
  • Reliable individual with sober habits.

Duties and responsibilities:

  • Handle claims as per delegated claims portfolio from cradle to grave.


 Daily Administration
  • Registering of new claims and ensuring that cover is in place and the correct excess is applied.
  • Ongoing daily administration all documents are timeously and accurately saved to the correct claim or policy file, as well as updating main statuses and additional statuses throughout the life cycle of the claim.
  • Estimates are to be added correctly and updated throughout the claim life cycle, referring to the "maximum probable loss" theory.
  • Liaising with the claims manager to establish your claims allocation and priority claims to be attended to.
  • Maintain and manage the outstanding claims list to acceptable levels and with the focus on finalising claims faster and with the necessary broker satisfaction.
  • Manage all relevant and expected communication to internal stakeholders within the agreed Service Level Agreement (SLA) or treaty requirements.
  • Ensure that claims are finalized within agreed SLA period.
  • Determine merit, investigation and determine whether external service providers are required.
  • Assess claims by reviewing field reports, assessments and/or digital images or document received.
  • Proactive identification of fraudulent cases and recovery potential and acting upon the identification in a proactive manner.
  • Proactive identification of salvage potential and acting upon the identification in a proactive manner.
  • Understands legal liability considerations in given claims.
  • Decide on settlement recommendation or refer to the Claims Manager.
  • Liaise with internal stakeholders, e.g. Underwriting, Assessing and Legal for Policy interpretation issues.
  • Proactively manage broker expectation and ensure that all communication to brokers are completed timeously and accurately.
  • You are responsible for all claims reporting to holding company and managed within the required treaty specifications.
  • Ensure that payments are raised correctly and accurately to the correct beneficiary.
  • All new beneficiaries receive the Beneficiary Form for completion.
  • Completed beneficiary forms and BEE Certificates are correctly saved within the Compliance folder.
  • Daily statistics are sent to the line manager at the end of each day.

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