Claims Analyst

**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.
- On-going 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 pro-active manner.
- Proactive identification of salvage potential and acting upon the identification in a pro-active 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.
- Pro-actively 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.