Desktop Merit Assessor

3 weeks ago


Cape Town, South Africa Sanlam Full time

CAREER OPPORTUNITY- Santam Direct Claims department has a position available for a Desktop Merit Motor assessor who will bebased in Tygervalley, Cape town.The desktop assessor is accountable for all motor claim interactions directly with the client. Processing of alldirect merit claims administration including co-ordinating and overseeing all actions on claims in this channel.The assessor would also need to identify problematic claims (red flags) and have it sent for further validationby one of the field teams. The outcome of each claim should be communicated to the client within the agreed SLA.**KEY RESPONSIBILITIES**
- Receive claim and facilitate resolution - responsible for the merit process.
- Handling of client queries to limit client complaints.
- Manage all relevant and expected communication to internal stakeholders within the agreed SLA
- Ensure that claims are finalized within agreed SLA
- Determine merit, investigation and determine whether external service providers are required as per SOP.
- Assess claims by reviewing field reports and/or digital images or document received.
- Proactive identification of fraudulent cases and recovery potential.
- Interaction with the Police, Witness and Third Parties etc. to validate merits.
- Understands legal liability considerations in given claims.
- Decide on settlement recommendation.
- Liaise with internal stakeholders, e.g. Underwriting, Claims Committee, Claims Technical, Assessing and Legalfor Policy interpretation issues.
- Pro-actively manage client expectation and ensure that all communication to client’s are completed within therequired SLA

**QUALIFICATIONS AND EXPERIENCE**
- Matric certificate or equivalent qualification
- Insurance related qualification
- Computer literate (MS Word, MS Excel and MS Power Point)
- Experience in high volume processes management (advantageous)
- 2 - 3 years’ experience in short term claims environment with focus on Personal Lines

**SKILLS**
- Experience in high volume processes management (advantageous)
- Knowledge of quality processes
- Computer Literate (MS Office Package)
- Proficient in English
- Excellent communication (verbal & written )
- Negotiation skills
- Ability to work under pressure
- Strong client service orientation
- Good knowledge and interpretation of insurance contracts

**COMPETENCIES**
- Client Focus - Adhere to strict turnaround times
- Internal stakeholder focus - Adhere to SOP and TAT
- Decision Making
- Problem Solving
- Collaborates
- Flexibility & adaptability
- Team Work
- Continues Learning
- Emotional Intelligence

**ABOUT THE COMPANY**
- Santam is the market leader in the general insurance industry in Southern Africa. We are a large, diversified, expanding and transforming company and whilst based in South Africa, we are rapidly moving into a number of emerging markets, both in Africa and Asia. Our success is rooted in our passion for our clients and everything we do is centred on our delivery of insurance good and proper.
Please note this appointment will be made in line with the Santam Employment Equity targets. People with disabilities are welcome to apply.



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