Loss Adjustor

Telesure Investment Holdings (Pty) Ltd (TIH), is the holding company of some of South Africa’s leading financial long and short term insurance providers. Our portfolio includes South Africa’s most loved and recognisable brands such as 1st for Women, Auto & General, Budget, Dialdirect, Virseker and 1Life. Employee Benefits Administration via our Hippo Advisory Services, which includes health insurance, provident fund and group life administration. Hippo is South Africa's first comparison website and compares insurance, other personal finance products, travel, health, money, travel, cars from a range of South African brands. We’re pioneers with a hunger for the best, bringing customer-focused innovation and service excellence to the financial services industry. We’re an undivided team of diverse thinkers and doers who believe in leading through technology and pushing beyond limits.

**Job Functions** Investigation & Compliance
**Industries** Insurance
**Specification**

Deliver and support sound quality of claims decision making, prevent fraud and manage expenditure through the validation of claims by using expert abilities in various fields of investigation.
Needs Assessment
Explore issues or needs, establishing potential causes and barriers as well as related issues.

Data Collection & Analysis
Ask questions, collect data from a variety of sources, analyse information and investigate claim. Ensure effective costing of claimed items through ensuring professional, thorough investigation of claims.
Make decisions according to established criteria to ensure standardization across the organisation by accurately administrating and underwriting claims.
Use appropriate tools (ITC, supplier contract and/or negotiation) to accurately cost applicable claims on a day to day basis.
Customer Service
Provide a quality service to customers while identifying opportunities to secure new business or support retention. Responsibilities may include processing cases, dealing with complex queries and investigating and resolving customer problems.
Uphold agreed service level agreements (set turnaround times) and ensuring customer satisfaction and retention.
Stakeholder Engagement
Effectively build, maintain and manage relationships with service providers and suppliers, colleagues, internal and external customers.
Work Scheduling and Operational Compliance
Contribute to optimize work practices and procedures by maintaining an acceptable workload in order to get the job done, coordinating with support services.
Ensure claims are finalized within the set parameters (turnaround time, terms and conditions applied accurately).
Administration
Produce, update and provide best practice support to customers on the claims administration process and other departmental systems, in line with claims policy, rules and SLAs.
Ensure accurate administration and underwriting of claims.
Maintain an acceptable claims expenditure ratio by finalizing and adjusting claims accurately.
Compliance
Identify shortcomings in compliance processes, systems and procedures, and develop ad hoc solutions to problems within an assigned unit or discipline.
Up-Sell Customer Propositions
Identify a selection of products or services that may meet the customer's requirements, explain the product/service features influence the customer to add additional cover.
Personal Capability Building
Develop own capabilities by participating in assessment and development planning activities as well as formal and informal training and coaching. Develop and maintain an understanding of relevant technology, external regulation, and industry best practices through ongoing education, attending conferences, and reading specialist media.
Remain up to date with current and new quality standards and product knowledge to enable effective decision making.

**Requirements**:
General Education
Grade 12/ SAQA Accredited Equivalent (Essential);
Regulatory Examination (Essential); Science (Mechanical / Physical),
Mathematics and African Language (Advantageous); Forensic Investigation
Diploma / Insurance Institute qualification (Advantageous)
General Experience
5 or more years work experience in any investigative work OR 2 or more years work experience within one or more of the following fields: insurance / police / forensic / audit / legal (Essential)
Non-motor claims experience preferable
- SAQA Accredited Equivalent - It is the onus of the applicant to provide TIH and

its subsidiaries with certified evidence that their qualification(s) meet the

Financial Service Provider, we are mandated to ensure that all our

role, you consent to having your relevant qualification and or accreditation or
confirm that you are working towards meeting the competency requirements.
You further consent to the relevant information being verified