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

resources (e.g. police, supplier etc.) and interviewing customers as well as other parties.
Analyze specific problems and issues to
find the best solutions. Solutions could be technical or professional in nature.
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)
- 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