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Claims Controller

4 months ago

Johannesburg, South Africa Affirmative Portfolios Full time

**Customer Service ~ Insurance**
**JHB North**
***:
**Claims Controller - Illovo**

**12 Month Fixed Term**

**Purpose**

To collate records and examine information to assist in determining claim settlements, within the government framework to ensure compliance with the short-term insurance regulations or to determine the validity of the claims from agent companies, assess the liability and negotiate settlements

**Qualifications**
- Higher certificate in insurance NQF 5
- Tertiary education preferable

**Experience**
- 3 - 5 years’ experience in a claims position of short-term insurance

**Duties and Responsibilities**
- Accurately record and examine received claims and any related documentation thereof
- Perform document diary maintenance on CMS system
- Assess claims received by the department for reserve and keep a regular follow-up outstanding reserve once claims are verified by claims manager
- Approve claims within delegated authority after verification of all documents and validation thereof under the policy cover
- Escalate complex claims to Supervisor
- Assist in the extrapolation of monthly reports and claims

**Agency/Broker Liaison**
- Inform underwriting department of haps in cover and/or wording documents as well as adjustors such as losses/gains on premium
- Exercise proper judgement and decision making to analyse the claims exposure, to determine the proper course of action and to appropriately settle the claims.
- Negotiate the settlement and disposition of claims within prescribed mandate, interpret related claims documentation

**Perform Ad hoc tasks**

Perform any reasonable tasks as and when required by the Line manager