Insurance Claims Investigator

2 weeks ago


Cape Town, Western Cape, South Africa Santam Insurance Full time

Santam Insurance is a leading general insurance company in Southern Africa, with a strong focus on delivering exceptional customer service and insurance solutions.

Job Overview

We are currently seeking a skilled Motor Merit Field Validator to join our team. As a Motor Merit Field Validator, you will play a critical role in ensuring that all flagged and segmented claims are thoroughly validated to achieve conclusive results.

Key Responsibilities
  • Validate and collate information on flagged claims to ensure accurate and reliable results.
  • Conduct thorough field validations on claims to verify their authenticity.
  • Review claims documents and photos to validate the claim and ensure it aligns with Santam's Claims Policy and Philosophy.
  • Handle customer queries effectively and fairly, providing timely and satisfactory resolutions.
  • Collaborate with management and staff to escalate high-risk claims and share best practices for fraud detection and prevention.
  • Liaise with external resources, such as third-party investigators and forensic experts, to gather additional information and support investigations.
Requirements
  • Matric/Grade 12 qualification or equivalent.
  • Tertiary National Diploma or University Degree in a relevant field (e.g., law, business, or forensic science).
  • At least 3 years of experience in short-term motor insurance, preferably in claims validation or investigation.
  • Strong analytical skills, attention to detail, and excellent communication skills.
  • Able to work independently and collaboratively as part of a team.

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