Desktop Claims Merit Specialist

4 days ago


Johannesburg, Gauteng, South Africa Santam Insurance Full time
About the Role

Santam's Motor Claims department is seeking a highly skilled and motivated Desktop Merit Consultant to join their team in Hill On Empire, Parktown.

This role is responsible for determining the merit of segmented motor claims by performing investigations, verifying the description of the event with the loss, and ensuring that all valid claims are processed within SLA from the desk.

The ideal candidate will have sound understanding of policy wordings and application thereof, as well as investigative abilities to identify red flag claims.

We're looking for someone who can think on their feet, has good communication skills, and is able to handle conflict and negotiate.

Key Responsibilities
  1. Manage workload and complete claims within SLA.
  2. Validate claims from the desk.
  3. Listen to relevant recordings, sales/claims/SOS.
  4. Complete merit report with all findings.
  5. Conduct assessments with clients, interview authorities & witnesses.
  6. Deal with Underwriters and Claims technical.
  7. Handle complaints, queries and all interactions with clients, Intermediaries, Service Providers, internal stakeholders, Relationship Managers.
  8. Present claims in claims committee.
  9. Make notes on systems, process claims and upload documents.
  10. Compile rejection letters and distribute them to relevant stakeholders.


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