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Claims Investigator Specialist

2 weeks ago

Bloemfontein, Orange Free State, South Africa Sanlam Full time

Santam is a large, diversified, expanding, and transforming company. We are rapidly moving into a number of emerging markets, both in Africa and Asia.

We are passionate about delivering Insurance Good and Proper, which is centered around our clients. Our business is driven by people, so we strive to recruit the best people possible.

In achieving our employment equity goals, we give preference to applicants from the designated groups in alignment with the Division's Employment Equity targets. This commitment drives us to achieve a diverse workplace with employment equity as a key goal to create an inclusive workforce, representative of the demographics of our society.

This role requires the ability to perform investigations, verify descriptions of events, negotiate with clients and service providers, and settle claims within a delegated threshold. It also involves interacting with the police, weather bureau, etc. to assess merit, and comparing information collected to the policy requirements and claim details presented.

Responsibilities:

  • Determining the quantum and merit of segmented non-motor claims.
  • Verifying the description of the event with the loss.
  • Negotiating with clients, intermediaries, and service providers.
  • Settling claims within a delegated threshold and according to contract conditions.
  • Interacting with the police, weather bureau, etc. to assess merit.
  • Comparing information collected to the policy requirements and claim details presented.
  • Determining equivalent replacement and assessing risk.
  • Deciding and negotiating on replacement/cash/claims card.
  • Authorizing repairs/cash settlement.
  • Writing Claims Report and updating the central claims file.

Requirements:

  • Matric (Grade 12) with Mathematics.
  • Five (5) years' or more relevant experience at digital non-motor level (full spectrum), field assessing experience advantageous.
  • Seven (7) or more years' relevant claims assessment experience (non-motor) (full spectrum).

Skills:

  • All relevant product training completed.
  • Familiar with IM external systems.
  • Experience in adjusting process, assessor reporting tools, building terminology, repair estimation on building damage, indemnity issues, non-standard roofing (thatching, floor coverings, gyproc), building repair calculator, and advanced electronic equipment.