Senior Claims Specialist

An insurance Brokerage located in JHB North. Brokerage specializes in luxury vehicle and Commercial Coverage.

**Role Purpose**: To manage the claims Administration and Negotiation process of your allocated client base in order to place the client in the position they were in immediately prior to their loss and always trying to adhere to the Brokerage Service standards and turnaround times.

**KPIs**:
**Claims Admin**: Take all the relevant details when the client phones. Check premium payment and cover immediately. If premium not paid or there is no cover, clarify with the A.E. or Member immediately before advising the client. If there is cover. Register claim on CIMS System upon notification of the claim. A checklist is to be created immediately after the claim is registered with ALL the necessary information filled in on the form. Claims forms are to be immediately sent to the insured for completion. Send first notification to the client and Insurance Company confirming receipt of all the documentation or when the claim is over our claims mandate. Arrange with the Insurer to have an assessor to inspect the damage upon receipt of claims documentation or the Insured can be referred to the closest drive in assessment center. Follow up on a regular basis for the assessment and keep the Insured informed of the progress. Follow up on the authorization with the repairer whether the vehicle been assessed and confirm immediately to the Insured that the repairs have been authorized. In the case of the Windscreen claim we will give authorization for immediate repair/replacement upon checking premium and cover details and getting the claim number from the Insurer. An assessor is to be appointed for all Porsche/Ferrari windscreen claims over R20k and authorization to be given immediately after receiving the assessors report or alternatively client to provide a picture of damaged windscreen & license disk.

**General Admin**: Ensure all claim forms are completed fully. If not it is to be returned to the Insured for completion. Prepare/obtain relative claims experience if this is requested by the underwriter or Relationship Manager. Any Ex-Gratia requests may not be confirmed to Clients until this is agreed in writing from your senior manager/Director and also from the Insurer. After a total loss on motor or specified items, you are to immediately, after becoming aware of the total loss, advise the underwriter to delete the item and to contact the Insured in order to add the new item. After a personal claim is registered on a true monthly policy you are to advise U/W the details of the claim so that they are able to adjust the premiums/NCB/CFG. This is to be done if the insured is aware that they are going to claim. Advise U/W of risk Improvements, and sum insured discrepancies if these details have been given by the assessor/Insurer. In all cases check the policy Of the Insured or Company to ensure that the claim falls within the scope of cover and to ensure all details on the claims file i.e. Excess’s and estimates and cover is noted properly. In the event of the client being unhappy about the progress of this claim or settlement, then you are to act as a spokesman between them and the insurer. You may never refer them to the insurer. Promoting the service that the Brokerage offers to our clients and/or third parties that we deal with daily. Ensuring good relations with Insurance companies, assessors, service providers and replacement institutions. Help other departments when the need arises. Keep CIMS System up to date at all times including the making of notes on the system. Updating payments on the CIMS System. Checklists to be saved onto CIMS. Payments through Insurance Company are to be loaded on a Bordereaux upon receiving the claims file back from the payments department. Ensure that diaries are kept up to date and regular follow ups are made with the insurer, assessors and also the repairers. Understanding the cover and wordings of the Personal and Commercial/Multimark policies by ongoing hands-on training. Ensure that important mails and/or queries are attended too. Liabilities are to be sent to the insurer after becoming aware of the approach and regular follow ups are to be done with the Insurer to ensure that the third party claim is settled. Recoveries are to be sent to the Insurer after the assessors report has been received and regular follow ups are to be made with the Insurer. If the recovery is successful then the U/W is to be advised regarding this and the NCB/CFG is to be adjusted and confirmation is to be sent to the Insured confirming this.

**Qualifications**:
Grade 12. FAIS Compliant with required Credits

**Skills**:
Knowledge of Personal and Commercial claims processes and procedures. Motor and Non motor classes of insurance. 3 - 5 years Claims Experience. Solid interpersonal and relationship building skills. Ability to handle pressure & meet deadlines. Must be computer literate (spreadshe