Claims Assessor/Investigator

1 week ago

Umhlanga, KwaZulu-Natal, South Africa Huntswood Full time

Job Overview:

As a Complaints Specialist in our team, you will actively investigate and resolve complaints, ensuring good customer outcomes, regulatory timeframes are achieved, and company processes are adhered to. Using  great communication skills, to work with customers and the business to gather all the information required to achieve great customer outcomes. Identify processes First Central can improve to remove common causes of customer friction

Job Responsibilities:

  • Thorough investigation and resolution of customer complaints in line with Company processes and KPIs, ensuring good customer outcomes.
  • To be accountable for individual complaints and ensure progression to resolution, referring upwards to the Customer Relations Team Leader as required.
  • Liaise with the appropriate business areas, where appropriate, to conduct full investigations to resolve complaints.
  • Provide feedback to the Prevention Lead with regards to complaint outcomes and any trends or root causes identified, so a root cause analysis can be addressed with the business accordingly.
  • Make fair and reasonable decisions in line with department guidelines escalating to the Customer Relations Team Leader where required. Handle complex complaints as necessary.
  • Work accurately within Company processes to achieve high quality assurance scores on customer interactions.
  • Work at a pace that ensures thorough investigation whilst meeting target metrics on the number of complaints resolved.
  • Ensure compliance with Company Policies, Values and guidelines and other relevant standards/ regulations at all times,
  • Ensure that all work is carried out to a high level of accuracy and always ensure compliance with all company and other relevant standards / regulations (including The Consumer Duty).
  • Support the implementation of the Customer Relations Strategy so that Customer Relations is not seen as only responding to complaints – working with other areas of the business as required.

Job Requirements:

  • Matric / NQF level 4
  • Excellent track record in resolving customer expressions of dissatisfaction, balancing customer and company needs
  • Some experience of working within the insurance industry is essential

Required Skills:

  • Previous experience in a complaint handling role, ideally with a favourable complaint recognition rate
  • Previous complaint handling experience within an FCA regulated business is ideal.
  • Experience in closing complaints, claim investigations, validations
  • Excellent communication skills, both verbal (great telephone manner) and written (accurately be able to summarise findings in a written response to the customer, without error)
  • Problem solving skills with the ability to translate and investigate problems and find resolutions
  • High levels of resilience and tenacity
  • Good organisational skills with the ability to meet tight deadlines at short notice

Required Knowledge:

  • Some understanding of FCA, The Consumer Duty and FOS
  • Some understanding of root cause analysis and sound knowledge of complaints handling
  • Solid understanding of regulatory requirements and company principles (including Consumer Duty)

Core Behaviour

Huntswood' s employees are described as dependable, driven and collaborative. 
The job holder should be able to demonstrate they are:

  • Confidential, reliable, and genuine
  • Dynamic, passionate, and determined
  • Friendly, compassionate, and cooperative

"It's not just about what we do, but the way we do it. And it's our values that make us special."

NB:  All appointments are subject to the positive outcome of pre-employment verification checks.

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