Officer: Claims Investigation
4 weeks ago
- Jobs by Location
- Job by industries
Key Performance Areas
Investigation and assessment of claims lodged.
- Trace insured driver / witnesses to consult and obtain statements and docket.
- Ensure that a proper sketch plan of an accident scene is drawn as part of the investigation and assessment process.
- Ensure that clear photographs of an accident scene, faces of the people interviewed, damaged vehicles and injuries to a person is taken as part of the investigation and assessment process.
- Obtain / and verify existing affidavits from different parties (e.g. claimants, witnesses, employers, etc.).
- Identify possible fraud and corruption and escalate to Forensic Investigation Department (FID).
- Testify in court cases when claimant is guilty and accused of fraud.
- Provide assistance in ensuring witness presence at court.
Administrative support.
- Validate supporting documents (e.g. employment details, paternity/maternity details, SARS documents, etc.) for all related quantum investigations.
- Verify details of the claimant and those injured in an accident through Natis and Cross Check systems (e.g. ID no, contact numbers, address/S, employment details etc.).
- Verify the details of the secondary vehicle/s involved in the accident to determine the owner/s.
- Quality check the supporting documents from the stakeholders to determine the validity of the logged claim.
- Validate loss of earnings.
- Provide progress reports as per the internal service level agreement.
Document and records Management.
- Monitor and maintain an effective filing system.
- Ensure that files are correctly categorised and stored to ensure a smooth retrieval of documents.
- Administer the records management and filing processes in line with the RAF filing plan.
- Ensure confidentiality of all documents under control and that correspondence from the department office reaches intended recipients.
- Perform File Retrieval in Archive Services.
Stakeholder Management.
- Provide advice to different parties (e.g. claimants, witnesses, employers, etc.)
- Handle any assessments associated complaints.
- Maintain relationships with internal and external stakeholders.
Qualifications
- NQF 7 (Bachelor’s Degree/Advanced Diploma) related qualification to discipline.
- Driver’s License
- Completed training as an investigator will be an added advantage.
- Being a certified fraud examiner will be an added advantage.
Experience
- Relevant 3 years’ experience in a similar environment.
- Experience in merit and quantum investigations will be an added advantage.
- Insurance jobs
-
Officer: Claims Investigation
1 month ago
Cape Town, South Africa Road Accident Fund Full timeNB: This a 12 Months Fixed Term Contract Purpose of the Job: The Officer Claims Investigations is responsible for effectively and efficiently providing investigative support services for claims lodged against the Road Accident Fund (RAF) Key Performance Areas Investigation and assessment of claims lodged. Trace insured driver / witnesses to...
-
Officer: Claims Investigation
3 weeks ago
Cape Town, South Africa Road Accident Fund Full timeJob title : Officer: Claims Investigation Job Location : Western Cape, Cape Town Deadline : December 27, 2024 Quick Recommended Links Jobs by Location Job by industries Key Performance Areas Investigation and assessment of claims lodged. Trace insured driver / witnesses to consult and obtain statements and docket. Ensure that a proper...
-
Investigator: Claims and Fraud
4 weeks ago
Cape Town, Western Cape, South Africa Road Accident Fund Full timeDiscover a rewarding career with the Road Accident Fund as an Investigator: Claims and Fraud. In this challenging role, you will be responsible for conducting thorough investigations into claims lodged with the RAF.Key Responsibilities:Claims Investigation: You will investigate claims lodged with the RAF, tracing insured drivers and witnesses to consult and...
-
Claims Investigator
1 month ago
Cape Town, Western Cape, South Africa Road Accident Fund Full timeWe are seeking a highly skilled Claims Investigator to join our team at the Road Accident Fund. The successful candidate will be responsible for investigating and assessing claims lodged against the RAF.Key ResponsibilitiesInvestigate and assess claims lodged by claimants, ensuring that all necessary documentation is obtained and verified.Conduct thorough...
-
Financial Claims Handler
7 days ago
Cape Town, Western Cape, South Africa Spartan Recruitment Services Full timeFinancial Claims HandlerWe are looking for a Financial Claims Handler to join our team at Spartan Recruitment Services. This role involves handling financial claims, resolving disputes, and ensuring smooth debt recovery operations.Key Responsibilities:Process and handle financial claims in accordance with company policies.Investigate and resolve disputes...
-
Merit Field Investigator
3 months ago
Cape Town, South Africa Sanlam Full time**CAREER OPPORTUNITY** - Santam’s Merit Claims department has a position available for a Motor Merit Field Assessor based in Cape Town, Western Cape.The Merit Field Assessor will ensure that all flagged and segmented claims are comprehensively validated to achieve conclusive results. The successful incumbent will maintain credibility by ensuring that all...
-
Claim Administrator
7 months ago
Cape Town, South Africa Secondments Recruitment Full time**Job Advert Summary**: Our client is looking for claim administrator to - Ensure all claims are investigated according to claims investigation processes. - All investigation steps to be followed and accounted for: - Ensure SIT is cleared prior to investigating any claim. **Minimum Requirements**: **Duties and Responsibilities**: - Ensure SIT is cleared...
-
Regional Office Claims Specialist
7 days ago
Cape Town, Western Cape, South Africa The Recruitment Council Full timeAbout The RoleAs a Regional Office Claims Consultant, you will play a pivotal role in managing claims processes for personal and commercial insurance policies.Key Responsibilities:Claims Process Oversight: Ensuring timely and accurate resolutions while adhering to policy terms and company standards.Documentation Verification: Collecting and verifying...
-
S37C Death Benefit Investigator
7 months ago
Cape Town, South Africa Old Mutual Full timeDescription Summary Attending to retirement fund death claims ito Section 37C of the Pension Funds Act (PF Act). This role is responsible for the execution of the following technical – legal duties on behalf of the Trustees of the South African Retirement Annuity Fund (SARAF) or SuperFund Retirement Fund. •Identify & trace dependants / nominees...
-
Regional Office Claims Professional
1 month ago
Cape Town, Western Cape, South Africa The Recruitment Council Full time**Job Opportunity at The Recruitment Council**Role OverviewThe Regional Office Claims Consultant will be responsible for overseeing the claims process, ensuring timely and accurate resolutions while adhering to policy terms and company standards.This role is a great opportunity to work with a leading South African short-term insurance brokerage focused on...
-
Regional Office Claims Consultant | Tygervalley
2 months ago
Cape Town, South Africa The Recruitment Council Full timeJob Title: Regional Office Claims ConsultantLocation: Tygervalley, Cape Town, WCEmployment Type: Full-TimeCompany OverviewLeading South African short-term insurance brokerage focused on tailored solutions and exceptional service.Role OverviewThe Regional Office Claims Consultant will manage the claims process, ensuring timely and accurate resolutions while...
-
Claims Administrator
1 month ago
Cape Town, South Africa Value Car Hire Full time**Key Responsibilities**: **Claims Intake and Documentation**: - Receive, log, and track vehicle accident claims reported by customers, employees, or third parties. - Ensure that all necessary documentation is gathered, including police reports, damage assessments, and customer statements. - Review accident details and assess claim eligibility based on...
-
Claims Handler
3 months ago
Cape Town, South Africa Evolution Recruitment Full timeAre you fluent in German, Swedish or Italian?An opportunity has become available to assist German, Swedish and Italian customers with their claims as a Claims Handler.Experience is an advantage, but not a must.Applicants as required to be fluent in the mentioned languages as these skills will be tested. Working hours: Monday - Friday (09h00 - 17h00), Office...
-
Claims Assessor
7 months ago
Cape Town, South Africa JenRecruitment Full timeA vacancy exists for a Claims Assessor in our Gap Claims Assessing Department. (Claremont Cape Town) **Job description & duties**: - To check and validate all GAP claim documents received and to request any outstanding documents - To follow the claims process and capture the claim information onto the system - To verify and update any client personal...
-
Claims Specialist X 2
3 months ago
Cape Town, South Africa Health Solutions Full time**Introduction** - Momentum Health Solutions, an entity of Momentum Metropolitan Holdings delivers sustainable, integrated health solutions that meet the needs of clients in the different segments and maximise lifetime client value. We build and maintain a culture of innovation and create value through unique insights of how to achieve specific outcomes by...
-
Claims Consultant
7 months ago
Cape Town, South Africa RGA Full time**Position Overview** The Claims Consultant assesses and manages claims effectively and efficiently, within the required SLA, ensuring optimal profitability of the business. **Responsibilities** - Claims assessment and management of Individual Life claims across all benefit types, for the South African operation, as well as other benefits relevant to the...
-
Claims Specialist
13 hours ago
Cape Town, South Africa Momentum Metropolitan Holdings Full time-Introduction Role Purpose To provide an effective and efficient service to clients by receiving, evaluating, and responding to inquiries timeously. Requirements - Matric - Relevant tertiary qualification would be an advantage, CustomerRelationship Management, Business Management, ProjectManagement, Operations Management. - Claims School training - Computer...
-
Claims Assessor
7 months ago
Cape Town, South Africa Kontak Recruitment SA Full timeCape Town, Western Cape - Administrative **Claims Assessor (JB4315)** **Claremont, Cape Town, Western Cape** **R16 000 - R19 000 CTC per month based on experience** **Permanent** A leading provider of insurance solutions, dedicated to delivering exceptional service and peace of mind to their clients and strives to exceed expectations by consistently...
-
Claims Specialist
7 months ago
Cape Town, South Africa Gen Re Full time**Shape Your Future with Us** General Re Corporation, a subsidiary of Berkshire Hathaway Inc., is a holding company for global reinsurance and related operations, with more than 2,000 employees worldwide. Its direct reinsurance companies conduct business as Gen Re. Gen Re delivers reinsurance solutions to the Life/Health and Property/Casualty insurance...
-
Lead Claims Lawyer in Cape Town
4 weeks ago
Cape Town, Western Cape, South Africa ARCS Full timeJob SummaryWe are seeking a highly skilled Claims Specialist to join our team at ARCS in Cape Town. As a key member of our Claims Department, you will play a critical role in assessing claims efficiently and effectively.About the RoleThis is an exciting opportunity for a Lead Claims Lawyer with 3-4 years post-admission experience to take on new challenges...