Officer: Claims Investigation

4 weeks ago


Cape Town, South Africa Road Accident Fund Full time
Job title : Officer: Claims InvestigationJob Location : Western Cape, Cape TownDeadline : December 27, 2024Quick Recommended Links
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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.

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