Claims Handler

6 months ago

Johannesburg, South Africa Energy at Work Projects Full time

Duties and Responsibilities:
• Capturing of all new claim where applicable.
• One point of contact for the client/broker and adherence to first call resolution.
• Deliver exceptional client service that exceeds customers’ expectations through proactive,
innovative and appropriate claims handling.
• Ensures that customer claim is handled efficiently.
• Verifies FNOL data or documentation provided to ensure correct settlements of claim
• Attend to validation and first call actions on all claims within 1 working hour after registration.
• Achieve minimum targets were applicable.
• Maintain appropriate diaries and messages on the operating system.
• Client input and communication is an integral part at the start of the entire claims value chain,
ensuring that complete and accurate data/documentation is obtained and captured. This
determines the direction of the claim to the entire claims value chain.
• Effectively maintains oversight of all relevant claims tasks and manages the claims handling
process to achieve timely settlement and to minimise inaccuracies
• Identify, investigate and resolve any issues relating to claims being handled in line with claims
policies and procedures such as SLAs and TAT.
• Accurately check/determine whether appropriate cover is in place, interpret policy wordings
and conditions to determine the validity of claims and advises the broker/policyholder
accordingly.
• Identify potential non-disclosure and misrepresentation cases and follow Insurer's procedures
to deal with these situations.
• Identify any red flags on claims which are potentially fraudulent and follow Insurer procedures
for dealing with these.
• Identify when a specialist is needed to investigate a claim and follow Insurers policies and
procedures for appointing these.
• Identify possible recovery and third-party claims and link the claim to the legal department
upon registration.
• Negotiates effectively within agreed mandate limits using an appropriate negotiation style.
• Be familiar with the Insurers estimate philosophy and apply accordingly.
• Adhere to Brolink' s guidelines for referral of claims to management (e.g., large losses)
• Selects and appoints external experts/vendors following Insurer's procedures and authority
levels.
• Utilises preferred service suppliers when dispatching service to clients in line with BBEEE
targets e.g., Spend direction tools.
• Assist with emergencies and afterhours process for outsourced business.

• Minimizes cash settlements vs utilization of preferred suppliers for settlement by managing the
percentage of cash versus quantum.
• Demonstrates an effective communication style, that motivates, across internal and external
teams and individuals that may become involved with claim tasks.
• Salvage collection and management of timelines on salvage claims
• Meeting of set deadlines.
• Validate claims accordingly within the department structure.
• Deliver strategic results in term of the Brolink Vision and Mission.
• Attendance of weekly team meetings, participation on one-on-one discussion and other
meetings required from time to time
• Align own behaviour with the organisation culture and values.
• Demonstrate commitment toward the team and participate in building team culture.
• Collaborate and work closely with all role players thereby leveraging constructive team
dynamics and innovation
• Identify and recommend areas/ways to improve processes.
• Proactively ensure the most effective use of time, resources, money, materials or equipment in
line with policies and procedures.
• Comply with corporate governance policies, procedures and standards.
• Proactively suggest improvements in customer services where applicable.
• Building relationships with all stakeholders, including brokers and service providers, to best
support the company shared goal to achieve profit.
• Manage own development to increase own competencies.
• Adhere to the company policies and procedures and contracted performance agreement.

QUALIFICATIONS AND EXPERIENCE

Minimum Requirements:

• Matric is an essential requirement
• FAIS Credits (as per FAIS requirement)
• Must be Fit & Proper in terms of the FAIS Act
• Regulatory Exam: Representatives
• Must not be debarred with FSB

Work Experience

Minimum Requirements:• 2 – 5 years’ experience: Personal lines claims experience with all types of Motor and NonMotor claims. Commercial experience will be an advantage.
• Full function claims administration (registration of claim, appoint assessors, read assessors
report, make decision on claim up to payment of claim)
• Experience in the financial services industry or short-term insurance industry

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