Johannesburg: Claims Handler (X4) posted by Energy at Work Projects

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