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Bryanston: CLAIMS HANDLER II posted by HR Option

Bryanston: CLAIMS HANDLER II posted by HR Option

Posted on 2025-05-21 00:00:00

Employer HR Option
Category Other Insurance
Location Gauteng  / Bryanston

Job Summary

Your:

Formal Education:

  • Matric
  • Relevant NQF 5
  • Successfully completed the RE 5 Examination Level 1
  • Commercial and Personal Lines Class of Business

Experience:

  • A minimum of three (3) years Claims experience with a claims settling mandate
  • A minimum of five (5) years working experience within the Short Term Insurance industry

will enable you to do the following duties:

Processes:

  • Effectively maintain claims standards and provide quality client service:
    • Register motor / non motor claims for personal and commercial policies
    • Appoint assessors
    • Confirm and make sure that cover is sufficient
    • Responsible for handling of and settling of claims for clients allocated and ensuring accurate capturing and updating on all data systems
    • Manage the claim from start through to settlement stage
    • Gathering information about the insurance claim from the client and any others involved
    • Examining the details on completed forms and checking these against the cover provided by the insurance policy
    • Consulting with other staff to decide the outcome of the claim and any compensation to be paid
    • Informing the client of the outcome of the claim in writing
    • Referring large or complex claims to other professionals such as a loss adjuster
    • Determine merits based on facts and investigation of reports presented
    • Settle claims within set parameters to avoid leakage
    • Obtain all information required for settlement or rejection of claims
    • Do continuous adjustments of reserves
    • Arrange / deal with the fulfilment of the following:
      • Car hire for insured in the event of an accident where vehicle not drivable or of car has been stolen
    • Arrange contractors to assist insured with obtaining critical documents to support claim
    • Manage salvage process
    • motor & non-motor salvage right through to recovery payment received
    • Follow up with loss adjustors/assessors periodically/ daily if required
    • Ability to negotiate claims with clients, service providers and Insurance market
    • Keep detailed, dated file notes of all discussions on the claim files
    • Ability to negotiate contentious claim with Insurance market and clients
    • Potential errors and omissions must be immediately referred to Claims Manager
    • Responsible for completion of claim files upon finalisation of claim and do filing to EDS
    • Ensure that claims files are maintained in accordance with operational standard and company procedures
    • Daily system updates (Such as diary & daily mail)
    • Detail Prompt feedback and handling of complaints (internal & external)
    • Ensure resolution of queries and complaints speedily
    • To submit and provide insurer feedback & reports as per agreed timelines
    • Ensure a pleasant claims experience
    • Facilitate and maintain sound working relationships with clients, colleagues, markets, and service providers, including but not limited to local markets
    • Ensure policy maintenance after a claim is completed
    • Update underwriting of items to be deleted/replaced
    • Maintain records of all reports submitted to clients.
View Job  Bedfordview: Commercial Sales Assistant posted by CFS RECRUITMENT

People:

  • Service delivery to ensure customer satisfaction:
    • Maintain service, quality and desired outputs within a specific functional process through ensuring compliance to tactical policies, procedures and standards
    • Resolve escalated customer queries and complaints and provide feedback to customers on matters resolved
    • Develop work routines in line with operational plans / schedules in order to manage achievement of service
    • Delivery goals
    • Share knowledge on, and participate in the creation of new standards, control systems and procedures to maintain service delivery.
  • Maintain effective people practices:
    • Align own behaviour with the organization culture and values
    • Share and transfer product, process and systems knowledge to colleagues
    • Collaborate and work with the Claims team to ensure required service levels are delivered.

Technology:

  • Continuous improvement to ensure effective service:
    • Ensure adherence to organizational policies, practices and procedures
    • Identify and recommend areas / ways to improve processes
    • DOFA confirmation from FSB
    • Cardinal 360 system experience will be an advantage. 

Click Go Apply to apply online!


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