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Personal Injury Claims Handler
HR GenieJohannesburg, South Africa30+ days ago
Job descriptionAt least 5 years short term experience and 4 within the claims environment. Receive, review, and register new claims via phone, email, or digital channels. Acknowledge receipt of claims to clients within stipulated turnaround times. Collect all necessary documentation from clients to substantiate claims (e.g., claim forms, supporting evidence, police reports, photographs, invoices). Assess policy coverage, terms, and conditions for each claim. Request additional information from clients or third parties when required. Conduct investigations through interviews, site visits, and consultation with service providers or loss adjusters. Verify the legitimacy and validity of claims. Apply technical knowledge to interpret policy wordings and determine liability. Calculate and agree settlement amounts in line with policy terms, ensuring fairness and compliance. Negotiate settlements with clients, service providers, and, where necessary, legal representatives. Authorise and process payments within designated authority limits. Maintain regular communication with clients throughout the claims process, providing updates and managing expectations. Respond to queries, complaints, and escalations in a timely and professional manner. Deliver empathetic service during potentially stressful situations for clients. Identify potential fraudulent activity and escalate cases in line with company procedures. Work closely with internal audit and fraud prevention teams as required. Maintain accurate records and documentation for all claims handled. Prepare and submit reports for management, compliance, and regulatory purposes. Stay informed of changes to insurance legislation, industry trends, and best practices. Participate in training and development opportunities to enhance skills and knowledge. Adhere to company policies, procedures, and ethical standards at all times.
Our client requires a Claims Handler. Your :
Formal Education :
- Matric
- RE 5 Examination Level 1
- Class of Business : Commercial and Personal Lines
- NQF 5 in short term insurance
Experience :
will enable you to do the following duties :
Claims Registration and Acknowledgement :
Initial Assessment and Documentation :
Investigation and Evaluation :
Claims Processing and Settlement :
Customer Service and Communication :
Fraud Detection and Prevention :
Reporting and Documentation :
Continuous Improvement and Compliance :
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Personal • Johannesburg, South Africa
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