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Officer : Undertakings X 3

Officer : Undertakings X 3

Road Accident FundCape Town, ZA
14 days ago
Job description

Job title : Officer : Undertakings X 3

Job Location : Western Cape, Cape Town

Deadline : October 13, 2025

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Key Performance Areas

Handle Claims

  • Interpret the settlement, the undertaking and any limitations to determine the Funds liability for future costs to be incurred.
  • Scrutinize past medical expenses to determine the Funds liability for future costs to be incurred.
  • Identify any differences between the final settlements and re-draft the undertaking to reflect the correct liability.
  • Take cognisance of all expert reports, of internal and external origin, to determine the following :
  • The nexus between the costs incurred and the accident.
  • The reasonability of the costs by comparing the costs incurred with the claimants personal circumstances and needs
  • Communicate with experts where there is uncertainty i.r.o. costs incurred.
  • Report any discrepancies to Senior Officer.
  • Pre-authorise costs still to be incurred in terms of the undertaking within the mandate and in line with the medical and legal assessment.
  • Recommend or approve payment of the costs as per the mandate; or repudiate the costs; or request more information or refer for medical intervention.
  • Refer cases to field Case Managers for further investigation
  • Determine the need for home visits and attend when required.
  • Determine the need for the appointment of experts to do further assessments.
  • Approve other officers payments on MIS which includes checking for duplicates and if the correct payee is being paid.

    • Update claims records

  • Correct / update any change in the settlement details on the undertaking system to ensure that the liability of the Fund is accurately reflected on the system.

    • Manage Correspondence

  • Draft legal correspondence to all external stakeholders.

    • Attend to queries

    Attend to queries from internal and external stakeholders pertaining to the undertaking including the following :

  • Liability of the Fund in terms of the undertaking.
  • How to submit a claim.
  • Status / progress made on the claims already submitted.
  • General enquiries.
  • Give advice to stakeholders on legal issues pertaining to undertakings.

    • Manage Litigation

  • Receive & record all litigation processes served in terms of the Undertaking.
  • Evaluate the documents, consider the Funds legal position with regards to the process.
  • Arrange for the matter to be held over, if necessary, alternatively.
  • Appoint an attorney for the Fund to defend the matter.
  • Refer the matter for assessment to determine the Funds liability.
  • Negotiate settlement with the attorney, alternatively, consider the opinions from the attorney and give clear instruction to the Funds attorneys to reach settlement.
  • Adhere to the time limits to prevent any wasted costs
  • Attend to opinions from attorneys to ensure that the Fund is ready for trial when due.
  • Report any risk to the senior to prevent any prejudice to the Fund.
  • Arrange for interim disbursements to be attended to appropriately at Legal costs.
  • Give proper instructions for settlement payments or payments in terms of court orders to prevent any unnecessary interest to be added.
  • Arrange for the bill for costs to be referred to Legal costs to attend to and follow up on payment thereof.
  • Report any actions from the Funds attorneys which is not in line with the Funds policies to the senior.

    • Compile Statistics

  • Keep daily stats of activities on Undertakings and related matters.
  • Submit daily stats and monthly stats as required by Management.
  • Keep record of statistics.

    • Keep claims records

  • Maintain record of all allocated matters.
  • Maintain record of litigated matters.
  • Maintain and apply a diary system used to pend matters to be followed up.
  • Scrutinize incoming correspondence and maintain proper record thereof.
  • Maintain proper record of files requested and returned to the I / S, referred to Medical and / or Administration cell.
  • Keep record of private telephone calls and submit accurate telephone accounts on a monthly basis

    • Qualifications

  • NQF 7 (Bachelor’s Degree OR Advanced Diploma) related qualification to discipline.

    • Experience

  • Relevant 3 years’ experience in the claims environment
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    Officer • Cape Town, ZA

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