Duties & Responsibilities
- Claims Administration
- Administer complete claims process according to defined claims procedures until claims are settled
- Apply policy terms and conditions
- Ensure accurate and timely claims processing
- Make assessment of claims validity and estimate value and administer mandated claims
- Act as intermediary between insurer and client and timeously relay communication, requests and documentation
- Engage with insurers regarding recoveries, diarise follow-ups and keep clients informed
- Ensure productivity targets are met
- Contribute towards and ensure continuous improvement in own and team performance
- Adhere to company mandates
- Participate and contribute in ad hoc projects
- Report any suspected fraud, misrepresentation and / or dishonesty
- Collect, review and analyze a clients relevant history and records and obtain additional information (as required) to accurately determine the level of risk for insurance purposes.
- Effect amendments to all policies on the system and send to the client as requested
- Liaise with the client to ensure all information / certificates are accurate and recorded on the system.
- Liaise with Management or relevant specialists to negotiate / discuss risk assessment.
- Analyse statistical information using in-house programmes to ensure premiums are competitive and that loss ratios remain profitable.
- Liaise with clients to specify conditions imposed on each policy
- Adhere to legal requirements, industry regulations and customer quality standards sent by the company.
- Continually build and maintain good working relationships with stakeholders.
- Perform the underwriting function according to the paperless system of operation / data management.
Desired Experience & Qualification
RE 5 and minimum NQF4 qualification and Matric