Job Summary
The role holder will be responsible for processing and payment of general insurance claims in accordance with the set standards and guidelines.
Key Responsibilities
Process claims accurately and in a timely fashion as per customer charter and agreed Service Level Agreements
Review documents and pertinent requirements regarding an insurance claim to establish liability
Ensure that the insurance claim made by the claimant is complete in form and complies with the documentary requirements of an insurance claim
Advice claimants regarding basic matters about their insurance coverage in relation to the insurance claim
Respond to both internal and external claims inquiries concerning benefits, claims process, service providers, and the filing/completion of proper forms
Record all claims transactions in the system
Track and follow up on receipt of necessary forms
Capture and maintain accurate data to ensure data integrity
Prepare weekly, monthly and quarterly reports and any other ad hoc reports as may be required by management
Issue release letters Issue authority letters for windscreen fitting and car hire
Maintain a diary system for all active files
Review files for continuing adequacy of reserves
Handle routine correspondences
Maintain a high level of service to customers at all points of contact such as telephone calls, emails letters or personal visits
Prompt attention to complaints
Appoint service providers such as assessors, investigators and loss adjusters
Issuance of release letters upon completion of repairs and submission of documents
Issuance of discharge vouchers
Proper adjustment of claims to avoid overpayment
Cross check claims information with IMIDS data system for fraud detection Investigate claims that appear to be suspicious
Enforce SLAs with service providers
Ensure policy excess is collected and apply depreciation where applicable
Settle payments via EFT to cut down on cheque processing costs
Qualifications
Bachelor's degree in insurance, Economics or other business related discipline
Progress towards Diploma in Insurance (ACII or AIIK), (at least 3 papers or equivalent)
Experience
2 years' experience in claims management
Competencies
Understanding of insurance operations and concepts
Knowledge of insurance regulatory requirements
Knowledge of claims procedures
Excellent organizational and stakeholder management skills