Role Purpose
To provide stakeholders (e.g. clients, account executives) with efficient claims advice and administration according to the required standards and procedures in support of the business strategy.
Financial
- Ensure appropriate minimisation of claims and claims expenses
- Ensure and contribute to minimisation of general expenses
- Ensure that all stakeholder (e.g. clients, AEs, insurers) communication is accurate, timeous, professional and relevant
- Build and maintain mutually beneficial relationships with internal (e.g. account executives) and external (e.g. clients) stakeholders
- Keep client informed regarding to progression of the claim
- Ensure and contribute to achieving the required client satisfaction targets
- Adhere to company quality standards and broader regulatory frameworks wrt the following processes (but not limited to):
- Claims Administration
- Receive claims notification, and send and obtain any relevant forms or documents as may be required
- Administer complete claims process according to defined claims procedures until claims are settled
- Appoint assessor or loss adjustor
- Apply policy terms and conditions
- Keep internal system and records up to date at all times
- Keep relevant internal stakeholders up to date on the progress of registered claims
- Make assessment of claims validity and estimate value and administer mandated claims
- Forward claims in excess of mandate to insurer
- Obtain quotes for services
- Arrange approval and payment for claims costs in line with claims and cover
- Act as intermediary between insurer and client and timeously relay communication, requests and documentation
- Follow the recoveries process, 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
- Keep accurate record of own activities
- Live the RBS values by committing to the organisational values
- Ensure continuous self-development
- Share information and knowledge with the team
Minimum Qualifications And Skills
- Matric or equivalent
- RE 5
- FAIS appropriate qualification/credits
- Computer literate
- CIMS - advantageous
- Excellent communication skills (verbal & written)
- 3years claims experience (Personal Lines and Commercial)
