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
