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Domestic & Commercial & Motor – Claims Administrator wanted: Salary R360 000 to R480 000 per year

Domestic & Commercial & Motor – Claims Administrator wanted: Salary R360 000 to R480 000 per year

Johannesburg, Gauteng
R360 000 – R480 000 a year

Our client, a dynamic Insurance Brokerage based in the Northern Suburbs of Johannesburg is seeking to employ a Claims Administrator – Short-Term Insurance – Domestic & Commercial, motor claims

Candidates must have :

Matriculation/Grade 12

FAIS Completed with required Credits

RE5

Technical Knowledge

Motor Processing
Claims Processing
3 – 5 years claims experience

Purpose of the Job:

To manage the claims administration and Negotiation process of your allocated client base in order to place the client in the position they were in immediately prior to their loss and always trying to adhere to the Company’s standards and turnaround times

PROFESSIONAL ATTRIBUTES

Solid interpersonal and relationship building skills
Ability to handle pressure and meet deadlines
Excellent IT Proficiency
Exceptionally detailed orientated
Understanding CIMS3
Clear credit history recommended.
KPA

ACTION

MEASUREMENTS

Claims Administration (motor and non-motor) of the allocated portfolio.

Take all the relevant details when the client phones

Check premium payment and cover immediately. If premium not paid or there is no cover, clarify with the A.E. or Member immediately before advising the client.

If there is cover.

Register claim on CIMS System upon notification of the claim. A checklist is to be created immediately after the claim is registered with ALL the necessary information filled in on the form. Claims forms are to be immediately sent to the insured for completion

Send first notification to the client and Insurance Company confirming

receipt of all the documentation or when the claim is over our claims mandate.

Carried out within 1 hour after registering the claim.

Carried out within 24 hours

Carried out within 48 hours

Motor claims

Arrange with the Insurer to have an assessor to inspect the damage upon receipt of claims documentation or the Insured can be referred to the closest drive in assessment center.

Follow up on a regular basis for the assessment and keep the Insured informed of the progress

Follow up on the authorisation with the repairer whether the vehicle been assessed and confirm immediately to the Insured that the repairs have been authorised.

In the case of the Windscreen claim we will give authorisation for immediate repair/replacement upon checking premium and cover details and getting the claim number from the Insurer.

An assessor is to be appointed for all Porsche/Ferrari windscreen claims over R 20K and authorisation to be given immediately after receiving the assessors report or alternatively client to provide a picture of damaged windscreen & license disk.

Carried out within 24 hours, depending on area and assessor schedule

After 48 hours

Carried out within 24 hours

12 hours

General Administrative Tasks

Ensure all claim forms are completed fully. If not it is to be returned to the Insured for completion.

Prepare/obtain relative claims experience if this is requested by the underwriter or A.E.

Any Ex-Gratia requests may not be confirmed to Clients until this is agreed in writing from your senior manager/Accounts Executive and also from the Insurer.

After a total loss on motor or specified items, you are to immediately, after becoming aware of the total loss, advise the underwriter to delete the item and to contact the Insured in order to add the new item.

After a personal claim is registered on a true monthly policy you are to advise U/W the details of the claim so that they are able to adjust the premiums/NCB/CFG. This is to be done if the insured is aware that they are going to claim.

Advise U/W of risk Improvements, if these details have been given by the assessor/Insurer

In all cases check the policy Of the Insured or Company to ensure that the claim falls within the scope of cover and to ensure all details on the claims file i.e. Excess’s and estimates and cover is noted properly.

In the event of the client being unhappy about the progress of this claim or settlement, then you are to act as a spokesman between them and the insurer. You may never refer them to the insurer.

Promoting the service that the Company offers to our clients and/or third parties that we deal with daily.

Ensuring good relations with Insurance companies, assessors, replacement institutions.

Carried out within 24 hours

Help other departments when the need arises.

Keep CIMS System up to date at all times including the making of notes on the system.

Updating payments on the CIMS System

Checklists to be scanned into CIMS2&3

Payments through Hollard Insurance Company are to be loaded on a Bordereaux upon receiving the claims file back from the payments department.

Ensure that diaries are kept up to date and regular follow-ups are made with the insurer, assessors and also the repairers.

Understanding the cover and wordings of the commercial/Multimark III policies by ongoing hands-on training

Ensure that important mails and/or queries are attended too

Liabilities are to be sent to the insurer after becoming aware of the approach and regular follow-ups are to be done with the Insurer to ensure that the third party claim is settled

Recoveries are to be sent to the Insurer after the assessors report has been received and regular follow-ups are to be made with the Insurer.

If the recovery is successful then the U/W is to be advised regarding this and the NCB/CFG is to be adjusted and confirmation is to be sent to the Insured confirming this.

Daily basis

48 hours

Daily Basis

Daily basis.

Carried out within 24 hours

Immediately

Immediately

Within 24 hours

Treating Customers Fairly

Daily/ongoing basis:

To follow the Company TCF Policy relating to all dealings with Clients

Full adherence to Policy

No Audit Findings

Attending of all required workshops and training

FAIS

Ensuring that all FAIS related documented in support of work processes and procedures is filed and kept up to date including Record of Advice, Needs Analysis, Disclosure Documents for the following processes:

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Source: jobs365