Claims Consultant

Rbs Insurance Brokers; Cape Town; On-site; ZAR 250 000 - 350 000; Full time

Job summary

A leading insurance broker in Cape Town seeks a claims administrator to provide stakeholders with efficient claims advice and manage the claims process. This role requires accurate communication with clients and insurers, adherence to company quality standards, and the ability to administer claims effectively. The ideal candidate should embody organizational values and strive for continuous self-development.

Responsibilities

• Provide efficient claims advice and administration to stakeholders.
• Ensure accurate and timely communication with clients and insurers.
• Administer the complete claims process until settlement.
• Act as intermediary between the insurer and client.

Job description

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

Client

• Ensure that all stakeholder (e.g. clients, AE’s, 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 the progression of the claim
• Ensure and contribute to achieving the required client satisfaction targets

Business Processes

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

Learning and Growth

• Live the RBS values by committing to the organisational values
• Ensure continuous self-development

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