Complaints and Claims Advisor

CXP are now part of the Huntswood Group; KwaZulu-Natal; On-site; ZAR 300 000 - 400 000; Full time

Job summary

A leading financial services provider seeks a Policy Review Adviser in KwaZulu-Natal. The role involves managing referrals related to misrepresentation, non-disclosure, and indemnity concerns, while ensuring compliance with company policies. The ideal candidate should possess a Matric/NQF 4 qualification, solid insurance experience, and high-level customer service skills. Strong proficiency in Microsoft Office is required. This position emphasizes thorough investigation and customer interaction to achieve resolutions effectively.

Qualifications

• Minimum of a Matric/NQF 4 qualification.
• Solid insurance experience.
• Vehicle insurance claims experience.

Responsibilities

• Investigate cases of potential misrepresentation and non-disclosure.
• Contact policyholders to resolve discrepancies related to misrepresentation.
• Administer incoming post and emails, including relevant document scanning.

Skills

Customer Service Skills

Communication Skills

Problem Solving Skills

Data Analysis Skills

Education

Matric/NQF 4 qualification

Tools

Microsoft Office

Job description

Job Overview:

The Policy Review Adviser will manage referrals received into the Policy Analysis Team from a variety of sources relating to misrepresentation, non-disclosure and potential indemnity concerns, within agreed authority levelsand within agreed SLA.

Job Responsibilities:

• Investigate all cases of potential misrepresentation and non-disclosure at policy inception and claims stage through to completion received via a variety of referral sources into CFS; working to agreed SLA’s and following the Policy Validation Guide and CFS Procedure documents Investigate the validity of FCIM’S customers claims history by carrying out post sale CUE (Claims Underwriting Exchange) match validation and processing any necessary changes to the policy.
• Investigate, through to a conclusion, policies where Quote Manipulation is suspected prior to the inception of the policy
• To investigate and manage any potential voidance cases referring to Policy Analysis Level 2 or Senior for sign off
• Contacting policyholders by phone and email, adhering to TCF and DPA principles, to resolve any discrepancies related to misrepresentation, non-disclosure or indemnity issues.
• To update and revise customers’ policy details making any necessary adjustments and cancellations.
• Make outbound calls to customers in relation to validation procedures/ queries whilst adhering to TCF and DPA principles.
• Administer and process incoming post and e-mail, including the scanning of relevant documents.
• Handle all complaints received effectively and efficiently adhering to FCIM Complaints policy
• Manage the delegated mailboxes ensuring all correspondence is actioned with agreed SLA’s.
• Promptly identifying matches that do not require further investigation and ensure closure is actioned in a timely manner, within SLA’s.
• Maintain positive relationships with all business employees and departments comply with the requirements, and act in accordance with, the Group Code of Conduct and Fitness and Propriety policies at all times
• Ensure compliance with Company Policies, Values and guidelines and other relevant standards/ regulations at all times
• Any other reasonable duties

Job Requirements:

• Minimum of a Matric/NQF 4 qualification
• Solid insurance experience
• Vehicle insurance claims experience
• Strong Microsoft Office experience with Word, Excel and Power - Point.
• High level Customer Service Skills

Experience Required:

• Previous experience in a complaint handling role, ideally with experience in early resolutions
• Experience in handling fraudulent claims/misrepresentation at policy inception will be advantageous
• Previous complaint handling experience within an FCA regulated business is ideal.
• Experience taking both outbound and inbound calls
• Providing the best resolution for the customer

Skills Required:

• Good communication skills, both verbal and written
• Good time management and organization skills
• Problem solving skills with the ability to adopt a logical approach to resolving problems
• Good data and statistical analysis skills
• Good technical skills
• Good IT and software skills, including good Microsoft Excel and Word knowledge

Preferred Requirements/Skills:

• Experience/exposure to UK customers'/clientele.
• RE qualification
• FAIS credits

Core Behaviour

Huntswood’s employees are described as dependable, driven and collaborative.

The job holder should be able to demonstrate they are:

• Confidential, reliable and genuine
• Dynamic, passionate and determined
• Friendly, compassionate and cooperative

"It's not just about what we do, but the way we do it. And it's our values that make us special."

NB: All appointments are subject to the positive outcome of pre-employment verification checks.