Policy Analysis Adviser

CXP are now part of the Huntswood Group; KwaZulu-Natal; On-site; ZAR 250,000 - 350,000; Full time

Job summary

A leading insurance service provider in KwaZulu-Natal is seeking a Policy Review Adviser to manage referrals related to misrepresentation and policy concerns. You will investigate claims, contact policyholders, and ensure compliance with company policies. The ideal candidate will have a Matric qualification and solid insurance experience, specifically in vehicle insurance claims. Strong communication and problem-solving skills are required for this role.

Qualifications

• Minimum of a Matric/NQF 4 qualification.
• Solid insurance experience.
• Vehicle insurance claims experience.
• Previous experience in a complaint handling role.
• Experience handling fraudulent claims/misrepresentation.

Responsibilities

• Investigate potential misrepresentation and non-disclosure cases.
• Contact policyholders to resolve discrepancies.
• Update and revise customers' policy details.
• Handle all complaints received effectively.
• Maintain positive relationships with all business units.

Skills

Communication skills

Time management

Problem solving

Data analysis skills

Microsoft Office proficiency

Customer service skills

Education

Matric/NQF 4 qualification

Tools

Microsoft Word

Microsoft Excel

Microsoft PowerPoint

Job description

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 levels and within agreed SLA.

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; work to agreed SLAs 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.
• Investigate and manage any potential voidance cases referring to Policy Analysis Level 2 or Senior for sign off.
• Contact policyholders by phone and email, adhering to TCF and DPA principles, to resolve any discrepancies related to misrepresentation, non-disclosure or indemnity issues.
• 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 delegated mailboxes ensuring all correspondence is actioned within agreed SLAs.
• Promptly identifying matches that do not require further investigation and ensure closure is actioned in a timely manner, within SLAs.
• Maintain positive relationships with all business employees and departments, comply 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 PowerPoint.
• 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.
• 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.