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