Claims Adjuster at Galileo Risk

Job description

Overall purpose of the position:

• The Claims Technician is responsible for coordinating and overseeing, managing and negotiating the settlement of the claim.
• The Technician is accountable for the claim during the entire life cycle (end-to-end).
• Effectively maintain claims standards and provide quality client service:
• Register motor / non motor claims for personal and commercial policies
• Appoint assessors
• Confirm and make sure that cover is sufficient
• Responsible for handling of and settling of claims for clients allocated and ensuring accurate capturing and updating on all data systems.
• Manage the claim from start through to settlement stage
• Gathering information about the insurance claim from the client and any others involved
• Examining the details on completed forms and checking these against the cover provided by the insurance policy
• Consulting with other staff to decide the outcome of the claim and any compensation to be paid
• Informing the client of the outcome of the claim in writing
• Referring large or complex claims to other professionals such as a loss adjuster.
• Determine merits based on facts and investigation of reports presented
• Settle claims within set parameters to avoid leakage
• Obtain all information required for settlement or rejection of claims
• Do continuous adjustments of reserves
• Arrange / deal with the fulfilment of the following:
• Car hire for insured in the event of an accident where vehicle not drivable or of car has been stolen.
• Arrange contractor’s to assist insured with obtaining critical documents to support claim
• Manage salvage process – motor & non-motor salvage right through to recovery payment received
• Follow up with loss adjustors/assessors periodically/ daily if required
• Ability to negotiate claims with clients, service providers and Insurance market.
• Keep detailed, dated file notes of all discussions on the claim files.
• Ability to negotiate contentious claim with Insurance market and clients.
• Potential errors and omissions must be immediately referred to Claims Manager.
• Responsible for completion of claim files upon finalisation of claim and do filing to EDS
• Ensure that claims files are maintained in accordance with operational standard and company procedures
• Daily system updates (Such as diary & daily mail)
• Detail Prompt feedback and handling of complaints (internal & external)
• Ensure resolution of queries and complaints speedily
• To submit and provide insurer feedback & reports as per agreed timelines.
• Ensure a pleasant claims experience
• Facilitate and maintain sound working relationships with clients, colleagues, markets, and service providers, including but not limited to local markets.
• Ensure policy maintenance after a claim is completed. – update underwriting of items to be deleted/replaced
• Maintain records of all reports submitted to clients.

Qualifications & Experience:

• Very good communication skills (both written & verbal)
• NQF Level 4: Complete full qualification as set by regulation
• Successfully completed the RE 5 Examination Level 1
• A minimum of five (5) years´ working experience within Insurance industry.
• A minimum of three (3) years´ claims experience
• Knowledge of CIMS3 an advantage