Claims Agent: Hoot Insurance at Innovation Group South Africa

Description    

• The role of the Insurance Claims Agent involves engaging with claimants and/or service providers to gather essential information required for processing claims, utilizing both written correspondence and phone calls.
• This includes evaluating claims based on received documentation and responses from claimants and providers. The agent ensures thorough assessment and verification to expedite accurate claim processing, maintaining adherence to company policies and regulatory requirements throughout the process.
• The role involves a digital way of work contributing to and embracing new processes and support on Digital Customer Queries

Minimum requirements 

• Matric NQF level 4
• Dealership experience
• 2-3 experience working in the Claims environment
• 6 months Claims experience
• I year Call Centre experience
• RE / FAIS
• Proficiency in computer skills and MS Office Suite ( Word, Excel, PowePoint & Access)

Key Responsibilities    

Finance .

• Ask correct questions and gain necessary information to process the claim or advise the client accordingly.
• If required, refer to independent Assessor or Investigator
• Review insurance policy to determine coverage.
• Capture claim on the system
• Finalize and close off the claim when all information is available.
• Authorise claims in accordance with policy parameters.
• Prepare insurance claim forms or related documents and review them for completeness.
• Calculate amount of claim.
• Post or attach information to claim file.
• Refer claims for payment or further investigation.
• Contact insured or other involved persons to obtain missing information.
• Contact Non collection on policies.

Governance and compliance

• Ensure that SLAs are met within the call centre
• Ensure departmental adherence to company policies and procedures.
• Operate within approved claims authority at all times.
• Ensure that the Divisional activities are coherent with Treating Customers Fairly operational deliverables of Claims and Policy Administration.
• Understand and implement IG’s “Treating Customers Fairly” policy.
• Ensure that all activities are in adherence to relevant control and compliance requirements, and quality standards

Customers

• Handle all customer interactions professionally and efficiently.
• Provide support to customers and communicate with internal and external clients in a professional manner.
• Collaborate and regular liaise with the Owner, Assessor, and other stakeholders.
• Communicate with Internal and External clients and Repairing Agents
• Support Digital Customer interaction chat and voice line

People

• Create a culture of ownership and accountability throughout the organisation in support of our values.
• Encourage frequent knowledge sharing between team members.
• Own development through personal growth and studies.
• Actively participate in team initiatives and functions. Motivate team and assist in creating an environment that contributes to employee wellbeing and growth