Claims Investigator: Desktop (Centurion) at Momentum Metropolitan Holdings Limited

Role Purpose    

• The purpose of this position is to determine the merit of segmented motor and non-motor claims by performing investigations, verifying the description of the event with the loss and make sure that all valid claims are being processed within SLA from the desk. You would also need to identify problematic claims (red flags) and have it sent for further validation by one of the field teams.

Requirements    

• Matric/ grade 12.
• Minimum 3 years’ relevant work experience in short-term motor merit claims/ claims investigation.
• Sound understanding of policy wordings and application thereof.
• Investigative abilities to identify red flag claims.
• Any previous claims handling, pre-support, and or post-support experience is advantageous.
• Attained product training in the following areas: Motor, Household Contents, Personal Possessions, and all Commercial products.
• Understanding of the Principle of insurance.
• Technical skills in the following areas: End-to-end claims handling procedure. Please

Duties & Responsibilities    

• Manage workload and complete claims within SLA. 
• Validate claims from the desk.
• Listen to relevant recordings, sales/ claims/ Momentum assist.
• Complete merit report with all findings.
• Conduct assessment with clients, interview authorities & witnesses.
• Dealing with Underwriters and Claims technical.
• Handle complaints, queries and all interaction with clients, Intermediaries, Service Providers, internal stakeholders, Relationship Managers.
• Presentation of claims in claims committee.
• Making notes on systems, process claims and upload documents.
• Compiling of rejection letters and distribution thereof to relevant stakeholders

Competencies    

• Analytical Thinking 
• Information Seeking
• Directiveness
• Initiative
• Flexibility
• Client-centric

Skills

• Ability to verify and interpret policy and appraisal detail.
• Be able to think on your feet. 
• Basic computer skills (MS office).
• Familiar with Momentum Insure systems.
• Good communication skills (Verbal and written).
• Excellent Telephonic skills.
• Ability to handle conflict and negotiate.
• Basic business ethics .