Claims Specialist - Durban at Hollard Insurance

Key Responsibilities

• Process all claims over binder mandate. Evaluate and investigate all claims received in order to prevent possible leakage to the company in the settlement of claims. Management of outstanding claims on a monthly basis
• Process all claims assigned within branch mandate - All claims received to be registered within 24 hours of receipt Premium checks to be done. To establish as accurately as possible the estimate to be retained by the branch (allow variance of 5%). Claims finalised and cheque requisitioned within 24 hours of final correspondence. . Ensure claims are paid in accordance with policy cover.  Identify multi claimants and bad risks. Ensure that transactions are processed within delegated authority limits and within set standards
• Provision and adherence to claims guidelines and signed agreement
• Interpretation and application of policy terms and conditions ensuring all validation checks for claims referred
• Underwriters to be advised of claims revealing adverse risk features as soon as they are evident, and reinstate policies where applicable
• Detection and management of fraud, dishonesty, misrepresentation
• Roll out of Hollard procurement strategy
• Onboarding of partners and partner training
• 48 hours turn around – for everything
• Managing rejections, ensuring fairness and diplomatic communication

Required Knowledge and Experience    

• Sound understanding of commercial and industrial short term insurance with at least 5 years’ experience:
• Knowledge of various policy wordings including commercial wording, business rules etc
• Knowledge and application of Short Term products
• Knowledge of insurance practices
• Knowledge of SA insurance market and competitors
• Business management skills
• Self-management skills can organise work, space, time
• Good communication skills including writing and presentation skills
• Relationship management skills have the right approach with the right people
• Negotiation skills internal & external
• Analysis and interpretation of data pertaining to claims
• Demonstrate common sense, self-motivation and discipline
• Well-presented / representative of Hollands image
• Visibly demonstrate the Hollard values
• Visibly assisting Hollard being the best business insurer
• Sound knowledge of MS Office including Word, Excel, PowerPoint, Outlook
• Career orientated When required perform any other duties necessary for the operational effectiveness of the company that is within your ability and scope

Educational Requirements    

• Matric
• NQF 5 Insurance Qualification
• Ensure minimum CPD points are obtained