Consultant: Loss Of Support Adjudication (X2) at Road Accident Fund

Key Performance Areas

Loss of support adjudication

• Review the claim against the loss of support adjudication standards.
• Assess loss of support supporting documents and data to determine the deceased duty to support (confirming affinity).
• Determine deceased ability to support the defendants by assessing income supporting data/documents in line with the approved quantum.
• Apply applicable case laws and Statutory limit to determine the LOE quantum.
• Based on the findings, make a determination to reject or approve.
• Assess actuarial reports and make a determination to whether to instruct internal actuarial team to make actuarial calculation or not.
• Make an offer and submit to offer management for further communication with the claimant.

Quality assurance

• Research, analyse, and review policies and laws relevant to assigned cases.
• Participate in the consultations process on the implementation of claims and related processes.
• Ensure that LOS Adjudication and processes are implemented and maintained at the highest standards.
• Maintain the implementation an unusual occurrence procedures.

Administrative support

• Deal with/and respond to correspondence.
• Produce documents, briefing papers, reports, and presentations.
• Assist with typing and editing briefs, technical papers, letters to various parties, and memos.

Reporting

• Track and report against set objectives and targets.
• Report on emerging risks.
• Provide ad hoc reports on process improvement initiatives.

Stakeholder management

• Maintain healthy relationships with all stakeholders.
• Follow up and resolve all queries, following up and making recommendations on which corrective actions are appropriate.
• Follow up and feedback to all stakeholders to keep them updated on the status of a query.
• Respond to queries within the predefined turnaround times.

Qualifications 

• Bachelor’s Degree/Advanced Diploma in a related qualification to discipline.

Experience

• Relevant 3 years’ experience in a claims adjudication related environment.