Digital Claims Adjustor - Parktown at Hollard Insurance

Role Objectives

• Comprehensive desktop investigations are conducted within a digital environment. This ensures improved customer service, retention of customers and minimizing any claims leakage through in-depth analysis of the information obtained through out the investigation.

Key Responsibilities
Stakeholder Management

• Quality of relationships with Internal and external stakeholders and ensure that we build relations and reputation to maintain and create opportunities
• Customer experience (Complaints and Compliments management)
• Osti – maintaining 0% overturn ratio. Immediately assist and respond all Osti matters by including T/L
• Complaints received to be handled immediately and feedback provided (Include Team Leader on response)

Claims Management

• Ensure accurate analysis and reports based on the layered voice system:
• Manage my performance against the key Claims measures, i.e. no of claims processed, TAT’s, Benchmarks, Car Hire Performance etc.
• Contact made with clients within 24 hours
• Provide regular feedback to the claims department and client (every 48 hours).
• Regular notes and updates to be documented on SPM
• Ensure that all documents are loaded immediately upon receipt on SPM during processing of claim.
• To ensure receipt of original registration or de-registration documents and vehicle keys, where applicable and handed over to our salvage or SVR division, howsoever directed.
• Detail discussion of claim outcome after decision has been rendered.
• High quality of investigation reports: Identification of fraudulent claims and dealing with them effectively (timeously escalating claims that should be dealt with.
• Ensuring claim finalization within mandate.
• Ensuring quality report writing and administration process followed by your administrator (resolve any issues that might be affecting your performance)
• Ensuring that Investigations adds value to business (value chain)

Customer Centricity

• Embed TCF as a way of doing business
• Manage investigation to be in line with OSTI and SAIA guidelines to allow for fairness towards clients and still with effective outcomes (TCF)
• Senior Claims Consultants/ Administrators KPI
• To uphold the STOPS TCF vision in my day-to-day activities and processes:
•  Ensure that Hollard TCF standards are adhered to.
• Effectively manage customer complaints per the agreed processes.
• Ensure all complaints are logged on the system as required.
• Ensure all operational process align with the Hollard TCF standards.
• Perform other ad-hoc related duties as required:
• Ad-Hoc responsibilities could be added in line with business needs or requirements

Required Knowledge and Experience    

• 5 years Insurance Claims experience, within a motor and non-motor claims environment
• Short-term and Commercial insurance exposure
• Policy admin experience
• Investigation experience

Educational Requirements    

• Matric with excellent English results