Funeral Claims Assessor at Telesure Investment Holdings (TIH)

Introduction
The Funeral Claims Assessor contributes to the organisational goals by processing and paying valid life/disability/dread claims and managing risk by identifying fraudulent claims

Specification
Contract Validation

• To ensure that a client policy is valid through the appropriate due diligence (such as listening to the policy sales/retention etc. phone conversation).
• To ensure that all premiums have been received on an appropriate policy.

Document Assessment

• To ensure that all appropriate documents are in place relating to a client policy and ensure that the appropriate disclosures are made by the life assured.
• To appropriately escalate any red flags / discrepancies to the relevant department (for example forensics) as and when identified

Finalization Of Claim

• To ensure that the correct decision is made with regards to acceptance/declining payment of claim based on appropriate documents received and relevant contract in place.
• Ensure that production targets are met and that relevant turnaround times and SLAs are adhered to.

Administration

• To ensure that the correct banking details is received and captured and that the correct amount in terms of an accepted claim is paid to the appropriate parties.
• To ensure that the appropriate settlement documentation is sent to the appropriate parties outlining the amounts paid and the reasons for it.
• To ensure that the relevant parties for a declined claim are contacted and the reasons for the claim being declined is explained thoroughly.
• To ensure that a claimant is kept informed at all times with regards to their claim process.

Level Of Education
Requirements

• Matric / Grade 12 or SAQA Accredited Equivalent
• RE 5
• 1 – 2 years working experience in the life insurance industry

Knowledge Of

• Human Anatomy
• Life Insurance Principles
• Basic Medical Industry

Skills

• Customer focused
• Communication (written and verbal)
• Computer Literacy
• Conflict Resolution
• Analytical skills

Job Closing Date: 30/09/2020