Merit Accident Desktop Assessor at Santam Insurance

What will you do?

Santam’s Merit Claims department has a position available for a Merit Accident Desktop Assessor. The role is based in Auckland Park, Gauteng. The purpose of this position is to determine the quantum and merit of segmented motor claims by performing investigations, verifying the description of the event with the loss and ensuring that all valid claims are being processed within the Service Level Agreement from the desk. The individual will also identify problematic claims (red flags) and send the claim to a Field Assessor for further validation.

Key Responsibilities

• Manage workload and complete claims within the agreed Service Level Agreement (SLA).
• Validate claims from the desk.
• Listen to relevant recordings, sales/ claims/ SOS.
• 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.
• Make notes on systems, process claims and upload documents.
• Compiling of rejection letters and distribution thereof to relevant stakeholders.

Qualifications And Experience

• Matric / Grade 12
• Minimum 3 years’ work experience in short term motor merit claims/ claims investigation.
• Technical skills obtained through training and courses in Heavy Haulage would be advantageous.
• Previous claims handling, pre-support and or post support experience is advantageous Knowledge of Abuntex and BPM will be an advantage.
• Attained product training in the following areas:
  • Motor modules for PL, C/L and Agri
  • Specialised motor product C/L and Agri
  • Principles of Insurance
  • Technical skills obtained through training and courses in the following areas:
  • Introduction to motor
  • Claims handling procedure

Knowledge And Skills

• Sound understanding of policy wordings and application thereof.
• Investigative abilities to identify red flagged claims.
• Ability to verify and interpret policy and appraisal detail.
• Telephonic, negotiation and conflict handling skills.
• Basic business ethics and financial principles related to claims.
• Time management
• Change management