Santam Limited is the largest short-term insurer in South Africa, with a market share in excess of 22%, providing short-term insurance products through broker networks and direct sales channels. The company was established in 1918 and offers personal, commercial, and corporate insurance solutions. Santam is a subsidiary of Sanlam Limited and has been listed ...
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The Merit Field Assessor will ensure that all flagged and segmented claims are comprehensively validated to achieve conclusive results.
The successful incumbent will maintain credibility by ensuring that all validations are conducted in accordance with the Santam Claims Policy and Philosophy and Standard Operating Procedures and appropriate forensic investigation practices.
KEY RESPONSIBILITIES
Handling of disputes that could arise between Motor merit field and intermediaries and / or claimants.
Validate and collate information on flagged claims.
Conduct a field validation on the claim.
Review the claims documents and photos to validate the claim.
Handle claim queries within the agreed service levels.
Handle customers effectively and fairly in line with TCF.
Finalisation of completed validations within the agreed turnaround times.
Regular liaison with management and staff at all levels of the company regarding high risk claims escalated/ flagged.
Consultation with clients, Third parties, Business and Business Partners on a continuous basis regarding fraud and irregularities.
Regular liaison with counterparts at other insurers.
Regular liaison with Santam Forensic Services.
Maintaining relationships with external resources as part collaboration, source of information and investigation purposes.
QUALIFICATIONS AND EXPERIENCE
Matric/ Grade 12
Tertiary National Diploma or University Degree would be advantageous
Short Term Motor Insurance experience 3 years or more
2-3 years’ claims experience
Understanding of how to handle validations of Motor Claims
Previous experience in the Mertis validation of motor claims
Strong analytical abilities and evaluate trends objectively
SKILLS
Investigative and good communication skills
Administrative and Merit examination
Excellent customer service skills and proven experience
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