Officer: Claims Investigation at Road Accident Fund

Key Performance Areas

Investigation and assessment of claims lodged.

• Trace insured driver / witnesses to consult and obtain statements and docket.
• Ensure that a proper sketch plan of an accident scene is drawn as part of the investigation and assessment process.
• Ensure that clear photographs of an accident scene, faces of the people interviewed, damaged vehicles and injuries to a person is taken as part of the investigation and assessment process.
• Obtain / and verify existing affidavits from different parties (e.g. claimants, witnesses, employers, etc.).
•  Identify possible fraud and corruption and escalate to Forensic Investigation Department (FID).
• Testify in court cases when claimant is guilty and accused of fraud.
• Provide assistance in ensuring witness presence at court.

Administrative support.

• Validate supporting documents (e.g. employment details, paternity/maternity details, SARS documents, etc.) for all related quantum investigations.
• Verify details of the claimant and those injured in an accident through Natis and Cross Check systems (e.g. ID no, contact numbers, address/S, employment details etc.).
• Verify the details of the secondary vehicle/s involved in the accident to determine the owner/s.
• Quality check the supporting documents from the stakeholders to determine the validity of the logged claim.
• Validate loss of earnings.
• Provide progress reports as per the internal service level agreement.

Document and records Management.

• Monitor and maintain an effective filing system.
• Ensure that files are correctly categorised and stored to ensure a smooth retrieval of documents.
• Administer the records management and filing processes in line with the RAF filing plan.
• Ensure confidentiality of all documents under control and that correspondence from the department office reaches intended recipients.
• Perform File Retrieval in Archive Services.

Stakeholder Management.

•  Provide advice to different parties (e.g. claimants, witnesses, employers, etc.)
•  Handle any assessments associated complaints.
•  Maintain relationships with internal and external stakeholders.

Qualifications

• NQF 7 (Bachelor’s Degree/Advanced Diploma) related qualification to discipline.
• Driver’s License
• Completed training as an investigator will be an added advantage.
• Being a certified fraud examiner will be an added advantage.

Experience

• Relevant 3 years’ experience in a similar environment.
• Experience in merit and quantum investigations will be an added advantage.