Officer Determination x10 at Road Accident Fund

Purpose of the Job: To provide claims handling to ensure prompt and fair settlement of claims.

Key Performance Areas

To estimate value of loss in terms of DOA

• Review documentation or determine further documentation needed.
• Scrutinize claims documentation (e.g. payslips, etc.)
• Determine and estimate quantum of claims.

To liaise with panel of experts for expert advice

• Consider experts reports particularly actuarial calculations.
• Instruct the relevant experts to quantify the benefits e.g. actuary, industrial psychologists on the advice of and approval of the assessor and/or senior assessor.

To quantify benefits and make appropriate offers.

• If no expert is required, calculate the value of benefits.
• Loss of support/earnings calculation on advice of the Assessor and/or Senior Assessor.
• Provide details of income and fringe benefits in major sectors.
• Determine contingency deductions to be applied.
• Interpretation on the cap limit under the Amendment Act.
• Assess the funeral account and award benefit in terms of the ARAF Act.
• Communicating and explaining offers to claimants.
• Attending to queries with claimants.
• Knowledge of rules of collateral and accelerated benefits.
• Factor in contingencies also consider merits allocated.
• Prepare offer as approved by the Assessor or Senior Assessor.
• Consider any prior payments/interim payments/WCC/Social grants/EIL under the advisement or approval of the assessor or senior assessor.
• Obtain approval in terms of delegation and send out offer.
• If accepted request payment.
• If not accepted revise the offer.
• If summons served, refer matter to Litigation.

To provide claims assistance during road shows

• Drawing files for road shows.
• Liaise with claimants to attend the road show.

Qualifications & Experience

•  NQF 7 Bachelor’s Degree or Advanced Diploma qualification
•  Relevant 3 years’ experience in claims experience

Technical and Behavioral Competencies required:

• Personal Mastery
• Emotional wisdom
• Ethics and governance
• Customer orientation and customer focus
• Detail orientated and analytical thinker
• Decision making
• Negotiation skills
• Time management
• Leadership skills
• Communication (Written and verbal)
• Computer literacy