OSTI Specialist - Parktown at Hollard Insurance

An exciting new OSTI Specialist opportunity has just become available in our Insure, Operations (Customer Experience Area).
Role Objectives

• To be part of the team that deals with complaints that have been escalated from the ombudsman office or by customers and/or brokers requesting adjudication on internal complaints.  Complaints are received in writing from the ombudsman office and/or customers and brokers and these complaints are required to be considered by gathering and reviewing all the necessary information in order to make a decision on the complaint.  Where the complaint is invalid, the case is required to be argued with the ombudsman offices or the Internal adjudication forum.  Where the merits of the case are not in line with fairness and equity and ombudsman principles, the desired outcome is required to be discussed with the relevant business area. Where Hollard has failed in some way, improvement recommendations are required to be made to the relevant business area.

Key Responsibilities

• To receive ombudsman as well as internal adjudication cases and argue these with the various ombudsman offices as well as the internal adjudication approval forum based on Treating Customers Fairly (TCF) framework, regulations, and ombudsman principles.
• Cases need to be considered on a fair and equitable basis and discussed with the business area(s).
• Liaison with Hollard Insure Business Units, administrators and partners to obtain the relevant information to consider the case from all angles.
• Liaison with the Ombudsman office.
• Presenting cases for review to the Internal adjudication approval forum.
• Accessing line of business systems to obtain client information.
• Draft written communications to the ombudsman offices as well as customers and brokers and clearly articulate the decisions that have been taken on cases.
• To make improvement recommendations where there has been a failure on the part of Hollard.
• To contribute to business operational efficiency by ensuring consistent decision making across the relevant business area(s).
• To ensure that Hollard is following best practice in terms of good governance related to the complaints process(s). Interact with the relevant business area(s) and be able to discuss and debate complex matters.
• Ombudsman and internal adjudication case administration.
• Monthly reporting.
• Assist the Customer Resolution Manager with Claims Decision Disputes.
• Attend various forums (weekly claims forum, Customer Resolution dispute forum, branch forums, monthly claims forum, etc.) to provide insights from an OSTI and an internal adjudication perspective in an attempt to avoid complaints and overturns on these cases

Required Knowledge and Experience    

• Minimum of 5 years exposure to complaints handling experience or claims experience
• Operational personal and commercial lines insurance experience
• Working knowledge of the OSTI office and processes– an advantage

Educational Requirements    

• Any tertiary education or studying towards tertiary education
• Degree in Law - an advantage
• Industry related NQF level 6 qualification