Policy Analysis Adviser - Umhlanga at Huntswood

Job Responsibilities:

• Investigate all cases of potential misrepresentation and non-disclosure at policy inception and claims stage through to completion received via a variety of referral sources into CFS; working to agreed SLA’s and following the Policy Validation Guide and CFS Procedure documents Investigate the validity of FCIM’S customers claims history by carrying out post sale CUE (Claims Underwriting Exchange) match validation and processing any necessary changes to the policy.
• Investigate, through to a conclusion, policies where Quote Manipulation is suspected prior to the inception of the policy
• To investigate and manage any potential voidance cases referring to Policy Analysis Level 2 or Senior for sign off
• Contacting policyholders by phone and email, adhering to TCF and DPA principles, to resolve any discrepancies related to misrepresentation, non-disclosure or indemnity issues.
• To update and revise customers’ policy details making any necessary adjustments and cancellations.
• Make outbound calls to customers in relation to validation procedures/ queries whilst adhering to TCF and DPA principles.
• Administer and process incoming post and e-mail, including the scanning of relevant documents.
• Handle all complaints received effectively and efficiently adhering to FCIM Complaints policy
• Manage the delegated mailboxes ensuring all correspondence is actioned with agreed SLA’s.
• Promptly identifying matches that do not require further investigation and ensure closure is actioned in a timely manner, within SLA’s.
• Maintain positive relationships with all business employees and departments comply with the requirements, and act in accordance with, the Group Code of Conduct and Fitness and Propriety policies at all times
• Ensure compliance with Company Policies, Values and guidelines and other relevant standards/ regulations at all times
• Any other reasonable duties

Job Requirements:

• Minimum of a Matric/NQF 4 qualification
• Solid insurance experience
• Working in a customer services environment
• Complaint handling experience
• Strong Microsoft Office experience with Word, Excel and Power - Point.
• High level Customer Service Skills 
• Previous experience within the contact centre/insurance industry beneficial

Experience Required:

• Previous experience in a complaint handling role, ideally with experience in early resolutions
• Experience in handling fraudulent claims/misrepresentation at policy inception will be advantageous
• Previous complaint handling experience within an FCA regulated business is ideal.
• Experience taking both outbound and inbound calls
• Providing the best resolution for the customer

Skills Required:

• Good communication skills, both verbal and written
• Good time management and organisation skills
• Problem solving skills with the ability to adopt a logical approach to resolving problems
• Good data and statistical analysis skills
• Good technical skills
• IT and software skills, including good Microsoft Excel and Word knowledge