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  • Posted: Oct 30, 2020
    Deadline: Not specified
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    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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    Merit Field Assessor (Bloemfontein)

    The Role

    Santam’s Merit Claims department have a position available for Motor Merit Field Assessor in Bloemfontein, Free State. The Merit Field Investigator will ensure that all flagged and segmented claims are comprehensively investigated to achieve conclusive results. The successful incumbent will maintain credibility by ensuring that all investigations are conducted in accordance with the Santam Claims Policy and Philosophy and Standard Operating Procedures and appropriate forensic investigation practices.

    What will make you successful in this role?

    • Handling of disputes that could arise between Motor merit field and intermediaries and / or claimants.
    • Investigate and collate information on flagged claims.
    • Conduct a field investigation 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 investigations 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 Motor Claims
    • Previous experience in the investigation of motor claims
    • Strong analytical abilities and evaluate trends objectively

    Knowledge And Skills

    • Investigative skills
    • Administrative and Merit examination
    • Excellent customer service skills and proven experience
    • Basic Investigation of Claims
    • Insurance knowledge Motor and Quality management
    • An inquisitive mind and good questioning skills

    go to method of application »

    Merit Accident Desktop Assessor

    What will you do?

    Santam’s Merit Claims department has a position available for a Merit Accident Desktop Assessor. The role is based in Auckland Park, Gauteng. The purpose of this position is to determine the quantum and merit of segmented motor claims by performing investigations, verifying the description of the event with the loss and ensuring that all valid claims are being processed within the Service Level Agreement from the desk. The individual will also identify problematic claims (red flags) and send the claim to a Field Assessor for further validation.

    What will make you successful in this role?
    Key Responsibilities

    • Manage workload and complete claims within the agreed Service Level Agreement (SLA).
    • Validate claims from the desk.
    • Listen to relevant recordings, sales/ claims/ SOS.
    • Complete merit report with all findings.
    • Conduct assessment with clients, interview authorities & witnesses.
    • Dealing with Underwriters and Claims technical.
    • Handle complaints, queries and all interaction with clients, Intermediaries, Service Providers, internal stakeholders, Relationship Managers.
    • Presentation of claims in claims committee.
    • Make notes on systems, process claims and upload documents.
    • Compiling of rejection letters and distribution thereof to relevant stakeholders.

    Qualifications And Experience

    • Matric / Grade 12
    • Minimum 3 years’ work experience in short term motor merit claims/ claims investigation.
    • Technical skills obtained through training and courses in Heavy Haulage would be advantageous.
    • Previous claims handling, pre-support and or post support experience is advantageous Knowledge of Abuntex and BPM will be an advantage.
    • Attained product training in the following areas:
      • Motor modules for PL, C/L and Agri
      • Specialised motor product C/L and Agri
      • Principles of Insurance
      • Technical skills obtained through training and courses in the following areas:
      • Introduction to motor
      • Claims handling procedure

    Knowledge And Skills

    • Sound understanding of policy wordings and application thereof.
    • Investigative abilities to identify red flagged claims.
    • Ability to verify and interpret policy and appraisal detail.
    • Telephonic, negotiation and conflict handling skills.
    • Basic business ethics and financial principles related to claims.
    • Time management
    • Change management

    Method of Application

    Use the link(s) below to apply on company website.


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