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Claims Consultant - Cape Town in Western Cape - Higher Life Personnel Solutions

Higher Life Personnel Solutions

Higher Life Personnel has built solid and lasting relationships with many valued clients since inception in 2007. Our unique strength as a recruitment company is that we specialise in finding and placing management and specialists in three distinct fields - Finance, IT and Engineering.

Over the years, we have built an extensive portfolio of clients who have responded positively to our value offering and the excellent levels of customer service. Our strength lies in our ability create opportunities around talent and engage with clients in harnessing and retaining this valuable resource. Our unrelenting focus on providing outstanding service delivers superior results to both clients and candidates. Recruiter from sector Human Resources, located in Gauteng, From 1 to 10 workers

    About this job ad 10 July

    Province

  • Cape Town, City of Cape Town, Western Cape
  • Description


  • ROLE PURPOSE:
    • To provide superior claims service to ensure the retention and the growth in our customer base, and the building excellent relationships with service providers, thereby contributing to the bottom line results of the company
    DUTIES / RESPONSIBILITIES CLIENT SERVICES
    • Ensure that clients are treated in a fair and reasonable manner at all times.
    • All request or required responses to clients must be dealt with in 48 hours of receipt.
    • Forward claims documents (i.e. claims forms) to client together with required supporting documentation within 24 hours of notification of claim.
    • Update clients on progress of claim via email of 1) acknowledgement of receipt of claim 2) advise appointment of assessor 3) authorisation of repairs / or 4) in the instance of a cash payment the amount paid and anticipated date of payment.
    • Keep client / AE informed at all times on progress of the claim.
    • Act on complaints immediately and resolve within 24 hours. ADMINISTRATION
    • Ensure that there is cover for the actual claim.
    • Register claim on CIMS.
    • Check that premiums are paid up to date.
    • Appoint assessor / Loss Adjustor within 2 hours of receipt of claim if all in order.
    • Authorise repairs or settlement immediately following receipt of assessor / Loss Adjustors report.
    • Claims over mandate forward to Hollard for authorisation.
    • All staff claims to be forwarded and authorised by Hollard only.
    • Stolen vehicles – Hollard Data Entry input form to be completed immediately and forwarded to Hollard
    • All rejections to be forwarded to Hollard.
    • Maintain a paperless environment throughout the claim process.
    • Maintain notes on CIMS regularly.
    • Diary to be used on all claims and to be pulled daily.
    • Fast track to be settled within 24 hours.
    • CAT claims to be recorded on CAT registers and followed through until settled. NEGOTIATIONS
    • Obtain quotes from service providers within 24 hours.
    • Negotiate quotes / early settlement discounts with the service providers.
    • Negotiate settlements / outstanding information with internal marketers.
    • Negotiate settlement with Third Parties and Third Party Insurers in a fair and reasonable manner.
    PAYMENTS
    • Receive and check invoices form services providers.
    • Complete payment requisitions immediately upon receipt and forward to Finance for uploading.
    • Capture all payment information on CIMS and finalise where applicable.
    SALVAGE & RECOVERY REGISTERS
    • Follow up on outstanding salvage every 14 days.
    • Record received funds on appropriate spreadsheets.
    • Keep registers updated at all times.
    RECOVERIES
    • Send all documentation to recovery specialist immediately following authorisation or settlement.
    • Follow up with final settlement figures to recovery specialist.
    • Request a follow up form recovery specialist every 30 days.
    • Keep client informed of progress at all times.
    • Advise client of successful recovery.
    • Refund excess to client within 24 hours of receipt of funds from recovery specialist.
    GENERAL
    • Manage your own outstanding portfolio.
    • Build and maintain relationships with service providers and internal parties.
    • Obtain a satisfactory score in applicable surveys used in the performance management process.
    • Ensure that the appropriate knowledge of the claims manual is maintained.
    • Actively participate as a team member and assist your team where necessary.
    • Actively participate during workshops and other forums to formulate and design new initiatives.
    • Ensure that the Fit-and-Proper FAIS requirement and other qualification as required are met as soon as possible and within the permitted timeframes.
    • Deal with any unresolved issues on CIMS when problems arise.
    STRICT REQUIREMENTS
    • Must come from an Insurer not negotiable.
    • Must have solid Insurer experience in Personal Lines claims for Individuals, there are no scheme accounts.
    • 60 claims per month (that’s from receiving and closing each).
    • Please can you check the references for sick leave, and time and attendance.
    • We are not looking for someone who takes lengthy smoke breaks and comes in late.
    • They must be technically strong, knows Personal Lines covers for Contents, Motor, sometimes here and there small pleasure craft, Fire, Theft etc.
    • They must have a minimum of 5 years solid Personal Lines experience in claims. 3 years is too little.
    • They need to have a sense of urgency, respond to calls and emails quickly, think on their feet, please check in reference.
    • They need to be fluent in English and Afrikaans, please can you actually speak to them in Afrikaans over the phone to test this.
    • Must be FAIS compliant, not negotiable
    • They need to have a clear professional phone manner and be clear over the phone

  • Requirements

  • Language(s): English
  • Availability for travel: No
  • Availability for change of residence: No

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