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  • Description

  • Our client operates in the market through multiple client-facing brands including insurance and investment brands.

    Responsibilities and work outputs

    • Receive personal line claims identified by the fraud prediction model for validation.

    • Confirm merits of each claim through comprehensive assessment of the item and incident.

    • Apply the policy to ensure the loss is covered in terms of the contract.

    • Compile a comprehensive report on all findings and make a recommendation on a claim based on merits/evidence found during the validation process.

    • Refer all recommendations not within your mandate to the line manager for approval.

    • Irrespective of the outcome of the claim the broker, client and claims advisor to be notified (rejected claims to be communicated verbally and in writing).

    • Obtain all evidence in a proper manner to ensure that it is admissible as evidence in a court of law.

    • Assist/influence other areas of the business once an investigation is concluded, i.e. report on the quality of the sale/policy wording and application or adjustment of underwriting criteria.

    • Report on any risks identified and suggested controls and report any other failures which influences the merits of an investigation.

    Experience and Qualifications

    • Matric

    • FAIS accreditation or a FAIS recognised qualification will be highly beneficial.

    • Minimum experience of 3 years investigative experience in Personal claims environment.

  • Requirements

  • Minumun level of education: Diploma /Bachelor's/ N6
  • Years of experience: 3
  • Availability for travel: No
  • Availability for change of residence: No
  • People with disabilities: Yes

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Job summary

  • Personal Lines Claims Investigator

  • Buffalo City, Eastern Cape

  • Company

    Fellowmax Recruiters
  • Type of contract

    Permanent contract

  • Work type

    Full Time

  • Salary

    R 15.000,00 monthly

  • Apply now