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Personal Lines Claims Investigator

Company:
Freebronx Joblistings
Location:
Pretoria, Gauteng, South Africa
Posted:
January 13, 2022

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.

If interested, please send your CV to: freebronxjoblistings@gmail.com

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