Risk Management High Level
Resume:
Ompolokile Innocent
Phale
Executive Summary
Ompolokile Innocent Phale is a highly focused, hard-working and driven person. I have been in the insurance industry for just over 13 years. Over the past 13 years, I have been exposed to claims management practice, legal recoveries and liabilities motor law claims, and risk management. I possess Elements of Short-term Insurance certificate (UNISA) and Paralegal Certificate (UCT).
I have had the pleasure of working for 2 of the big 4 Insurance Companies in South Africa, i.e., Hollard Insurance and currently Santam Insurance Company.
All the companies I’ve worked for are highly challenging and have pressurized environments with high volumes and performance targets to meet and my tenacity, self-motivation, results driven and ability to work effectively and focused under pressure enabled me to excel and consistently performing at a high level of expectation.
Nationality : South African Citizen
Race : African
Gender : Male
***************@*****.***
Employment History Summary
01 October 2017 – To date
Recoveries & Liabilities Claims Specialist • Santam Insurance
15 June 2015–31 September 2017
Recoveries & Liabilities Claims Specialist • Hollard insurance
01 August 2007–13 June 2015
Recoveries & Liabilities Claims Specialist • Santam Insurance
01 November 2005–31 June 2007
Call Centre Consultant (Tele sales Insurance) •Direct Channel Marketing.
Employment History Detailed
Company
Santam Insurance
Position
Recoveries & Liabilities Claims Specialist
Period
01 October 2017 – To date
Responsibilities
Attending and managing all aspects related to a portfolio of high quantum, specializing in claims: such as claims registration, case management, drafting case law arguments/counter claims, diary management, recoveries, liabilities and settlement negotiations.
Drafting settlement agreements and other legal documents within my mandate.
Strategically managing a portfolio of recovery and liability claims.
Managing loss adjusters and attorney’s appointments on matters and ensuring compliance with agreed service level agreements.
Monitoring and managing legal spend of attorneys and loss adjusters.
Managing system processing and compliance with systems by way of payments, updating signed off reserves, proper recordal of information etc,
Attending to Operational duties as allocated
Compiling and managing risk reports when required
Actively managing and recording claims above certain thresholds on Risk Module and reporting on matters to Claims Co and Executive where required.
Complying with internal and external regulatory framework and internal and external processes and procedures in accordance with organizational standards.
Drafting processes and procedures that are compliant with relevant regulatory framework and applicable legislation
Company
Hollard insurance
Position
Recoveries & Liabilities Claims Specialist
Period
15 June 2015–31 September 2017
Responsibilities
Claims Leadership
Team management (5 whilst at Hollard)
Providing appropriate and required level of involvement, assistance and/or guidance to junior Claims Staff;
Assist Management team in providing continuous training and development to claims department.
Assisting in identifying and developing SOP’s and processes to ensure legal claims department effectiveness.
Taking initiatives in creating opportunities of interaction with Brokers and Insureds.
Evaluating and investigating all potential recoveries/third party approaches received
Maintaining high level of service internally and externally
Providing regular feedback/updates to brokers
Communicating in a professional manner with internal and external parties and responding to queries
Appointing assessors to certain quantum, negotiating settlement with third parties / insurers.
Identify possible recoveries, Recording money receipt in respect of third party and recovery,
Interacting regularly with attorneys, avoiding litigation against our client.
Requesting all third-party documents: Proof of ownership/E-Natis, Insurance status of the third party.
Daily diary management
Recovering our damage amount from the third party (insured and uninsured)
Extensive liaison with individuals, insurance companies and attorneys telephonically or by typing letters.
Corresponding with service providers (Attorneys and tracers) and brokers.
Providing legal advice to our clients
Updating clients, and other insurance companies
Target driven as per recovery matters.
Negotiating settlements by proving our claim with relevant case law
Settling and liaising with third parties (insured and uninsured)
Processing of payments received, and payments banked.
Refunding our client’s excess and payments to our clients
Closing or finalizing claims and informing our client’s thereof
Company
Santam Insurance
Position
Recoveries & Liabilities Claims Specialist
Period
01 August 2007–13 June 2015
Responsibilities
Evaluating and investigating all potential recoveries/third party approaches received
Maintaining high level of service internally and externally
Providing regular feedback/updates to brokers
Communicating in a professional manner with internal and external parties and responding to queries
Appointing assessors to certain quantum, negotiating settlement with third parties/insurers
Identify possible recoveries, Recording money receipt in respect of third party and recovery,
Interacting regularly with attorneys, avoiding litigation against our client.
Requesting all third-party documents: Proof of ownership/E-Natis, Insurance status of the third party.
Daily diary management
Recovering our damage amount from the third party (insured and uninsured)
Extensive liaison with individuals, insurance companies and attorneys telephonically or by typing letters.
Corresponding with service providers (Attorneys and tracers) and brokers.
Providing legal advice to our clients
Updating clients, and other insurance companies
Target driven as per recovery matters.
Negotiating settlements by proving our claim with relevant case law
Settling and liaising with third parties (insured and uninsured)
Processing of payments received and payments banked
Refunding our client’s excess and payments to our clients
Closing or finalizing claims and informing our client’s thereof
Company
Direct Channel Marketing
Position
Call Centre Consultant (Tele-sales Insurance)
Period
01 November 2005–31 June 2007
Responsibilities
Underwriting New Policies
Life Policies
Advising on the product offered(Financially)
Answering Calls and Making Calls
Responding to Client’s Queries
Capturing client’s Information/Data
Educational Background
Thabo Senior Secondary School
Grade 12 Certificate -2004
Unisa – Elements of Short term Insurance -2010
University of Cape Town – Paralegal Certificate -2012
Oxbridge Academy – Diploma in Occupational health and Safety -2015
Additional Training
Intermediate Microsoft Excel, Word, Power Point
IIG Leadership programme
Data Warehouse
Project Management
Negotiation Skills Entrepreneurial and Commercial Thinking
Client Service
Business Writing Skills
Client Delight
Communication
Hands-on-Management
Leadership Skills
References
Available on request.
Contact this candidate