Claims Consultant

Purpose of the role: 

To provide stakeholders (e.g. clients, account executives) with efficient claims advice and administration according to the required standards and procedures in support of the business strategy.

PERSPECTIVE OUTPUTS

Ensure appropriate minimisation of claims and claims expenses Ensure and contribute to minimisation of general expenses

Ensure that all stakeholder (e.g. clients, insurers) communication is accurate, timeous, professional and relevant 

Build and maintain mutually beneficial relationships with internal (e.g. account executives) and external (e.g. clients) stakeholders  Keep client informed regarding to progression of the claim  

Ensure and contribute to achieving the required client satisfaction targets

Business processes · 

Adhere to company quality standards and broader regulatory frameworks wrt the following processes (but not limited to):  Claims Administration 

Receive claims notification, and send and obtain any relevant forms or documents as may be required 

Administer complete claims process according to defined claims procedures until claims are settled 

Appoint assessor or loss adjustor & Apply policy terms and conditions 

Keep internal system and records up to date at all times 

Keep relevant internal stakeholders up to date on the progress of registered claims 

Make assessment of claims validity and estimate value and administer mandated claims  

Forward claims in excess of mandate to insurer 

Obtain quotes for services 

Arrange approval and payment for claims costs in line with claims and cover 

Act as intermediary between insurer and client and timeously relay communication, requests and documentation 

Follow the recoveries process, diaries follow-ups and keep clients informed 

Ensure productivity targets are met 

Contribute towards and ensure continuous improvement in own and team performance 

Adhere to company mandates, Participate and contribute in ad hoc projects, Report any suspected fraud, misrepresentation and/or dishonesty, Keep accurate record of own activities