Job Summary

The role holder will be responsible for processing and payment of general insurance claims in accordance with the set standards and guidelines.

Key Responsibilities

• Process claims accurately and in a timely fashion as per customer charter and agreed Service Level Agreements
• Review documents and pertinent requirements regarding an insurance claim to establish liability.
• Ensure that the insurance claim made by the claimant is complete in form and complies with the documentary requirements of an insurance claim.
• Advice claimants regarding basic matters about their insurance coverage in relation to the insurance claim
• Respond to both internal and external claims inquiries concerning benefits, claims process, service providers, and the filing/completion of proper forms.
• Record all claims transactions in the system.
• Track and follow up on receipt of necessary forms.
• Capture and maintain accurate data to ensure data integrity.
• Prepare weekly, monthly and quarterly reports and any other ad hoc reports as may be required by management.
• Issue release letters
• Issue authority letters for windscreen fitting and car hire.
• Maintain a diary system for all active files.
• Review files for continuing adequacy of reserves
• Handle routine correspondences.
• Maintain a high level of service to customers at all points of contact such as telephone calls, emails letters or personal visits.
• Prompt attention to complaints
• Appoint service providers such as assessors, investigators and loss adjusters Issuance of release letters upon completion of repairs and submission of documents. Issuance of discharge vouchers
• Proper adjustment of claims to avoid overpayment.
• Cross check claims information with IMIDS data system for fraud detection Investigate claims that appear to be suspicious.
• Enforce SLAs with service providers.
• Ensure policy excess is collected and apply depreciation where applicable.
• Settle payments via EFT to cut down on cheque processing costs.

Qualifications

• Bachelor’s degree in insurance, Economics or other business related discipline
• Progress towards Diploma in Insurance (ACII or AIIK), (at least 3 papers or equivalent)

Experience

• 2 years’ experience in claims management

Competencies

• Understanding of insurance operations and concepts
• Knowledge of insurance regulatory requirements
• Knowledge of claims procedures
• Excellent organizational and stakeholder management skills