IN BOTH GROUP AND INDIVIDUAL LIFE CLAIMS IS ESSENTIAL Evaluate claims forms and supporting documentation Compare the reorts to our exisitng claims criteria to establish if claim is payable Decide on levels of provisions Writing claims assessment standards/policies Auditing/QA of work done by peers Deliver claims payment required to evaluate claims Liase with relevant re-insurers to determine validity of claims and get their approvals Experience in both group and life individual life claims is essential Sound Business and Operational knowledge
IN BOTH GROUP AND INDIVIDUAL LIFE CLAIMS IS ESSENTIAL Evaluate claims forms and supporting documentation Compare the reorts to our exisitng claims criteria to establish if claim is payable Decide on levels of provisions Writing claims assessment standards/policies Auditing/QA of work done by peers Deliver claims payment required to evaluate claims Liase with relevant re-insurers to determine validity of claims and get their approvals Experience in both group and life individual life claims is essential Sound Business and Operational knowledge
monitor all claim related activities, which include the complete claim processing cycle of all claims, all claim claim related enquiries or complaints including Pension Fund Adjudicator and FSCA complaints / enquiries enquiries.
Afrikaans speaking Commercial & Personal lines Claims Consultant to join a busy, well established and non-motor claims and assist clients with any general and claim-related queries. Capturing all new claims where innovative and appropriate claims handling Ensures that customers claims are handled efficiently Maintain is an integral part at the start of the entire claims value chain, ensuring that complete and accurate Must love Claims Claims Negotiator with at least 3 years Personal and Commercial Lines Claims experience
Kindly apply if you meet the minimum requirements. Should you not hear back from us within 2 weeks consider your application as unsuccessful.
lines claims experience across all commercial sections of the policy.
- Full function claims administration
(registration of claim, appoint assessors, read assessors report, make
decision on claim up to payment
payment of claim)
- Knowledge of Heavy Haulage Vehicles, Business Interruption, Personal Accident and
but is not limited to):
- Evaluate claims forms and supporting documentation in preparation
Compare the reports to the existing claims criteria to establish if claim is payable
- Decide on levels
raised based on information received
- Writing claims assessment standards/policies
- Auditing/QA
Deliver claims payment decision
- Determine requirements / documents required to evaluate claims
-
with relevant re-insurers to determine validity of claims and get their approvals where required
- Explain
Fully Qualified Claims Consultant Required for - Personal / Domestic Insurance NQF 4 Short Term Insurance Administer complete claims process according to defined claims procedures until claims are settled Apply Mak assessment of claims validity and estimate value and administer mandated claims Act as intermediary Must to be considered Matric 2 - 3 years Domestic Claims exposure R 22 000 Inclusive of Benefits
seeking a dedicated and experienced Claims Assessor to ensure that all claims are assessed accurately and paid of 2 years of claims assessing experience in the Medical Aid industry. Assess all claims using the appropriate Ensure accurate and timely processing of claims. Verify claim details and documentation for accuracy and healthcare providers and members to resolve any claim-related queries or issues. Adhere to the clients structures while processing claims. Maintain accurate records of all claims assessments and payments. Provide
support in the generation and provision of reliable claims assessment activities, to support key deliverables
Customer