Senior Claims Consultant.

Closing Date 2023/11/01

Reference Number HOL231025-9

Job Title Senior Claims Consultant

Business Unit Hollard Insure

Department Northern Region

Job Family Operations - incuding Claims, Policy Servicing, Underwriting and Retentions

Job Type Classification Permanent

Reporting To Claims Manager

Number of Positions 1

Location - Town / City Pretoria

Location - Province Gauteng

Location - Country South Africa

Job Advert Summary

The Senior Claims Consultant will be responsible for Branch claims as well as Outsourced Binder Brokers claims management which entails monthly estimate review, average cost per claim, affective procurement utilization and authorization/management of claims above binder mandate

Appropriate personal and commercial lines claims annual FSB audits

Monthly reporting per binder holder on a one-on-one basis

Assistance with any technical or referral queries from binder broker

Ensure strong working relationship with relevant stakeholders internal and external

Contribute to the growth and profitability of Hollard

Key Responsibilities

Process all claims over binder mandate. Evaluate and investigate all claims received in order to prevent possible leakage to the company in the settlement of claims. Management of outstanding claims on a monthly basis

Process all claims assigned within branch mandate - All claims received to be registered within 24 hours of receipt. Premium checks to be done. To establish as accurately as possible the estimate to be retained by the branch (allow variance of 5%). Claims finalized and cheque requisitioned within 24 hours of final correspondence. . Ensure claims are paid in accordance with policy cover. Identify multi claimants and bad risks. Ensure that transactions are processed within delegated authority limits and within set standards

Provision and adherence to claims guidelines and signed agreement

Interpretation and application of policy terms and conditions ensuring all validation checks for claims referred

Underwriters to be advised of claims revealing adverse risk features as soon as they are evident and reinstate policies where applicable

Detection and management of fraud, dishonesty, misrepresentation

Roll out of Hollard procurement strategy

Onboarding of partners and partner training

48 hours turn around for everything

Managing and referring rejections to senior management, ensuring fairness and diplomatic communication

Required Knowledge And Experience

Sound understanding of commercial and industrial short-term insurance with at least 5 years experience:

Knowledge of various policy wordings including commercial wording, business rules etc.

Knowledge and application of Short-Term products

Knowledge of insurance practices

Knowledge of SA insurance market and competitors

Business management skills

Self-management skills can organize work, space, time

Good communication skills including writing and presentation skills

Relationship management skills have the right approach with the right people

Negotiation skills internal & external

Analysis and interpretation of data pertaining to claims

Demonstrate common sense, self-motivation, and discipline

Well-presented / representative of Hollands image

Visibly demonstrate the Hollard values

Visibly assisting Hollard being the best business insurer

Sound knowledge of MS Office including Word, Excel, PowerPoint, Outlook

Career orientated When required perform any other duties necessary for the operational effectiveness of the company that is within your ability and scope

Educational Requirements

Matric

NQF 5 Insurance Qualification

RE & FAIS Compliance advantageous

Ensure minimum CPD points are obtained