Personal Lines Claims Investigator

at Scillano HR Services  

Full-time
in Kimberley, Northern Cape
created 1 month ago
Expires 12 Sep
viewed 7
Personal Lines Claims InvestigatorOur client operates in the market through multiple client-facing brands including insurance and investment brands.
Responsibilities and work outputs Receive personal line claims identified by the fraud prediction model for validation.
Confirm merits of each claim through comprehensive assessment of the item and incident.
Apply the policy to ensure the loss is covered in terms of the contract.
Compile a comprehensive report on all findings and make a recommendation on a claim based on merits/evidence found during the validation process.
Refer all recommendations not within your mandate to the line manager for approval.
Irrespective of the outcome of the claim the broker, client and claims advisor to be notified (rejected claims to be communicated verbally and in writing).
Obtain all evidence in a proper manner to ensure that it is admissible as evidence in a court of law.
Assist/influence other areas of the business once an investigation is concluded, i.e.
report on the quality of the sale/policy wording and application or adjustment of underwriting criteria.
Report on any risks identified and suggested controls and report any other failures which influences the merits of an investigation.
Experience and Qualifications Matric FAIS accreditation or a FAIS recognised qualification will be highly beneficial.
Minimum experience of 3 years investigative experience in Personal claims environment. Read More...
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