Job Description

Provides efficient, end-to-end claims administration and advice, ensuring adherence to procedures, policy terms, and regulatory standards. Builds strong stakeholder relationships, ensures accurate and timely communication, supports cost minimisation, and contributes to continuous improvement and client satisfaction.

Role Purpose
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.
Financial:

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

Client:

• Ensure that all stakeholder (e.g. clients, AE's, 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, diarise 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

Learning and Growth:

• Live the RBS values by committing to the organisational values
• Ensure continuous self-development
• Share information and knowledge with the team

Job Requirements
Minimum Qualifications and Skills:

• Matric or equivalent
• RE 5
• FAIS appropriate qualification/credits
• Computer literate
• CIMS - advantageous
• Excellent communication skills (verbal & written)

Minimum Experience:

• 3 years claims experience (Personal Lines and Commercial)

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Skills Required