Claims Assessor

Key Purpose

To investigate and validate non-motor claims to determine validity based on the Discovery Insure contract. To correctly quantify and validate losses and serve as a mediator between clients and/or brokers. Provide feedback and support to claims consultants and foster good relationships between brokers and clients.

Areas of responsibility may include but not limited to
• Non-motor claims investigation and validation, including settlement, rejection and repair within service level agreement.
• Turn-around time and predetermined mandates.
• Loss adjustment by correctly quantifying losses and/or verifying claimed amounts. Mediation between Insure client and/or broker.
• Reporting on all assessed claims and making recommendations.
• Analyse client behaviour to determine legitimacy of claims.
• Investigate and report on fraudulent claims.
• Perform administrative tasks and meet strict deadlines.
• Make recommendations to prevent fraud.
• Analyse, collecting, evaluating and handling of evidence.
• Claims forum presenting of claims.

Education and Experience
• Matric (Essential)
• 5 years’ minimum short term insurance claims experience (Essential)
• 5 years’ short-term insurance non-motor claims validations and investigations experience (Essential)
• Interviewing techniques (Essential)
• Investigation terminology (Essential)
• Tertiary qualification relating to investigations and interviewing e.g. Certified Fraud Examiner (Advantageous)
• Hold a valid driver license
• Willing to travel