Business Unit: Discovery Insure
Function: Claims Administration
Date: 6 Jan 2025
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
- 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, collect, evaluate and handle 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
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