Loss Adjustor- Non Motor – KZN Job at Telesure Group Services – in KwaZulu-Natal
Deliver and support sound quality of claims decision making, prevent fraud and manage expenditure through the validation of claims by using expert abilities in various fields of investigation.
Explore issues or needs, establishing potential causes and barriers as well as related issues. Validate claims by investigating, applying expertise, utilizing resources (e.g. police, supplier etc.) and interviewing customers as well as other parties. Analyze specific problems and issues to find the best solutions. Solutions could be technical or professional in nature.
Data Collection & Analysis
Ask questions, collect data from a variety of sources, analyse information and investigate claim. Ensure effective costing of claimed items through ensuring professional, thorough investigation of claims. Make decisions according to established criteria to ensure standardization across the organisation by accurately administrating and underwriting claims. Use appropriate tools (ITC, supplier contract and/or negotiation) to accurately cost applicable claims on a day to day basis.
Provide a quality service to customers while identifying opportunities to secure new business or support retention. Responsibilities may include processing cases, dealing with complex queries and investigating and resolving customer problems. Uphold agreed service level agreements (set turnaround times) and ensuring customer satisfaction and retention.
Effectively build, maintain and manage relationships with service providers and suppliers, colleagues, internal and external customers.
Work Scheduling and Operational Compliance
Contribute to optimize work practices and procedures by maintaining an acceptable workload in order to get the job done, coordinating with support services. Ensure claims are finalized within the set parameters (turnaround time, terms and conditions applied accurately).
Produce, update and provide best practice support to customers on the claims administration process and other departmental systems, in line with claims policy, rules and SLAs. Ensure accurate administration and underwriting of claims. Maintain an acceptable claims expenditure ratio by finalizing and adjusting claims accurately.
Identify shortcomings in compliance processes, systems and procedures, and develop ad hoc solutions to problems within an assigned unit or discipline.
Up-Sell Customer Propositions
Identify a selection of products or services that may meet the customer’s requirements, explain the product/service features influence the customer to add additional cover.
Personal Capability Building
Develop own capabilities by participating in assessment and development planning activities as well as formal and informal training and coaching. Develop and maintain an understanding of relevant technology, external regulation, and industry best practices through ongoing education, attending conferences, and reading specialist media. Remain up to date with current and new quality standards and product knowledge to enable effective decision making.
Grade 12/ SAQA Accredited Equivalent (Essential);
Regulatory Examination (Essential); Science (Mechanical / Physical),
Mathematics and African Language (Advantageous);
Forensic Investigation Diploma / Insurance Institute qualification (Advantageous)
5 or more years work experience in any investigative work OR 2 or more years work experience within one or more of the following fields: insurance / police / forensic / audit / legal (Essential)
2 years non-motor experience
- SAQA Accredited Equivalent* – It is the onus of the applicant to provide TIH and its subsidiaries with certified evidence that their qualification(s) meet the equivalent NQF level required for this role at time of application.
Financial Sector Conduct Authority (FSCA)** competency requirements: FAIS recognized qualifications / Regulatory Examinations / Class of Business Certification and / or CPD according to
your DOFA (where applicable) – As a registered Financial Service Provider, we are mandated to ensure that all our representatives are always and remain fit and proper at all times. By applying for this role, you consent to having your relevant qualification and or accreditation or confirm that you are working towards meeting the competency requirements. You further consent to the relevant information being verified.
The Company’s approved Employment Equity Plan and Targets will be considered as part of the recruitment process. As an Equal Opportunities employer, we actively encourage and welcome people with various disabilities to apply. TIH is committed to an organisational culture that recognises, appreciates and values diversity & inclusion.
Should you not hear from our team in 30 days, kindly consider your application unsuccessful.
Unlock your greatness & be unstoppable
Telesure Investment Holdings (Pty) Ltd (TIH), is the holding company of some of South Africa’s leading financial service providers. Our portfolio includes short-term insurers, a long-term insurer, health insurance as well as an insurance and personal finance comparison platform. We’re pioneers with a hunger for best, bringing customer-focused innovation and service excellence to the financial services industry. We’re an undivided team of diverse thinkers and doers who believe in leading through technology and pushing past their limits.
What we offer
TIH offers an exceptional benefits programme, and competitive compensation packages. You have options for Life Cover, Disability Benefits, Provident Fund, Medical Aid, and more. Office benefits include free undercover parking, free Wi-Fi, ATMs, an onsite gym, subsidised meals, convenience store, coffee shop, free seasonal fruits – every day, and an Active Access walking programme
Company: Telesure Group Services –
Company Location: KwaZulu-Natal