- in Editorial / Review


Johannesburg, Gauteng
Full-time, Permanent

Role Purpose:

To deliver efficient and professional superior claims service across the Accident & Health portfolio in South Africa in accordance with: Chubb EMEA/E&A guidelines, service level agreements and delegated authority.
The primary function is to achieve the best possible outcome of all claims presented by working closely with TPA’s, brokers and clients and offering support when required. To ensure that only claims that fall within the scope of the cover are paid accurately and efficiently.
Ensuring that sound and thorough practices are adhered to when performing coverage and loss verification analyses.
To liaise with the claims line of business managers, local underwriters, finance, etc.

Key Responsibilities:

Processing new insurance claims notifications and guiding insured/broker on how to proceed with the claim.
Collecting accurate information and documentation to proceed with the assessment of a claim
Assess claims in accordance with Chubb’s service level and quality requirements and the General Insurance Code of Practice. This includes determining coverage, reserving within timeframes, making payments, responding to customer queries, providing updates, and requesting additional information as needed to manage a claim.

To ensure systems, procedures and controls are followed and to ensure claims are investigated adequately, reserves are posted promptly and accurately and are monitored and updated timeously and that valid claims are paid in accordance with best practice, compliance and regulatory requirements.
To provide support in respect of all high profile claims that impact the business and ensure they are brought to a successful conclusion. This may involve liaison with policyholders, other professionals, insurers, loss adjusters, brokers, attorneys, LOB heads and third parties by letter, telephone, or meetings.
Monitor performance and processes of service providers to make recommendations in respect of process and contract compliance, escalating breaches to Claims Management.
Handling any complaints associated with a claim
Alert underwriters on accounts that attract high frequency losses for preparation of renewal terms
Monitoring and handling of any recoveries and applying the Key fraud Indicators to the claims.
Ensuring the customer is treated fairly and that the customer receives excellent service in accordance with industry and company guidelines
To work within the framework of Chubb ethical and service standards. To fulfil compliance and regulatory requirements (including complaints procedure).


Knowledge & Experience

Minimum GCSE, but preferably A level standard. Competent in Microsoft Office. To have sound understanding of the insurance! reinsurance market. May have or expected to study for ACn (Associate of Chartered Insurance Institute) or ASCT (Associate oftbe Society of Claims Technicians). Continues to develop technical and broader business skills.
Solid experience of claims handling in a company, Lloyd’s or insurance broker environment. Experience of workflow systems. Ability to acquire new IT skills.

Working for Chubb

Source: Indeed

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