Claims Officer

Job Summary

Responsible for the efficient administration and processing of claims, including receiving and recording claims reports and supporting documentation, preparing claim files, conducting preliminary investigations, and facilitating claim settlements. The role also involves submitting files for recovery and following up to ensure successful recoveries, reviewing and updating claim statuses, liaising with company attorneys on legal matters, and maintaining an accurate and organized filing system.

Specific Duties

1. Receive and record claims reports and supporting documentation Guide customers in the accurate completion of the claim forms. Advise customers on the claims process, required documentation and estimated timelines. Record claims on the 4D software same day as report received. Administer customer feedback questionnaire for all new claims. Link all supporting documents to the claim on 4D. Inspect and take photographs of damaged vehicle(s) / property. 2.Prepare files and conduct preliminary investigations on claims Arrange claim form and supporting documents in file jackets. Contact third party’s insurers to ascertain information regarding their stance on liability. Request and follow up for police reports and witness statements where necessary. Liaise with Accounts to ascertain client’s account balance.
2. Prepare claims settlements Review estimates and prepare settlements. Communicate approved settlements with insured and third parties. Inform insured of loss payee if it’s other than themselves. Add payments immediately after settlement offer has been accepted and supporting documents received. Administer customer feedback questionnaire for all Own Damage settled claims.
3. Submit files for recovery and follow up until successful recovery made Send demand letters when our stance is that the third party is liable. Prepare subrogation letter and compile claims details for submission. Submit subrogation details to third party/ third party’s insurer and follow up until successful recovery is made. Record all recoveries on 4D and pass transaction for authorization. Discuss subrogation with difficulties to determine suitable actions to be taken such as passing the file to our solicitors.
4. Review claims periodically and update their statuses accordingly Ensure that all claims accurately display their current statuses. Review all outstanding claims periodically and discuss the next steps to be taken.
5. Liaise with Company attorneys to provide and receive update on legal matters Prepare and forward claim files with legal actions to the Company’s attorneys. Follow up with emails or telephone calls to get updates from the attorneys and update the file accordingly.
6. Maintain an efficient filing system Arrange claim files in a manner that is easy to understand and file and/or locate files.

Requirements

High School Diploma CII Certificate in Insurance At Least 3 years' experience in the insurance industry We require a detail-oriented claims officer with a passion for claims handling and customer service. The candidate must demonstrate detailed knowledge of technical insurance and law and knowledge of practical claims handling.