Description

To intimate and finalize claims and live our values, while providing excellent customer service to both internal and external clients. 
You will be working for a company that is over 100 years old with strong values which are customer centric.

Key Performance Areas:
Receive claim and prepare documentation

Receive, investigate and intimate all claims daily, differentiate... between new claims and other correspondence
Determine status of policy and whether the deceased enjoys cover, verify and adjust policy details where necessary
Investigate premium, policy and claim history
Open and process claims according to claims procedure, and refer fully completed claims to underwriter
Request additional information from Branch and Client by way of phoning, sending e-mail or fax or sms or 702 Letter
Complete all claims within twenty-four hours
Investigate complaints received and report back to all stakeholders

Receive and complete daily correspondence

Receive daily loose correspondence, match with file and refer to underwriter
Receive diary letters daily, match to file and send original to client
Send all claim related correspondence for scanning

Handle complex enquiries from clients, branches and other departments

Attend to all written and verbal enquiries from clients, branches and other departments
Compile claim quotations on the system

Cheque requests

Compile cheque requisitions and write backs
Receive cheques from finance department and send out with necessary letters
Attend to all cheque stop payments or reversals within 3 days of receipt
Process ex gratia payments on the day of receipt

Compile statistics and perform ad hoc duties

Compile daily statistics of finalized claims
Perform ad hoc duties as requested by supervisor / Management

Accident Benefit

Process accident benefit
Request for outstanding requirements
Send to underwriter when documents are received

Requirements

Matric
2 - 3 Years' experience in Life insurance / dealing with death Claims more

Description
We are looking for an individual with excellent problem solving and investigation skills to join our Complaints team, under the supervision of the Administration Head: Complaints. You will ensure that clients are treated fairly, while thoroughly investigating and resolve their complaints while implementing corrective/remedial actions within AVBOB's complaints management framework.... Your objectives are to effectively manage and resolve complaints pertaining to AVBOB Insurance policies, as well as their associated benefits.

Efficiently review complaints related to insurance matters, including but not limited to AVBOB Insurance policies and their benefits from various sources and resolve them within regulated timelines, ensuring that all stakeholders’ interests are considered.
Conduct regular root-cause analyses, advise the direct line Complaints management for considerations and recommendations into remedial/corrective actions to be taken to prevent future occurrences.
Draft and submit complaints reports to the Complaints Administrative Head and/or Complaints Manager, providing data-linked customer feedback on the resolution of complaints in the division (Voice of the customer), complaints from relevant Ombudsman, legal representatives, and various consumer platforms.
Provide insights into enhancements of systems and processes to comply with TCF/FSCA and other legislative requirements, and to improve overall efficiency and effectiveness within the complaints process.
Team Supervision: Ensure that subordinate staff members are adequately trained and developed to meet client expectations and improve overall service delivery and overall review process of their complaint management and objectives. Ensure adherence to all AVBOB's internal processes and procedures, including HR principles and practices. Maintain clear and effective communication with clients, internal teams, and external stakeholders to address and resolve complaints.
Manage, supervise, and monitor day-to-day operational activities within the complaints department, ensuring that all targets, objectives, and timelines as per the Complaints management process are met. Report to the Complaints Administrative Head and occasionally to the Complaints Manager.

Requirements

Grade 12
You should have functional experience and knowledge in complaints resolution or a similar role, with a focus on insurance policies.
3 – 4 Years ‘experience in the customer service space
You should be in possession of Regulatory Exam – RE1 will be an advantage.
You should have in depth knowledge of TCF/ FSCA and other regulatory requirements related to insurance
Proven track record in a supervisory capacity is essential more