Investigator, Insurance

Job Purpose

Ensure comprehensive mobile investigations are conducted ensuring improved customer service, retention of customers and minimizing any claims leakage through in-depth analysis of the information obtained through out the investigation.

• Maintain relationships with internal and external stakeholders
• Build relations and maintain a good reputation with all stakeholders to create opportunities.
• Complaints and Compliments management.
• OSTI – maintaining 0% overturn ratio.
• Assist and respond to all OSTI matters by including T/L
• Complaints received to be handled immediately and feedback provided to relevant parties.
• Manage performance against the key Claims measures, i.e. no of claims processed, TAT’s, Benchmarks, Car Hire Performance etc.
• Make contact with clients within 24 hours
• Provide regular feedback to the claims department and client (every 48 hours).
• Regular notes and updates to be documented on SPM
• Ensure that all documents are loaded immediately upon receipt on SPM during processing of claim.
• Ensure receipt of original registration or de-registration documents and vehicle keys, where applicable and handed over to our salvage or SVR division, howsoever directed.
• Detail discussion of claim outcome after decision has been rendered.
• High quality of investigation reports:
  Identification of fraudulent claims and dealing with them effectively (timeously escalating claims that should be dealt with.
• Ensure claim finalization within mandate.
• Ensure quality report writing and administration process followed by your administrator (resolve any issues that might be affecting your performance)
• Ensure that Investigations adds value to business (value chain)
• Embed TCF as a way of doing business
• Manage investigation to be in line with OSTI and SAIA guidelines to allow for fairness towards clients and still with effective outcomes (TCF)
• Ad-Hoc responsibilities could be added in line with business needs or requirements