Kevin Du Plessis
Claims Adjuster
181 Apollo Street, Ennerdale, Johannesburg
Summary
Dynamic Claims Handler with extensive experience in Insurance, excelling in claims investigation and negotiation. Proven track record in managing complex claims and resolving disputes effectively. Strong risk management and problem-solving skills, consistently achieving high client satisfaction through effective communication and education. Committed to delivering results in fast-paced environments.
Overview
17
17
years of professional experience
Work History
Claims Adjuster
Standard Bank HOC
05.2025 - 02.2026
- Claim Registration,
- Dealing with non-motor claims.
- Appointment of service providers and assessors,
- Assessing damage report and scrutinizing claims, authorizing and rejection of claims negotiating and making payments.
- Liaising with banks and similar institutions regarding
- Prepare reconciliations of claims accounts
- Negotiating and making payments.
- Follow ups on repairs, processes and statuses
- Escalations and Complains
- Repudiation disputes
- Ombudsman disputes
- Examined claims forms and other records to determine insurance coverage.
- Collaborated with claims department and industry anti-fraud organizations to resolve claims.
Claims Handler (Hospital Cash and Death Claims)
AIG (American International Group)
03.2023 - 06.2024
- Registering and received new claims.
- Assessing claims documents and scrutinizing and Identifying diseases using (ICD) 10 code and procedures.
- Conducting investigations into the circumstances surrounding a claim, which may involve interviewing policyholders, witnesses, and other relevant parties, as well as gathering evidence.
- Identifying and investigating possible fraud.
- Decision making authorizing and rejection
- negotiating and making payments.
- Negotiating settlements and discussing outcome of the claim.
- Handling disputes, appeals and complaints related to claims.
- Educating policyholders and claimants about the claims process, their rights, and their responsibilities
Sales Agent
Global Investment Position (Old Mutual Policies)
01.2021 - 03.2022
- Assisted call-in customers with questions and orders.
- Increased sales revenue by consistently meeting and exceeding sales targets.
- Enhanced product knowledge through continuous training and professional development opportunities.
- Achieved top performer status within the company due to consistent high sales numbers.
Claim Handler and Negotiator
Intergrisure
12.2018 - 05.2019
- Claim Registration,
- Vehicle and complex claims
- Appointment of service providers and assessors,
- Scrutinizing claims, authorizing and rejection of claims (decision making)
- Desktop investigations of claims
- Complaints handling
- Assessing damage report and scrutinizing claims, authorizing and rejection of claims negotiating and making payments.
- Liaising with banks and similar institutions
- Systems – Auduatex and Ubuntex
- Negotiating and making payments.
- Follow ups on repairs, processes and statuses
Absa Insurance
Absa Insurance
11.2017 - 07.2018
- Claim Registration,
- Building and house owners
- Appointment of service providers and assessors,
- Assessing damage report and scrutinizing claims, authorizing and rejection of claims negotiating and making payments.
- Liaising with banks and similar institutions regarding
- Negotiating and making payments.
- Follow ups on repairs, processes and statuses
Claim Handler and Negotiator
Discovery Insure
08.2013 - 02.2017
- Claim Registration,
- Dealing with motor and non-motor claims.
- Appointment of service providers and assessors,
- Assessing damage report and scrutinizing claims, authorizing and rejection of claims negotiating and making payments.
- Liaising with banks and similar institutions regarding
- vehicles and settlements thereof.
- Systems – Auduatex and Ubuntex
- Determine and arranging salvage on all claims.
- Negotiating and making payments.
- Follow ups on repairs, processes and statuses
- Escalations and Complains
- Repudiation disputes
- Ombudsman disputes
Claims Consultant Negotiator
Santam
02.2009 - 06.2013
- Claim Registration,
- Dealing with motor and non-motor claims.
- Appointment of service providers and assessors,
- Assessing damage report and scrutinizing claims, authorizing and rejection of claims negotiating and making payments.
- Liaising with banks and similar institutions regarding
- vehicles and settlements thereof.
- Systems – Auduatex and Ubuntex
- Determine and arranging salvage on all claims.
- Negotiating and making payments.
- Follow ups on repairs, processes and statuses
- Escalations and Complains
- Repudiation disputes
- Ombudsman disputes
Education
FETC NQF 4 150 Credits
Moonstone
Johannesburg, South Africa02-2026
RE 5
Moonstone
Johannesburg, South Africa08-2024
Class of Business Personal Lines
Moonstone
Johannesburg, South Africa 04.2001 -
Matric
Fred Norman
Johannesburg, South Africa 04.2001 -
Skills
Claims processing
Risk management
Teamwork and collaboration
Claims investigation
Claims Management (Motor, Non‑Motor, Property, hospital cash)
Negotiation & Settlement Handling
Ombudsman & Dispute Resolution
Client Education & Communication
Prioritizing work and Time management abilities
Problem-solving abilities
Timeline
Claims Adjuster
Standard Bank HOC
05.2025 - 02.2026
Claims Handler (Hospital Cash and Death Claims)
AIG (American International Group)
03.2023 - 06.2024
Sales Agent
Global Investment Position (Old Mutual Policies)
01.2021 - 03.2022
Claim Handler and Negotiator
Intergrisure
12.2018 - 05.2019
Absa Insurance
Absa Insurance
11.2017 - 07.2018
Claim Handler and Negotiator
Discovery Insure
08.2013 - 02.2017
Claims Consultant Negotiator
Santam
02.2009 - 06.2013
Class of Business Personal Lines
Moonstone
04.2001 -
Matric
Fred Norman
04.2001 -
FETC NQF 4 150 Credits
Moonstone
RE 5
Moonstone