LUVO NXASANA
Commercial And Personal Claims Handler
WESTONARIA,GP
Summary
I AM TARGETS DRIVEN INDIVIDUAL WHO TRULY ENJOYS AND LOVES HIS WORK. I AM DEDICATED INSURANCE PROFESSIONAL WITH DEEP UNDERSTANDING OF INSURANCE CLAIMS. I SPECIALIZE IN END-TO-END CLAIMS ADMINISTRATION, CLAIMS & DOCUMENT PROCESSING, ALL WHILE MANAGING AND PROVIDING EXCEPTIONAL CUSTOMER EXPERIENCE. I AM ALSO A GOOD COMMUNICATOR, WHICH IS AN ESSENTIAL SKILL NEEDED IN THIS JOB. I CAN SPEAK FLUENTLY AND BREAK DOWN INFORMATION IN THE MOST STRAIGHTFORWARD MEANS POSSIBLE. I'M AN EXCELLENT TEAM PLAYER CAPABLE OF WORKING INDEPENDENTLY OR WITHIN A TEAM. I CURRENTLY HOLD AN RE 5 CERTIFICATION, CLASS OF BUSINESS BOTH COMMERCIAL AND PERSONAL LINES CERTIFICATE (COB) AND FETC SHORT TERM INSURANCE QUALIFICATION (FAISE CREDITS). WILLING TO RELOCATE TO: JOHANNESBURG, GAUTENG
Overview
12
12
years of professional experience
Work History
Claims Consultant
PSG Insure
05.2025 - Current
- Register claims and appoint assessors
- Manage claims in terms of claims SLA
- Make decision regarding merit – indemnify or not
- Negotiate settlement
- Manage the salvage process (motor & non-motor salvage)
- Detection of fraud and management of fraudulent indicators
- Keep the operational system updated
- Provide thorough and timeous feedback to the relevant parties.
- Complaint’s resolution
Claims Clerk
MIBFA
01.2024 - 03.2025
- Processing transfers of benefits in and out of the Fund
- Liaison with Actuaries with regards to Section 14 of the Pension Fund Act
- Liaison with the Financial Services Board
- Calculation of transfer value
- Estimates of benefits
- Balancing of Funds, Adding of Payments & Running & Finalising of Cashbooks
Claims Consultant
Absa Group Limited
08.2023 - 01.2024
- Validating claims
- Negotiating settlement and finalizing claims as per given mandate
- Liaising with underwriting regarding endorsements and premium checks
- Answering calls to clients doing follow ups and also leasing with stakeholders to make decision on claims
- Drafting rejection letters and no cover letters while referring to the policy terms and conditions and policy schedule
- Managing lots of workload in work box and emails
- Provide effective customer relations
- Handle all queries efficiently and in the most appropriate manner possible
- Assist with queries from the public and other departments for all functions
- Handle call overflow and message centre for claims department
- General Office Administration - Ad hoc duties
- Analysis of media articles daily with update report to claims team for events which could give rise to claims in relation to Sasria cover
- Perform any reasonable tasks as and when required by the Line Manager
- Daily, weekly, or monthly activity reporting
Claims service administrator
Sasria Limited
08.2021 - 02.2023
- Claim payment process
- Create stakeholder on the system and link to file
- Check claim estimate before payment is loaded
- Check the release and/or invoice for accuracy
- Load payments as per the releases and/or invoice
- Authorise payments
- Salvage Administration
- Management and daily reconciliation of vehicles written off
- Tracing all salvage and liaising with salvage dealers
- Ensuring tenders made on written off vehicles and accepting best tender
- Negotiate and agree salvage value with salvage service provider
- Keeping record of all invoices issued
- Follow up with salvage service provider on payments outstanding
- Analysing invoices for deductions
Personal and commercial claims negotiator
Old Mutual Insure
06.2015 - 02.2020
- Provide advice on making a claim and the processes involved
- Process new insurance claims notifications
- Collect accurate information and documents to proceed with a claim
- Analyse a claim made by a policyholder to establish whether it satisfies the policy conditions
- Guide policyholders on how to proceed with the claim
- Identify reasons why full payment may not be made
- Explain to policyholders when their claim is not covered
- Contact tradespeople from a network of approved professionals and arrange for them to make repairs on the policyholder’s property
- Monitor the progress of a claim
- Investigate potentially fraudulent claims liaise with solicitors, as well as other legal and claims professionals, and negotiate the terms of a claim
- Prepare an initial estimate of costs and then closely monitor and keep a record of costs
- Get advice from external specialists, such as loss adjusters and forensic accountants, on complex cases
- Ensure fair settlement of a valid claim
- Ensure the customer is treated fairly and that the customer receives excellent service in accordance with industry and company guidelines
- Handle any complaints associated with a claim
- Adhere to legal requirements, industry regulations and customer quality standards set by the company
- Additional experience (2018/2019) Assisting non motor digital assessors with processing and finalizing geyser and resultant damages claims
Sales Representative
MiWay Insure
05.2014 - 06.2015
- Advising and selling short term insurance products, household contents, All risk, homeowners and motor section products, liaising with underwriting and other services providers.
- Doing follow up via email & telephone.
- Administration and collecting relevant information to close the sale
Part time learnership Bridging and computer course
Harambee Youth Employment Accelerators
02.2014 - 05.2015
- Harambee offers training, work readiness interventions, and ongoing support to help young people succeed in their jobs.
- They focus more on meth mathematical solutions, Basic computer skills on Office 360 and, telephone and email etiquette, sales scriptured and un scriptured Rapid Typing and call center training.
Education
RE 5 Regulatory Examination - Insurance And Risk Management
Moonestone
Sandton05.2023
Matric - Grade 12
Lavela Secondary School
Gauteng12.2012
High School Diploma -
ARTG/Inseta
Sandton 04.2001 -
Skills
Investigation techniques
Policy interpretation
Claims investigation
Problem-solving
Time management
Customer service
MS office
Problem-solving abilities
Teamwork skills
Multitasking Abilities
Computer literacy
Excellent communication
Claims
Decision-making
Claims processing
Adaptability and flexibility
Verbal and written communication
contact Number and Referrences
My Contact Number:
0640068916
0639333541
Timeline
Claims Consultant
PSG Insure
05.2025 - Current
Claims Clerk
MIBFA
01.2024 - 03.2025
Claims Consultant
Absa Group Limited
08.2023 - 01.2024
Claims service administrator
Sasria Limited
08.2021 - 02.2023
Personal and commercial claims negotiator
Old Mutual Insure
06.2015 - 02.2020
Sales Representative
MiWay Insure
05.2014 - 06.2015
Part time learnership Bridging and computer course
Harambee Youth Employment Accelerators
02.2014 - 05.2015
High School Diploma -
ARTG/Inseta
04.2001 -
RE 5 Regulatory Examination - Insurance And Risk Management
Moonestone
Matric - Grade 12
Lavela Secondary School