Reinier Botes
Claims Specialist
Randpark Ridge
Summary
Experienced professional with a diverse skill set in administration, sales support, and short-term insurance claims. Proficient in handling various aspects of administrative tasks, providing sales assistance, and managing insurance claims processes. Possesses a National Credit Act certificate, demonstrating a commitment to compliance and regulatory knowledge. Known for attention to detail, efficiency, and dedication to delivering exceptional customer service.
Overview
10
10
years of professional experience
1
1
Language
Work History
Claims Specialist
The PFS Group
07.2022 - Current
- Assess and process insurance claims (domestic and commercial) for accuracy, completeness, and compliance with policy terms and regulations.
- Investigate and gather relevant information, including policy details, incident reports, and medical records, to determine the validity of claims.
- Communicate with policyholders, claimants, brokers, and relevant stakeholders to obtain documentation and clarify claim details.
- Evaluate coverage and liability, considering policy limits, exclusions, and deductibles.
- Determine claim settlements, and negotiate with claimants or representatives to reach fair, prompt resolutions.
- Review and analyze documentation (photos, estimates, invoices) to verify the extent of loss or damage.
- Collaborate with internal teams (underwriting, legal, finance) to assess risks and make informed decisions.
- Maintain accurate claim records, correspondence, and payment logs in compliance with company and regulatory standards.
- Stay updated on industry trends, legislation, and best practices to enhance efficiency and service delivery.
- Provide professional customer service by addressing inquiries, concerns, and complaints.
- Handle liability claims: review evidence, witness statements, and laws to determine fault, negotiate recoveries, and manage costs (property, medical, legal).
- Manage salvage claims: assess recovery opportunities, coordinate the disposal/sale of assets, and minimize losses.
- Administer windscreen claims: verify coverage, obtain repair estimates, and coordinate with approved vendors for a swift resolution.
- Effectively manage claims across both domestic and commercial policies, ensuring fair settlements and compliance at all stages.
Sales Support Agent / Sales Support Credit Control
Motovantage
11.2018 - 03.2022
- New Business Processing:
- Checked, corrected, and processed new business received by the Sales Team within provided deadlines.
- Ensured speedy resolution of all new business problems raised within deadlines.
- Communication Management:
- Liaised with Policy Holders to ensure understanding of product risk aspects, aligning with new business problems raised.
- Communicated with Selling Dealerships on behalf of the Sales Team to resolve raised issues.
- Team Support and Follow-ups:
- Provided reminders and follow-ups to Sales Team members regarding outstanding issues and required feedback.
- Logged and processed all operational queries from the Sales Team, directing them to the correct Operational Division for resolution.
- Conducted follow-ups with Operational Divisions on outstanding queries and ensured timely feedback.
- Record-keeping and Financial Reconciliation:
- Maintained up-to-date record-keeping of all handled queries on in-house systems and databases.
- Reconciled payments to match outstanding business and facilitated the clearing of referrals to activate policies.
- Submitted new business for payment referencing, ensuring compliance with company protocols.
New Business Administrator, Underwriting Control
Motovantage
02.2016 - 10.2018
- Loading Monthly and Term Warranty Policies:
- Responsible for accurately inputting monthly and term warranty policies into the system.
- Ensured that all relevant details, including coverage terms and customer information, were correctly recorded.
- Collaborated with the warranty team to verify policy specifications and resolve any discrepancies.
- Loading Monthly and Term Service and Maintenance Plans:
- Managed the administration of monthly and term service and maintenance plans.
- Entered plan details into the system accurately and efficiently, ensuring alignment with customer agreements and company policies.
- Coordinated with service departments to schedule maintenance appointments and facilitate plan benefits delivery.
- Cancellation of Policies:
- Handled the cancellation process for various insurance policies and service plans.
- Interacted with customers to process cancellation requests, providing assistance and guidance as needed.
- Updated records promptly to reflect policy cancellations and related transactions in compliance with company procedures.
- Debit Order Management:
- Oversaw the loading and management of debit orders for policy premiums and service plans.
- Verified banking information and ensured the accurate setup of debit orders according to customer agreements.
- Monitored debit order transactions regularly, addressing any issues or discrepancies promptly to maintain payment integrity.
Education
FASit Qualification NQF 4 -
Inseta
01.2019
National Credit Act for F&I’s Certificate - undefined
Moonstone Business School Of Excellence
01.2019
National Senior Certificate - Afrikaans, English First additional Language, Mathematics Literacy, Business Studies, Life orientation, Tourism, Computer Application Technology
Hoërskool Florida
01.2015
Skills
- Administration
- Proficient in managing administrative tasks such as document preparation, scheduling, and data entry
- Skilled in organizing and maintaining office systems to ensure smooth operations
- Sales Support:
- Experienced in providing comprehensive support to sales teams, including handling inquiries, processing orders, and facilitating effective communication between customers and sales representatives
- Short-Term Insurance Claims Processing
- Skilled in efficiently processing short-term insurance claims, from initial filing to resolution Able to navigate insurance procedures and documentation requirements to ensure timely and accurate claim processing
- Customer Service:
- Dedicated to delivering high-quality customer service experiences, with a focus on understanding and addressing customer needs and concerns promptly and courteously Capable of building strong customer relationships through effective communication and problem-solving skills
- Attention to Detail
- Meticulous in reviewing and analyzing information, with a keen eye for accuracy and precision Capable of identifying and rectifying errors to maintain high standards of quality in work output
- Efficiency
- Skilled in optimizing processes and workflows to maximize productivity and minimize waste of time and resources Able to prioritize tasks effectively and work efficiently to meet deadlines and achieve goals
References
- Dominic, Ten Napel, Sales Support Manager, 072 080 5382, Motovantage
- Santjie, Beyer, Claims Manager, 079 639 7082, The PFS Group
Affiliations
- Dominic Ten Napel, Sales Support Manager, Motovantage 072 080 5382
- Paulo De Almeida, Claims Team Leader, The PFS Group 082 601 9420
- Nicky Teasdale, Sales Support Manager, Motovantage 082 225 2686
Timeline
Claims Specialist
The PFS Group
07.2022 - Current
Sales Support Agent / Sales Support Credit Control
Motovantage
11.2018 - 03.2022
New Business Administrator, Underwriting Control
Motovantage
02.2016 - 10.2018
National Credit Act for F&I’s Certificate - undefined
Moonstone Business School Of Excellence
FASit Qualification NQF 4 -
Inseta
National Senior Certificate - Afrikaans, English First additional Language, Mathematics Literacy, Business Studies, Life orientation, Tourism, Computer Application Technology
Hoërskool Florida
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