Relebogile Patience More

• Accountable for all claim interactions directly with the client/broker.
• Responsible to determine merits, quantum, item identification, buying.
• Responsible for negotiating and settlement of claims with the insured/broker
• Responsible for communicating with the client/broker from beginning to end
and is the one contact person for the client/broker.
• Ensures that the claim is handled efficiently.
• Identifies, investigates and resolves any issues relating to claims being
handled in line with Santam policies and procedures such as Service Level
Agreements, Standard Operating Procedures.
• Ensures that the claim is handled efficiently and identifies and advises the
intermediary/policyholder of the prescribed or most appropriate mechanism
for resolving claims settlement disputes.
• Communicates the process from the start of the claim and acts as a contact
person if the client needs additional information.

• Manage workload and instructions from system through any communication
and or documents.
• Required to check completeness and correctness of documents.
• Responsible for all actions to get claim assessment ready.
• Contact client or intermediary telephonically for any identified outstanding
information.
• Required to follow up on claims to receive digital images and or any
documentation necessary for Assessment.
• Handle complaints, queries and all interaction with clients, Intermediaries,
Service Providers, internal stakeholders, Relationship Managers, Claims
Committee and Underwriters.
• Process payments and orders as per Assessor recommendation and
instruction.

• Prioritize daily activities to enable processing and maintenance of all claims
• Check the accuracy of registered claims cover detail and add claimant details
timeously
• Confirm estimate is accurate, deducting the excess to work out estimate of claim
through investigating policy cover
• Identify claims that requires further investigation(fraud)
• Arrange assessment in adherence with SLA
• Obtain necessary documents /assessors report and make amendment to
estimates ensuring authorization within policy cover
• Reduce/maintain motor own damage service efficiently
• Ensure stakeholders are kept informed on regular basis with regards to the
progress of claims on policy and procedure
• Finalize payments
• Reduce/maintain turnaround of motor own damage claims
• Ensure effective implementation and compliance of claims/operational systems or
procedures
• Ensure dairy is maintained
• Forward settlement figures of a claim to brokers which demonstrates breakdown
of payments
• Log calls timeously with relevant departments

• Deal with and resolve any queries relevant to the area; if unable to resolve
escalate to the manager for resolution
• Ensure consistent maintenance of high levels of professionalism, service
excellence and customer excellence
• Adhere to internal policies, processes and procedures

• Deal with all customers in a professional manner

• Delivering good customer service by keeping promises on turnaround
times
• Adhere to scheduled times
• Communicate accepted and unacceptable policies with brokers
• Implement correct underwriting to maintain profitability
• Resolving queries timeously
• Underwrite new business
• Insurance checks and previous claims history
• Assist with new and existing quotes
• Take inbound and make outbound calls in accordance with predetermined
schedules and online customer requests
• Telephonically take customer through the service process
• Finalize calls at point of contact, where possible
• Deal with all customers in a professional manner
• Manage workloads to ensure that deadlines and targets are met
• Be personally responsible for reaching set targets
• Identify trends and opportunities for improvements on new
products/services based on customer input and escalate to Team leader

• Increased client satisfaction by providing tailored insurance solutions based on individual needs and risk assessments.
• Improved customer retention rates with proactive communication and ongoing policy reviews.

• Informed clients of policies and procedures.
• De-escalated and resolved customer complaints with punctual, polite and professional service.
• Delivered exceptional customer service by proactively addressing concerns and fostering a positive experience throughout all interactions.
• Enhanced client satisfaction by promptly addressing inquiries and providing accurate information on products and services.
• Conducted regular performance reviews with team members to identify areas for development.