Reuben Ramalamula
Claims Specialist
Kibler Park Johannesburg
Summary
I am an experienced Insurance Claims Investigator with extensive knowledge of the insurance industry and trends. I have full exposure to the insurance industry having worked as a Customer Service Agent, Claim Advisor, Assessor and Investigator. I am highly motivated to learn, grow and excel in my career. I have experience as a Multi Skilled Investigator covering all insurance skill sets.
Overview
22
22
years of professional experience
3990
3990
years of post-secondary education
1
1
Language
Work History
Specialist Investigator
Discovery Insure
11.2023 - 11.2024
- Validate motor claims
- Conducting risk assessments with clients to establish merits of the claim
- Liase with authorities to obtain relevant documentation
- Visit the scene and inspect vehicles to confirm the damages claimed for
- Request footage where applicable to confirm the claimed peril
- Repudiate invalid claims and settle legit claims within a specified turn around time
- Complete monthly refresher courses to keep up to date with the industry's changing dynamics
- Provide after settlement courtesy to the clients to ensure they are in the same position they were prior to the loss
Investigation Specialist
King Price Insurance PTY LTD
02.2018 - 10.2023
- Validate motor claims in all provinces
- Conduct assessments in the client's own language to enable fairness and thorough understanding of the process
- Visit the police station and interview officers who attended the scene
- Visit the scene to check for possible footable
- Interview witnesses to the incidents
- Inspect vehicles to confirm the damages correspond with the claimed event
- Reject invalid claims in claims forum and settle legitimate claims with the client
Claims Investigator
Miway Insurance Limited
05.2017 - 01.2018
- Tasked with validating all Limpopo claims
- Advantageous in executing the task was the different languages I can speak
- This eased the validation process of the motor claims as clients were comfortable in speaking their own languages
- Conduct assessments with the clients
- Visit the scene and vehicle to confirm the incidents
- Interview all stakeholders pertaining to the claimed event
- Settle valid claims and repudiate invalid claims after presenting the same to the claims forum
Multi Skilled Regional Investigator
OUTsurance PTY LTD
09.2015 - 04.2017
- Tasked with investigating motor, non-motor and business insurance claims
- Covered the entire Mpumalanga region including Limpopo
- Conduct risk assessments with the clients
- Confirm stock records for business claims
- Inspect the scene and vehicle for motor claims
- Interview client and neighbors for non-motor claims
- Conduct a thorough inventory on non-motor claims to confirm clients are correctly insured
- Finalised claims within a set turn-around time
Claims Assessor
OUTsurance PTY LTD
07.2008 - 04.2012
- Validate claims and settle legit claims within a set turn around time
- Present illegitimate claims to the claims meeting with recommendation to repudiate the claims
- Prepare monthly reports to ensure all KPI are met
- Create a database from authorities to ensure quicker receipt of documents from the SAPS
Claims Advisor
OUTsurance PTY LTD
03.2005 - 06.2008
- Answer call center calls and assist clients to register claims on the system
- Assist clients with emergency assistance requests pertaining to motor and non motor perils
- Appoint service providers in close proximity to the client's location for quicker assistance and resolving of the peril
- Assist new recruits with system training and insurance jargon to enable them to provide a seamless awesome service to the clients
Quality Controller
Vodacom PTY LTD
02.2003 - 04.2005
- Evaluate service rendered to clients with regards to all cellphone queries
- Investigate and make contact with the clients on complex queries till they are resolved
Education
Matric -
Vuwani Secondary School
National Diploma - Public Management and Administration, Public Law, Public Administration, Economic Development
Technikon of Northern Transvaal
Pretoria Soshanguve11-1997
Skills
- Claims Enquiries
- Problem Solving Ability
- Fraud Investigation
- Regulatory Compliance
- Oral and written Communication
- Risk Management evaluation
- Data Analytics
- Time Management
- Strategic thinking
Accomplishments
- Collaborated with different departments in the development of SOP (Standard Operating process).
- Acting claims team manager in charge of a team of 10 advisors when the team manager was unavailable.
- Certified scene reconstructor level 1.
Additional Information
Mr Eddie Nelushi
Company: OUTsurance PTY LTD Team Manager
Contact Number: +27 (0) 82 596 5122
Mr Phillip Lewarne
Company: Discovery Insure : Team Manager
Contact Number: +27 (0) 81 350 3200
Mr Charl Victor
Company: King Price Insurance : Team Manager
Contact Number: +27 (0) 60 504 4030
Mr Riaan Bruins
Company: Miway Insurance : Team Manager
Contact Number: +27 (0) 83 700 3188
Timeline
Specialist Investigator
Discovery Insure
11.2023 - 11.2024
Investigation Specialist
King Price Insurance PTY LTD
02.2018 - 10.2023
Claims Investigator
Miway Insurance Limited
05.2017 - 01.2018
Multi Skilled Regional Investigator
OUTsurance PTY LTD
09.2015 - 04.2017
Claims Assessor
OUTsurance PTY LTD
07.2008 - 04.2012
Claims Advisor
OUTsurance PTY LTD
03.2005 - 06.2008
Quality Controller
Vodacom PTY LTD
02.2003 - 04.2005
Matric -
Vuwani Secondary School
National Diploma - Public Management and Administration, Public Law, Public Administration, Economic Development
Technikon of Northern Transvaal
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