SOLLY MPHELA
MULTI-SKILLED SPECIALIST CLAIMS CONSUTANT
JOHANNESBURG
Summary
Friendly insurance professional experienced in investigating and processing insurance claims. Hardworking and communicative individual excels at interpreting policies and negotiating payment solutions. Recognized for providing optimum service to policyholders and quickly identifying fraudulent claims.
Overview
4
4
years of professional experience
2
2
Certifications
Work History
Senior Claims Specialist - Short Term Insurance
Discovery Insure
Sandton City
11.2022 - Current
- Managing and processing Motor and Non-Motor insurance claims in timely and efficient manner.
- Assessing and validating write-offs, vehicle theft, burglary claims , including reviewing documentation and conducting investigations to determine coverage and liability.
- Communicating with policyholders and claimants to gather information, provide updates, and answer questions related to claim process.
- Maintaining accurate records and documentation throughout claims process.
- Identifying and escalating potential fraudulent activities or discrepancies for further investigation.
- Collaborating with internal departments and external stakeholders, such as repair facilities, assessor, and legal counsel, to ensure claim resolution.
- Contributing to continuous improvement of claims processes and customer experience through feedback and innovative solutions.
- Conducted risk evaluations on claims settlement proposals to encourage sound decision-making regarding settlement offers
Motor Claims Consultant
Discovery Insure
Sandton
03.2021 - 10.2022
- Responsible for all actions to get claim assessment ready.
- Contact client or broker telephonically for any identified outstanding information.
- Handle complaints, queries and all interaction with clients, brokers, service providers, internal stakeholders, Relationship managers, claims committee and underwriters.
- Analyzing the settlement amount and negotiating this with insurer to ensure the client receives a fair settlement.
- Process payments and orders as per Assessor's recommendation and instruction.
- Responsible for arrange and manage car hire requests and extensions.
- Compiling of all rejection letters and distribution thereof to relevant stakeholders.
Junior Claims Consultant (Fast Track Claims)
Discovery Insure
Sandton
01.2020 - 02.2021
- Processing vehicle glass, geyser, stolen cellphone and benefit limit claims.
- Complete understanding of claim handling process and processing claims accordingly.
- Adhering to claims SLA's regarding claim validation finalization and settlement.
- Ensure the best customer experience for both internal and external customers.
Salvage Administrator ( Internship Program)
Discovery Insure
Sandton City
05.2019 - 12.2019
- Administer salvage process for Motor and Non Motor salvage.
- Handling all salvage claims in accordance with salvage handling procedure.
- Facilitating and managing salvage with external service providers and salvage companies.
- Providing technical advise on salvage matters to claims department.
- Managing stock in bond vehicle at Auction Nation.
- Managing towing, release fee and upliftment costs.
- Handling of NATIS documents as per guidelines set out in SAIA code of conduct.
- Appointing external service providers to assist with salvage and recovery of stolen vehicles.
- Capturing on UNICODE system.
Education
Bachelor of Commerce - Accounting
University of Limpopo
Limpopo 01.2014 - 12.2017
Skills
Ability to verify and interpret policy and appraisal detail
Good Communication skill
Telephonic skills
Ability to handle conflict and negotiate
Customer service orientation
Adapting to Changing circumstances
Accomplishments
- Top Performer Award
- Most Helpful consultant Award
Certification
SAGE Pastel Partner certificate
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Quote
" Be the change that you wish to see in the world."
Mahatma Gandhi
Timeline
Senior Claims Specialist - Short Term Insurance
Discovery Insure
11.2022 - Current
Motor Claims Consultant
Discovery Insure
03.2021 - 10.2022
Junior Claims Consultant (Fast Track Claims)
Discovery Insure
01.2020 - 02.2021
Salvage Administrator ( Internship Program)
Discovery Insure
05.2019 - 12.2019
Bachelor of Commerce - Accounting
University of Limpopo
01.2014 - 12.2017