Insurance Claims Handler

Job Placements · Umhlanga, KwaZulu-Natal

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Role Overview

The Claims Handler serves as the initial point of contact for customers reporting an incident, accident, loss, or insurance claim. This role is pivotal in delivering an exceptional customer experience while accurately gathering and assessing claim information. Capturing comprehensive and precise details at First Notification of Loss (FNOL) is essential, as it directly influences claim outcomes and customer satisfaction throughout the claims journey.

Key Responsibilities

Claims Intake & Investigation

  • Receive inbound calls, emails, and online claim notifications from policyholders and third parties.
  • Accurately capture detailed information regarding incidents, losses, accidents, injuries, and damages.
  • Verify policyholder information and assess claim eligibility in line with client procedures.
  • Obtain and review supporting evidence, including documentation, photographs, and witness statements where necessary.
  • Conduct initial liability and coverage assessments promptly and thoroughly.
  • Identify and escalate potentially fraudulent, complex, or vulnerable customer cases appropriately.
  • Ensure all claim details are recorded accurately within the claims management system.

Customer Service

  • Provide empathetic, professional, and clear communication as the first point of contact during potentially stressful situations.
  • Explain the claims process, outline next steps, and set clear customer expectations.
  • Maintain regular communication and provide timely updates throughout the claims process.
  • Deliver customer service aligned with UK regulatory standards and best practises.

Claims Administration

  • Create and maintain comprehensive, accurate claim files.
  • Process all documentation within agreed service level agreements.
  • Liaise effectively with insurers, repairers, solicitors, medical providers, engineers, and other relevant third parties.
  • Coordinate inspections, repairs, recovery services, replacement vehicles, and other claim-related requirements.
  • Ensure compliance with GDPR, FCA regulations, and company policies at all times.

Performance & Compliance

  • Achieve productivity, quality, and service level targets consistently.
  • Adhere strictly to all regulatory and compliance requirements.
  • Maintain high standards of data accuracy and quality assurance.
  • Engage proactively in coaching, training, and continuous improvement initiatives.
  • Escalate complaints, vulnerable customer cases, and complex claims in accordance with established procedures.

Essential Skills & Experience

Essential

  • Minimum

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