Claims Consultant

Claims Consultant

Positions Available: 10
Comoany : Telesure Investment Holdings
Posted : 2022-Oct-26
Closing : not given
Location : Gauteng
Job Ref #: C0090489
Industry: Insurance
Job Type: Permanent

TIH is the holding company of some of South Africa’s leading financial service providers. Our portfolio includes short-term insurers, a long-term insurer, health insurance as well as an insurance and personal finance comparison platform. We’re pioneers with a hunger for best, bringing customer-focused innovation and service excellence to the financial services industry.

Job Description

Process already-captured claims efficiently and accurately through drawing on the relevant criteria to ensure standardisation across the organisation to enable decision making on a claim.


Customer Management (Internal)

Help manage customer by carrying out standard activities to complete the customer request.

Data Collection & Analysis

Ask questions, collect data from a variety of sources, analyse information and investigate claim. Make decisions according to established criteria to ensure standardisation across the organisation by accurately administrating and underwriting claims. Use appropriate tools to accurately cost applicable claims on a day to day basis.

Work Scheduling and operational compliance

Organise own work schedule in order to get the job done, coordinating with support services and completed work within SLA.

Ensure claims are finalised within the set parameters (turnaround time, terms and conditions applied accurately). Remain up to date with current and new product knowledge to enable effective decision making.


Produce, update and provide best practice support to customers on the claims administration process and other departmental systems, in line with claims policy, rules and SLAs.


Respond to routine requests using telephonic conversation or emails (internal and external).

Document Management

Create, organise and maintain files containing the correspondence relating to policies and matters.

Document Preparation

Prepare and manage claim documentation for customers.


Prepare insurance claim forms or related documents and review them for completeness.
Enter claims information into database systems.
Pay small claims. Calculate quantum amount of claim.
Post or attach information to claim file.
Transmit claims for further investigation.
Contact insured or other involved persons to obtain missing information.
Review insurance policy to determine coverage.
Organise or work with detailed office records, using computers to enter, access, search or retrieve data.
Provide customer service, such as limited instructions on proceeding with claims or referrals to auto repair facilities or local contractors.
Finalise claims and communicate the outcome to the customer.
Listen and transcribe client conversations.
Request Client Conversation Retrieve Client Conversation.
Issue repair / replace vouchers Load and action 15-minute messages.
Complete Things To Do (TTD’s) and requests.
Refer to Loss Adjuster when required.
Arrange to collect salvage – non-motor where applicable.
Arrange to collect salvage – Motor where applicable

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