Loss Adjustor (cape Town) at Nedbank

Job Purpose

• To manage, control and attend to contractor audits, authorizations over-mandate, upfront assessments, customer complaints and enforce correct interpretation of the Homeowners Insurance Policy with panel service providers and clients. Perform a mentoring and coaching support function to Nedbank Insurance, service providers and clients on products and technical aspects where specialised knowledge is required in resolving intricate challenges regarding claims relevant to Homeowners Insurance Cover.

Job Responsibilities

• Assessments of claims: Advise and provide technical support to Nedbank Insurance's claims, underwriting, product and client experience departments;
• Minimizing claim losses on within and over-mandate claim; Assess, audit and authorize claims in terms of allowable rates;
• Ensuring that the claims authorization mandate per claim is adhered too.
• Quantification by either drafting a scope of work and finalizing the cost of the claim according to agreed rates or comparing quotations and reports received from service providers and clients compared to the scope of work and rate guide.
• Managing the cost from the start of the claim until the claim is finalized within the set parameters and agreed scope of work;
• Handling and resolving complaints and queries from clients, internal stakeholders as well as external stakeholders such as builders, engineers etc.

Risk Management:

• Detect and identify fraudulent claims and any overcharging by clients and service providers;
• Perform risk management function by identifying underwriting risks and inadequate
• Sum Insured's of dwellings; Ensure adherence to all legislative requirements.

People Specification

• Policy interpretation of Homeowner's Insurance Cover.
• Vendor Management: Training of service providers (policy wording, processes and rates); Monitoring of service providers (report writing, policy interpretation, claims costs and service); Maintaining and sustaining good business relationship between service providers, clients, Broker Support.
• Reporting and operational efficiency: Ensure quality and accuracy of reports , pricing and workmanship rendered by service providers;
•  Effectively utilize the daily new claims repot to assist in identifying opportunities for further claims assessments.
• Finalise all reports and administration within agreed turnaround and internal service level agreements.
• Keeping technical skills current and stay abreast fo any changes to legislation relevant to Home Owners.
• Arbitrations, second opinions and disputes: Short-Term Insurance Ombudsman matters that require further investigation; Clients proving to the contrary with rejected claims; Complaint against service provider; Client not happy with valuation (insurance replacement cost); As a result of the high cost of second opinions the internal assessor is to ensure that the service providers are suitably skilled and trained.

Essential Qualifications - NQF Level

• Matric / Grade 12 / National Senior Certificate

Preferred Qualification

• 3 year Construction Technology certificate/ Diploma or
• 4 year Building Science or Construction Degree
• Training Courses: Fire Investigation, Kwikot Benchmark training advantageous

Essential Certifications
Preferred Certifications
Minimum Experience Level

• 3 years related working experience as a loss adjuster or internal assessor handling building or personal lines insurance claims.