Experience

Old Mutual iWYZE

• South Africa
• Insurance
• 200 - 300 Employee

• Claims Consultant

  • Jan 2023 - Present

  Claims consultant for Gap cover•Analyze the rationale behind non-payment by medical aid,relying on the provided medical records•Giving clients claim related feedback every 48hours•Discussing finalization of claims payments and rejectionswith clients•Customer care related assistance,Updating clients information on the policy and explaining the full benefits.

• Claims Consultant

  • Jul 2022 - Jan 2023

  Junior Life Claims AssessorTelephonic Registration of claims and validating of the information provided by the client for un-underwritten life policies•Transcribing the clients information in full (Multilingual)•In person client services for walk in clients •Gave daily reports of claims process to management •Compiled full reports for claims and sent to our Reinsurer• Full underwriting of the policy,in order to determine the validity of claims.•Consulting with Underwriting and Reinsurance directly • Discussing finalization of claims,rejections and payments Show less



Sanlam

• Financial Services
• 700 & Above Employee

• Claim assessor

  • Feb 2021 - Dec 2021

  As a Risk and Claims assessor I worked on long term and short term insurance claims and assessed risk and non-risk claims specifically dealing with funeral claims. Other operational functions I performed are:• Evaluating claims and processing payments• Engaging with clients for a well-organized claim process • Generating performance reports • Manual calculations of claim payouts and age recalculations• Fraud detection on ID, BI1663 form and signature comparison• Paying client claims allocated within 4 hours**While at Sanlam I also completed an NQF L4 FETC Long Term Insurance training course with the Insurance Sector Education Authority (INSETA). The course focused on the following:• Long-term insurance Funeral, Life insurance and Retirement benefits • Basic principles of personal income tax • Managing risk in the work environment • Applying law of contract to insurance • Client engagement (verbal and written)• Fraud detection• Insurance rules and regulations Show less

• Client Service Learner (Learnership)

  • Feb 2020 - Feb 2021

  As a Learner I worked with non-risk claims focused on cashbacks, refunds and investment maturity claims. Other operational functions:• Raising and process payments • Account verification with the use of AVS• Engaging with clients on product components and validity of claims (product knowledge)