Insurance Underwriting and Claims Auditor

SUMMARY:
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POSITION INFO:

SALARY (TOTAL COST TO COMPANY) R ----- Per annum negotiable

Required minimum Qualifications

• Auditing or Business degree advantageous
• RE and FAIS compliance

Required Experience/ Required Knowledge and Skills (relevant or in a similar role)

• Specialist Liabilities underwriting experience with at least 3 years’ experience including:
o Product knowledge
o Industry segmentation knowledge and applicable risk exposures
o Enquiring mind – seek out additional information in order to best understand a risk before underwriting such risk
o Underwriting procedure
o Insurance terminology
o Rating principles
o Risk Management
o Market knowledge (including competitors)
o Claims procedure
o Credit Control
o Reinsurance market, reinsurance and treaties
o Financial analysis
• Minimum two years audit experience
• Analytical with attention to detail
• Willingness to develop new underwriting experience in respect of new products introducedÂ
• Business management
• Self-management (can organize work space, time…)
• Good communication (including writing and presentation skills)
• Negotiation (internal & external)
• Relationship management skills (have the right approach with the right people)
• Analysis and interpretation of data pertaining to assigned risks
• Well-presentedÂ
• Good knowledge of MS Office – Intermediate level (including Word, Excel, PowerPoint, Outlook)
• Career orientated

Job Purpose
• Undertake face to face and desktop audits (where required) of underwriting and claims files, within the set standards required by the company.
• Ensure consistency in underwriting and claims.
• Underwriting
o To ensure underwriting standards are met in terms of:
? Risk Acceptance.
? Target Business.
o To ensure that policies incepted by underwriters are done so within their respective underwriting mandates.
o To ensure underwriting information has been captured correctly on their respective system as well as within their respective shared drive.
o To ensure that the correct reinsurance is in place.
• Claims
o To ensure claims processes are sound.
o To ensure notifications are recorded timeously and reserves are raised accordingly.
o Ensure that Agreements of Loss and Risk Improvements are implemented.
• Ensure compliance and quality control adherence.
• Ensure adherence to regulatory standards set with Treating Customers Fairly principles.
• Ensure credit control and E Filing adherence.
• Enhance the image of the company through the continuous delivery of efficient and effective customer service.

Key Responsibilities
• Technical Underwriting expertise: To evaluate and investigate adherence to the underwriting and claims processes. Ensure that policy transactions (quotes, new business, endorsements, renewals, post loss reviews, underwriting risk assesssments, cancellations and declarations) are issued and changes recorded accurately and in a timely manner. Ensure transactions are in adherence within delegated authority limits and within set standards/guidelines and service level agreements. Ensure reinsurance is in place and treaty capacity not exceeded. Ensure post loss adjustments are actioned. Prepare and communicate all findings in writing to all relevant role-players within 48 hours after the end of the month of concluding desktop audit. Propose improvements and ensure follow ups are done on all findings. Assist various role-players with preparatory work for formal audits.
• Technical Claims expertise: Ensure that claims transactions are processed correctly and timeously (recording of circumstances and claims, appointment of loss adjustors and attorneys, reserves raised accordingly, risk improvement letters received, banking details verified, agreement of losses received, and claims paid timeously). Evaluate and investigate all claims audited in order to prevent possible leakage to the company in the settlement of claims. Propose improvements and ensure follow ups are done on all findings. Assist various role-players with preparatory work for formal audits.
• Liaise with direct manager in underwriting and claims, product champion and training team on underwriting and claims training requirements of the teams as a whole.
• Ensure all technical aspects and administrative functions of underwriting and claims are adhered to.
• Analyze on a quarterly basis all declines so as to ensure that reasons for declines are correct and interrogate the data accordingly.
• Recommend changes to improve productivity, profitability, growth and the quality of the assigned book of business.
• Customer service: Maintain a high level of service to customers (internal and external) according to service level agreements and within the service standards as set by the company. Ensure that customer service standards are maintained in accordance with TCF and assist with technical advice and other assistance over and above the normal audit duties.
• Effective and timeous communication: Communicate in a professional manner with internal and external parties and respond to queries and all communication received within 24 hours.
• Recordkeeping: Maintain working papers. Provide necessary reporting relating to the division. Provide feedback (reporting) to management on achievements, pending issues, problems and suggested recommendations.
• Quality control: Quality standards to be adhered to at all times.
• Reporting: Provide necessary reporting of the audit. Prepare and distribute related reports for distribution within 48 hours after the end of the month.
• General: When required perform any other duties necessary for the operational effectiveness of the company that is within your ability and scope.
• Employee Growth: Take responsibility for your own career growth and have regular discussions with the relevant role players.

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