Responsible for resolving formal complaints and legal requests from Regulatory Agencies, Attorneys, Clients and others. Additionally, the Analyst will track escalation data for operations and reporting purposes and propose settlement agreements as necessary.
- Oversight of the business’s Complaints Claims Assessment system and processes.
- Manage multiple issues/cases at one time simultaneously based on workload.
- Accurately, independently and fairly assess and review claims and complaints based on the T&C.
- Identify and escalate serious or urgent cases to the MD.
- May identify opportunities for a process improvement for the betterment of the overall customer experience and/or Assurant Operations from a cost saving perspective.
- Liaising with medical advisor, to discuss medical conditions and complex cases where required and report findings accurately.
- Ensure that Service Levels Agreements, Internal and Regulatory timelines are met.
- Required to log and track each issue in multiple tracking systems for the purpose of generating reports.
- Maintain a high level of Complaint-handling skills, in accordance with agreed service level agreements, contracts and against policy conditions. These skills include:
- Write letters to organizations such as Kifid and Ombudsman
- Write letters to customers or third parties related to complaint handling
Provide support in court cases/court and liaise with our external/internal legal departments
- Maintain a high level of Customer Service and administration skills at all times, which may include: Monitoring and checking claims, dealing with correspondence, Investigating and answering queries.
- Accurately, independently and fairly assess and review Complaints directly related to claims.
- Conduct claims reviews on high value claims
- Assist and deal with ad-hoc projects.
- Contribute to the development of strong customer and client relationships, by understanding individual customer circumstances and requirements and delivering appropriate solutions.
- Maintain and display a thorough understanding of products, services and procedures. This to be reflected in all activities carried out
- Maintain the department’s quality and customer service standards, responding promptly to service needs of customers. Be fully customer and client focused to ensure seamless handling of all work.